36951D - Ward

111CAMA/ ❑DREDGE & FILL 36951b
GENERAL PERMIT Previous permit#
r 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 H /OWC7 .
Rules attached.
Applicant Name GO 4-4- �Ck r d Project Location: County &LI,7;,. L.. ,r _
Address :_AS O CD Lt \k N 1-( v i-,'-1 v .c-A Street Address/State Road/ Lot#(s) 3 0
City (T r C-R-r1 F)o r"V State ' C- ZIP V 1 L}C, (f (...U rn b E r )6 n d.
Phone # (_; ) - (19— O 11-4GFax#( ) Subdivision
Authorized Agent City OCea/j 15(G C-4Ch ZIP ar4}69
Affected ❑CW )kEW )(PTA ❑ES ❑PTS Phone# ( ) River Basin LL.t rribcr
AEC(s): ❑OEA ❑HHF ❑IH ❑UBA N/A Adj.Wtr. Body AI LU(A) C n NA L (nat /m n /unkn)
li PWS: ❑FC:
ORW: yes /( ) PNA yes / no Crit. Hab. yes i no Closest Maj. Wtr. Body - f wt(..)
Type of Project/Activity CC/ 1---/`i.'c 7 it-4 %4.Cciati i i— /uGC ii i kg -b U c_k.
J (Scale: r A- ZU ' )
Pier(dock)length _ I(0 X �'T�
Platform(s) 10 X 1 (p
Finger pier(s)
Groin length
number --- -
Bulkhead/Riprap length , C C/ iv-r ,t-(,.'
avg distance offshore
max distance offshore
Basin,channel
cubic yards
Boat ramp
Boathouse/Boatlift -_- /Q
Beach Bulldozing
Other
I
Shoreline Length . 56
v . I 5°I7V\M. ' I 1
SAV: not sure yes
Sandbags: not sure yes e) PL ( u),^CIE?.{-c ')h{-(et
Pt
Moratorium: n/a yes €)
Photos: yes toy
Waiver Attached: yes no ___ : —.. ----------_ .--- --_ _----------- -----_
A building permit may be required by: T�,Ly-n GCf QCC-4,'-) /5I G (3Co[.h . I I See note on back regarding River Basin rules.
Notes/Special Conditions /QL( C6/1 a;17.60.5 Cif r7f/,/o2 Up /)pp /..v , ;)ac/c 71
!; it 7 %/ 1p, ,-1L C4 3f 1 4/cr a d1c (; f- c1r,c k. hoc
5co-ff WO r d 'r �eGts.,
Agent or Applicant rinted Name Permit Officer's Signature
-, f----, //7/' lI 'c//7 c'
— **Please read compliance statement on back of permit** Issuing Date Exration Date
cC
1/ /6'617 ' '? 7 5C�ch A//07i.S,11
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(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
1638 Mail Service Center Elizabeth City, NC 27909 Washington, NC 27889
Raleigh, NC 27699-1638 252-264-3901 252-946-6481
Location: Fax: [phone] Fax: [phone]
(Serves:Camden,Chowan,Currituck, (Serves: Beaufort, Bertie, Hertford, Hyde,
Parker Lincoln Building
2728 Capital Blvd. Dare,Gates, Pasquotank and Perquimans Tyrrell and Washington Counties)
Counties)
Raleigh, NC 27604
9I 9 733 2293 / 1 888 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: SCOtt ().)6r
ADDITIONAL NAMES:
AEC DESIG: pi i E/1/ DEVELOP AREA: . 0 L PROJ DESC: p -i-
(Will only take 6) — (Will only take 1)
WORK: I)k (oi 4-
(Will only take 4)
TE Icy) It
MAINT:
(Will only take 4)
IMP: OLv o,21--
(will only take 6)
ACTION EXPIRATION
DREDGE&FILL REQUIRED: if?'/U4f 16/01
CAMA MAJOR DEVEL REQUIRED: //7 / ' 7/DY-

ENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY
• Complete items 1,2, and 3.Also complete A. Sign -
item 4 if Restricted Delivery is desired. / �� CI Agent
• Print your name and address on the reverse ---El Addresse
so that we can return the card to you. Rec-. -N�Printed Name) C. Da e of eliver
• Attach this card to the back of the mailpiece, /C D
or on the front if space permits. 1 ! r L3
D. Is delivery address different from item 1? /❑ Yes
1. Article Addressed to: If YES,enter delivery address below: CINo
f1?;cLaATTco (
c10 Po lanQroveRei C 3. Service Type
W;K S 1,. �.b..1? IC. ❑Certified Mail ❑ Express Mail
7(O/ CI Registered ❑ Return Receipt for Merchandis
2 1p CI Insured Mail ❑ COD.
4. Restricted Delivery?(Extra Fee) ❑ Yes
2. Article Number
(Transfer from s, 7002 0860 0005 3217 3105
PS Form 3811,August 2001 Domestic Return Receipt 102595-02-M-15,

