36989D - Thomas

CAMA / DREDGE & FILL
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DGENERAL PERMIT Previous permit#
New Modification Complete 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 I 5A NCAC 7/I/2pa
D Rules attached.
Applicant Name kOeS `.-1170,i 4I*. ei Project Location: County rc-ii Gu
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Address If8'J (-'✓'i CGc T • `try 1 UL.. _ Street Address/State Road/Lot #(s) /0UZ
City %ctteg-i-evi11a State 1C ZIP ?30(• _-W eS+ 10e4... YIVC
Phone # ( ) 'AA'.
# ( ) Subdivision _
Authorized Agent (.✓C< 1Ar✓ City :) . k. Is fa ✓I Ci ZIP -Z 8'A-!, S"
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Affected ❑Cw - EW 4PTA ES PTS Phone# ( ) River Basin ,- / ry bier'
❑OEA HHF —IH UBA N/A
AEC(s): Adj. Wtr. Body /4-1 LOIA.) (natFinanyunkn)
0 PWS: FC: `-- -`
ORW: yes //no PNA yes / no Crit.Nab. yes / no Closest Maj. Wtr. Body LvL(i
Type of Project/Activity (�GI-L5tn./CIL AiFr, to✓cvCU �Ck ur)d J .i Li}t
II `r ' )
(Scale:
Pier(dock)length /U ° •
1 ..
Platform(s) /,2,1(/4' F
i •
Finger pier(s) . kl 1yn/w
Groin length i
number
Bulkhead/Riprap length
avg distance offshore
max distance offshore /y
Basin,channel t —
l t .
cubic yards • k.1_-_.•Boat ramp _ i . i ,
1
Boathouse/Boatlift /it X/2
L J ,
7u
Beach Bulldozing 'i , y' 70 . - I
Other
•
Shoreline Length 1
f
SAV: not sure yes no
Sandbags: not sure yes no Q/ '• •! ! (c�Pc�
Moratorium: n/a yes no
!/ G
Photos: yes /�Jr o
Waiver Attached: yes 'Jo ---_____.__i.---.--_---.__v^—_-__ 1._-- =------_—__
A building permit may be required by: i;7.4-4-7 G/ C(',� iS/aild E See note on back regarding River Basin rules.
Notes/Special Conditions 'l " . • / /, G , !S c f 774 .JL c.) 1,./
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r7: �r! -7" _ r:L.-1 /- . .:( o-e �c
Agent or plicant,P jnted Name Permit Officer's Signature
/- r :� / . / 4�f Mac;/ f i
Signature **Please read compliance statement on back of permit** Issuing Date Expiration Date
. _ (J4..... /5(li r7C{.. P• /vit'1L•-
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(252-946-648 I)or the Wilmington
Regional Office(910-395-3900)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
I 638 Mail Service Center Elizabeth City, NC 27909 Washington, NC 27889
Raleigh, NC 27699-1638 252-264-390 I 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
9I9 733 2293 / I-888-4RCOAST Morehead City District Wilmington District
Fax: [phone] 15 I-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: /,{J['S /7zVyva S
ADDITIONAL NAMES:
AEC DESIG: � �'j DEVELOP AREA: . 0> PROJ DESC: p - l z
(Will only take 6) —— — (Will only take 1)
WORK: /13 -70 l3 i ( 2 r Z
(Will only take 4)
• MAINT:
(Will only take 4)
IMP: •
(will only take 6)
ACTION EXPIRATION
DREDGE&FILL REQUIRED: z4 /LI 04 M a1 17, Uii
CAMA MAJOR DEVEL REQUIRED: I-7, 04-
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;: ntVICif\Ay CA&STAL MithampirENT
ADJArTl itI glAbi PRApRRTV CAME NATiFtn
ATjnN/WANTR FORM
Name Of Individual Applying For Permit •(Al P., S //
Address Of Property: / d G 2 Cl'. 74 4 f 1 .
©R� �SL��I �C 2 giyx
(Lot or Street I,Street or{toad City&County)
I hereby certify that I own property adjacent to the above-referenced property. The individual ?`.;
applying for this'permit has described toe as shown on the attach drawing the development
letter.are '�proposing. A description or drawing,with dimensions.'should be provided with this
•
I"have no objections to this proposal.
If ynn have nilottinns In what is being
pmxxeci_ pleases}yrite thw.' Tliviein•
n.1-n, Fi q •n.uF �.11 a �u :flu 'll.)1 �, .■ F �.iu u• '
in 10 d yre of thin
if ynn have been nntifnvi h d Ma lrt reels rnn derwl fie.cant aenitobjectian
y Certified Mail
I mad that a!pier,dock,mooring pilings;breakwater,boat house,lift or
sandbags• set back a minimum distance of L5'from my area of riparian access unless waive must af u
wish to waive th&setback,you must initial the appropriate blank below.) �. you
•
.. I do wish to waive the 15'setback requirement.
I ddanot wish to waive the 15'setback ant.
eleiquo
i Date A7•191rivA
4.� �
Print
: . Name . • NCDENR
Telephone Number;with Area code ►
rogairor
•
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i iVict[t\'OF en Mir AT.R[ LAGFMF.A"i;
" .. An:1A(;Fh'T RIP4RTAN PROPF`.RTY AWNFR NO'C71'IrATION/WAwFR FORM
•' same Of Individual Applying For Perms 16 _ TI -
Addres=of Property 10 0 2 141. Yg c h f -0,,,
Sty , . sZlndNc2g'4‘5
(Lot or Street I,Street or'Road,City&County)
' I hereby certify that I own property adjacent to the above-referenced individual•
applying for this permit'has described to'r6 drawin
e as shown on the attached
g the e development •
are p *: A desc ripdon or drawing;with dimensious;should be provided with this
letter.
. I have no objections to this proposal.
If ynu have nhjlictieus to what it hying
P"apate:I pleas the t)ivieinn of Coastal
.. '.1.1 '.I,4.1. 1 1..I♦ ••I-..11�e. I:. ;,.-,.I►. •,. l I.I I mo. .. ►I I V..,.A,_1 Il .
if ynu have been nnfird (' •;•'" • ,
by d*rifir:l Maid _
WATVF:R SRCTTON
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that a pier�erdtsta om o icg pilings;
breakarrater,boat
minimum house,lift or must�
wish back a minimwaive um
my area of riparian access unless waived by me. (If you
... setback,you must initial the appropriate blank below.)
,..: I do Trish to waive the 15'setback respire neat.
I shun wish to waive the 1S'setback requirement,
e-...,,y_c(s2__
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Print Name •
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,o _2-1c -SQ,) INICDENR
Telephone Number jWith Area code NORM CORI,w,OPPSIMENT
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