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Ot_CAMA / DREDGE & FILLw :fir?
GENERAL PERMIT Previous permit#
�� KNew Modification r7Complete Reissue ❑Partial Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environment and Natural Resources
and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC /H /a av * 2//au
❑Rules attached.
Applicant Name A,-,G s' )44:y 74- c 4/G/a Project Location: County 73,1e n5Gel/C k
Address /„i Z /�G r//r? ,J-r" Street Address/State Road/Lot#(s) ra513 /3 2.
City I d n Beach State NC ZIP.?$Cc Q... 7 r')(r r//Ti
Phone # ( •:') "/2, 9957 Fax#( ) Subdivision
Authorized Agent L7I'Gq ve.a!er, City //e ecYprJ BGa(7/- ZIP ,,Yy/o !2
Affected C CW AW C� �4,PTA ES -PTS Phone # ( ) - River Basin �.LIM F}riI—
❑IDEA CIHHF C IH UBA N/A
AEC(s): Adj. Wtr. Body ✓7C- (nat /man /unkn)
C PWS: `FC:
ORW: yes I no PNA yes /©o Crit.Hab. yes / no Closest Maj.Wtr. Body r�/e ✓1Ci
Type of Project/Activity /\C-frr/QGe Ek/Sr'7n4 (r�G.k �''/ /'le-c.J tJz)G�
JJ (Scale: /"= 2 .` )
Pier(dock)length 3 X/(p _-- I I
I
Platforms) .�O X/� / _. l• 1
3
Finger pier(s) 7 k/4 I i - 1 1- I �Ila- 1 I T I .
Groin length i •; i ! --- _ --i
number i
Bulkhead!Riprap length •T"* I I —t I i 1 d T
avg distance offshore _ . i
max distance offshore ! I
`' i
Basin.channel —— — —i I �i y _` �—
cubic yards i i----� � I �I .
Boat ramp — -- • I r 4 —
l.. f
Boathouse/Boatlift 1 i { - ' I j I 1 -» I
,
Beach Bulldozing ! 1 + - I i
Other t vL—a.1j . et..
/D i- f . .
50
l_ •. kAa' T �
Shoreline Length .-- ltiV 3 •n ;$"/li,c.l/.;ic 1�'J11 �3
L 1
SAY: not sure yes no ' . ! - 77:- r j
Sandbags: not sure yes no, _—_ _�i ,9CC _. —_.�_ I 1 --
1 — ; Htii
Moratorium: n/a yes _ ,13� I f
Photos: yes no —F-__ i i— ! ` I + ! f ` ~- I i I i
Waiver Attached: yes no
I � ;' i T I I I i � ..
A building permit may be required by: 1'7 ZcJCi E/GCr C A '72 1t137 . I See note on back regarding River Basin rules.
Notes/Special Conditions /4// ce —Ylddj717G-7"7S 7i/..//er0 t-ipp/y QhC/ l[// C'O - a/ 4ci s
(=,-Go aede,2 G�4 --c.. ��lf-c-�
Agent or plica t P a Permit Officer's Signature
n l _ 5 / .-/1i5+4 i2�o�
Signature **Please read plianc statement on back of permit*i' Issuing Expiration Date
Application Fee(s) Check# Local Planning Jurisdiction Rover File Name

Statement of Compliance and Consistency
This permit is subject to compliance with this application, site drawing and attached general and specific conditions. Any
violation of these terms may subject the permittee to a fine or criminal or civil action; and may cause the permit to become
null and void.
This permit must be on the project site and accessible to the permit officer when the project is inspected for compliance. The
applicant certifies by signing this permit that I)prior to undertaking any activities authorized by this permit,the applicant will
confer with appropriate local authorities to confirm that this project is consistent with the local land use plan and all local
ordinances, and 2) a written statement or certified mail return receipt has been obtained from the adjacent riparian
landowner(s).
The State of North Carolina and the Division of Coastal Management, in issuing this permit under the best available
information and belief,certify that this project is consistent with the North Carolina Coastal Management Program.
River Basin Rules Applicable To Your Project:
Tar-Pamlico River Basin Buffer Rules Other:
Neuse River Basin Buffer Rules
If indicated on front of permit,your project is subject to the Environmental Management Commission's Buffer Rules for the
River Basin checked above due to its location within that River Basin. These buffer rules are enforced by the NC Division of
Water Quality. Contact the Division of Water Quality at the Washington Regional Office(252-946-6481)or the Wilmington
Regional Office(9 I 0-395-3900)for more information on how to comply with thesebuffer rules.
Division of Coastal Management Offices
Central Office Elizabeth City District Washington District
Mailing Address: 1367 U.S. 17 South 943 Washington Square Mall
1638 Mail Service Center Elizabeth City, NC 27909 Washington, NC 27889
Raleigh, NC 27699-1638 252-264-3901 252-946-648 I
Location: Fax: [phone] Fax: [phone]
Parker Lincoln Building (Serves:Camden,Chowan, Currituck, (Serves: Beaufort,Bertie, Hertford, Hyde,
Dare,Gates,Pasquotank and Perquimans Tyrrell and Washington Counties)
2728 Capital Blvd. Counties)
Raleigh, NC 27604
9I 9 733 2293 / 1 888 4RCOAST Morehead City District Wilmington District
Fax: [phone] 151-B Hwy. 24 127 Cardinal Drive Ext.
Hestron Plaza II Wilmington, NC 28405-3845
Morehead City, NC 28557 910-395-3900
202-808-2808 Fax: [phone]
Fax: [phone] (Serves: Brunswick, New Hanover,
(Serves:Carteret,Craven,Onslow-above Onslow-below New River Inlet-and
New River Inlet-and Pamlico Counties) Pender Counties)
www.nccoastalmanagement.net Revised 10/05/01