UNITED STATES POSTAL SERVICE 1 Q D
First-Class Mail
_ M Postage&Fees Paid
•
LISPS
Permit No.G-10
• Sender: Please print you?name, address, and ZIP+4 n-this box •
•
1970 Oc ear �R,ve/vi led
�cear• 1s /ewe 4(CZ '
r„��i�,>>E,► ",ri

SENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY
• Complete items 1, 2,and 3.Also complete A. Signature
item 4 if Restricted Delivery is desired. gent
■ Print your name and address on the reverse X ��� __ —� ❑ Addresse
so that we can return the card to you. B. Received by(Printed Name) C. Date of Deliver
• Attach this card to the back of the mailpiece, _
or on the front if space permits. ��
D. Is delivery address different from item 1? El Yes
1. Article Addressed to: If YES,enter delivery address below: ❑ No
gc/i
9826 05 1/0 y 36/N
Limit „ca" vc 2(i3(0 3. Service Type
�C �1► o ❑Certified Mail ❑ Express Mail
❑ Registered ❑ Return Receipt for Merchandis
❑ Insured Mail ❑ C.O.D.
4. Restricted Delivery?(Extra Fee) ❑ Yes
2. Article Number
(Transterfron- 7pp2 0860 300S 3217 3099
PS Form 381 .,., y,� cuu r Domestic Return Receipt 102595-02-M-15

UNITED STATES POSTAL SERVI c�1 L(F ,.o First-class Mail
A..W y Pdstage&Fees Paid
P M 0 usps
>- ry /O Permit No.G 10
• Sender: Please print your name, address, and ZIP+4 in this box •
SCo#-- kia ici
/97D GIt'ea // i' 'J
Oc& ! s/e fteXit(C 2� 9

,tA WITHIN CAMA LINE = 3750 SQ . FT . _ I
!OVERAGE
AREA WITHIN CAMA LINE - 1053 : 75 SQ . FT .
• SET 1/2" IP . -�7
• '4 \
' 0 5 0 . . v 7' . •
F;
`-po\ . ."()-6,_
LOT 46 , gyp'' �; h o ���� ����7
N1 O 0 p0 •0 1 • �' rN
• .o
• " D
�D
0 SET 1/21,0 c.'' ` t
b
,ET 1/2" IP oo
' . cf)\ \i': C. -
41.°
o
0 0 � Z -o
\* otO __ _ \ .
...---A • . . 51° \'
CAMA LINE
\ 0 SET 1/2" IP \
O •
"g LOT 44 .
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c
0
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o pp'
S1°.
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5
• _
•
I . PROPERTY IS IN A FLOOD HAZARD AREA. AE 15.0
SURVEYED BY USING MAP CAB. H,• PAGE 374
AND EXISTING PHYSICAL CONDITIONS.
MAP OF SURVEY FOR I _

•
Aral I0N OF COASTAL MANAGEM NT
DJACENT R PAR AN PROPERTY OWNER NOTIFICATION/WA/VER. FORM
Name Of Individual Applying For Permit: O �J' (0.rC�1
Address Of Property: 3p
r �5
(Lot or Street 1, Street or Road, City & County)
her h
I eby certify that I own property adjacent to the above-
ref
property. The individual applying for this
permit
described to me as shown on the attached drawing vhas
they are proposing. A description or drawing, the development
should be provided with this letter. with dimensions,
____ I have no object
ions to this proposal.
v u ave ob 'ect 'o to w at
v � • n s be nc n noosed `e
e t e
W. '* ' at n a a acem n 7 a Ve
t 405 ca days e e of 9 - w ' 0
s ne ob ' no •notice. o esaonse cons 'de d t sane
n you av been notified by C Y't 7 f i n 1 • ,
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater
house, lift must be set back a minimum distance o boat f 15'
from my area of riparian access unless waived by me.
(If wish
to waive the setback, you ust initial the appropria eo
m blank
below. )
I do wish to waive the 15 'setback requirement.
y,
I do not wish to waive the I5'setback requirement.
Signature "-%
7, , c--// Date e
Print Name �Y r
Telephone Number With Area Code

r
•
•
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1 eru rt l 1
1 �r rt h a n r r d Q O r u le ��Y
nt. Ser bark or Qrlarl r. __�..-
SCOTT WARD CUSTOM HOMES, LLC
1607
3800 LIILY FARM RD
i
11
,
GREENSBORO NC 27 406 9618
PAY
j TO THE DATE 66-112/531
ORDER OF ___XZ/ 62201 "I
RR��j'
iv BRANCH BANKING qND TRU87 COMPANY OCEAN ISLE,NORTH CAROLINA Iii
FOR
110016
7u• 1:053iO112ii: 5215