GENERAL PERMIT COMPUTER FORM
APPLICANT NAME: n-eA/�f c7S
ADDITIONAL NAMES: 147‘y74
AEC DESIG: DEVELOP AREA:O‘2, . PROJ DESC: /3 - (�
(Will only take 6) (Will only take 1)
WORK: 5 ,-I 50 f f ion /U
(Will only take 4)
i E 7//4
MAINT:
(Will only take 4)
IMP: 4 r,J 7.95
(will only take 6)
/Try
•
ACTION EXPIRATION
DREDGE&FILL REQUIRED: 7 z Aa 8/i zjo�
CAMA MAJOR DEVEL REQUIRED: 57/z/Ge-el 0/i z/o ff

otdeh Ql- 4 / 6
DIVISION OF COASTAL MANAGEMENT
•
AD.YACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER- FORM
. Name Of Individua_l „J
A_oplyi For Permit: L ,�► '��. q ,�
r
' Address ' Of Property: /3a r iN r
(Lot Or Street #, Street Or Road Ci = .
�y & County) .
i hereby certify that I own- proper-t adjacent
Y above-
referenced property. Y to the above-p_one_ ty. The individual applying for this permit has
described to me as shown on the attached drawing
they are proposing. A description or the development
t
should be provided t drawing, with dimensions,
provided with this letter.•
- I have no objections to this proposal .
•
IfI- you have objections to what
'v i ci On of Coastal o is bei nc or0DOsed, pl a=se write the
i 1 Manaceme t. 127 Cardinal Drive Exten=i on .
�V �i nC`0-1 North C=
days - _ Cal --ne . 28405 Or' call 91095
0= receipt Gi this 3 -3°00 within 10
notice. No response is considered the s=tee
as no objection ; _ _
you rave been noti=i ed l bV C`rti f i =d
mail .
•
WAIVER SECTION ' • .
•
I understand that a pier, dock, mooring Dili c breakwater,, lift P_gs, brc=_';:va�.er, boat
must be set. back a minimum distance
from my area of riparian unless y u wish
access ss waived (IfY w h
to waive the setback, by me. Cu i e�
below. ) you must initial al the appropriate blank
i do wish to waive the IS `setback reaui relent.
I do not wish to waive the
IS 'setback recuirEment.
-S+ 2 cur.
Date
1 •
Print Name �-�r '
Telephone Number With Area Code ED 11--11N1 F=

05/11/2004 21:21 8043846035 BIRD PAGE 02
05/0�,:084 21:58 910w429806 G HUL.LEN rF,ut »,
•
�+�c.Sd r v R'" w
, Name of Individual vidua, AQP For Permit:
' f..,42xLiiiiii__
Address Of Property: D
r ' r, f.
(Lot or Street p, Street rs_-
oa iLy z Ceunty) .
1 hereby cattily that i over. .
referenced property. The individual applying Yyafore thisto the
described to tat as shovers on the a t for above-
referenced are r Permit has
they
be proposing' A description or drawing, the dimensions.
provided with this letter_ •
with diaansions,
-_-X— I have no objections to this proposal.
r y
i V �t who +
{ 1 ...
L . Yii
r
v i
i .122 A 3�"5- •,
.2 wftoi i2
V
—.nuMI
Y understand vut a pier, dock, mooring
house, lift •
must be sat back aiminimum disance'ofb13'
from my area of riparian access unless waived r
to waive the setback, you must initial the yams- you lath
below. ) PDzoP: ata blank
I Go wish to waive the 15 'setback ragvireement. •
.....4L... ' gg not, with to waive the 15'satbesck requirement.
t.
•
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HOLDEN DOCK& BULKHEADS "„ ''''''''' .''
GREGORY A & DOROTHY HOLDEN r t • L ,:
PH:910-842-9732 1(�5
1302 STONE CHIMNEY Rb SW ` .'
SUPPLY,NC 28462 ? 746 ia -0 �1 Go-izl5/840 y
PAY TOTNE "'
S ORDER OP `
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