36965D - West

0 CAMA / DREDGE & FILL D
GENERAL 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 'f# / L-. )0 .
�� � Rules attached.
Applicant Name T it it (Je.Sf' Project Location: County /�
Address ;l. 6 A S -✓i j I e Street Address/State Road/ Lot#(s) ,q g
City C.K-EA r'1 I'SLe 5c-ct(.i State iC, ZIP 6`'l 67 i /i5 ilk Vi i 1 C.
Phone # ( tS(4I- 14(-1bccE5 Fax# ( ) Subdivision
Authorized Agent 5-eve Tsher City )r' _,n IS (c 6r•r. r ZIP .n i(c('
Affected `1 CW [ PTA ❑ES PTS Phone # ( ) _ River Basin G...t i r^::I;Gt
❑OEA ❑HHF ❑IH ❑UBA N/A
AEC(s): Adj.Wtr. Body Cc-,na_( (nat(mar)/unkn)
❑PWS: ❑EC:
•
ORW: yes /fno PNA yes /�o.) Grit.Hab. yes / no Closest Maj. Wtr. Body y/'t-��
Type of Project/Activity l ,<-, + -t Jct Pic f l I i oC tI r ir.�J bc,c IQ
(Scale: I ?- 20 )
Pier(dock)length j 51/r +�r�
' --
Platform(s) _ 6 1.1(p
Finger pier(s)
Groin length
-- --/ l r. , Q.___
number
Bulkhead/Riprap length I U '
avg distance offshore F l«.-t'
r_
max distance offshore ,v
Basin,channel \-.4/ t v., C✓
cubic yards 7 �'
Boat ramp I I
V __
Boathouse/Boatlift !_._ �? 11
-j,,I L.h.c n (Uc)
Beach Bulldozing 11 rN-C i ,i_-c,1
Other I �I
i
Shoreline Length _-IC.)0
I
SAV: not sure yes no) 6 —
Sandbags: not sure yes 1
Moratorium: n/a yes
Photos: yes t
Waiver Attached: yes n - -----
Lr
A building permit may be required by: C IArYi(✓T OCEAkt is(e. 11_., . C See note on back regarding River Basin rules.
Notes/Special Conditions }'K( G-crin 44'1,trIA.5 .I '711 iz&c, AppA„
,.e T'5 he r _ (,? 3a‘)t-
Agent or Applicant Printed, ame Permit Officer's Signature
dra,u Z'7, U it .. �J U
Signature **Please read compliance statement on back of permit** Issuing Date Expiration Date
j 06 aO (p C'kec. I s j3 ,,c IV v-/-4-y xk-e
. Application Fee(s) Check# Local PlanningJurisdiction 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
Dare,Gates, Pasquotank and Perquimans Tyrrell and Washington Counties)
2728 Capital Blvd. Counties)
Raleigh, NC 27604
919-733 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 I 0/05/0 I

GENERAL PERMIT COMP
UTER FORM
APPLICANT NAME: gr7h/7
aIPSIL
ADDITIONAL NAMES:
AEC DESIG: ��� T ___ } i Z
� DEVELOP AREA: �' � PROD DESC: � -
(Will only take 6)
(Will only take 1)
WORK: // /5
(Will only take 4)
MAINT:
(Will only take 4)
INIP: Ctu) I V.F
(will only take 6)
ACTION EXPIRATION
DREDGE&FILL REQUIRED: _ // 7/Uy Li/7h y
CAMA MAJOR DEVEL REQUIRED: 1/47/4Y V2 7 (0}1

1 J3TISTON OF COAS r i MANAaR
es.f Duck
Name Of Individual Applying For Pe 't-
Address Of Property: A l3oqe
A 1i to lie .S t
.0 S kw,s-c4310 Coui.t
(Lot or SL .eet #, st:ree or cad, City & County)
I hereby certify that I own property adjacent to the above-
referenced property. The individual applying for this permit has
described to me as shown on the att ched drawing the development
they are 'proposing. A description or drawing, with
should be provided with this letter, dzmPsions,
I have no objections to .his proposal.
Tf vou_have j.Qr bons to_wha i s _being 'Proposed, ease tA-r-i fi� the
LZnI.Li2n_,, ND7i }l Csroi inn ?8an� r,.-� rah 1 '1 CI
days Of rer•Qi�- of S-hi ���
a pot iVP I11Q 171Irmg- iS Porsi der j the same
as rto obj ert-.Dn if you have been notified by CerY i f i ed Mail
WAYVER SECTTOM
I -amdersi-wrvil that a pier, dock, mooring pilings, breakwater, boat
house or boat lift mist be set back a •nr',4 r rnn of ,
distance 15 dram
my area of riparian access - unless waived by me. (If
L you wish to
waive the
setback, you must initial the appropriate blank below. )
2 do wish to waive thethe ,15 ' setback- requiremnt.
Wife = do rot wish to waive the 15' setback requirement.
IdUe-tkouv, /00.1
Sign Name Date
3C (A), 11141,44 'c" R'.t Lc-`I/
Print Name
}r �r/p Z 26' 73ze--
Telephone Number With Area Code
NCDE4R
NOO7H CAROUN4 DEFARTrWdr a

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•;SENDE COMPLETE THIS SECTION ti -COMPL NETE THfS SECTIO ON DELIVERY x; z
` .i ' k .t..R.1.
> Complete items 1,2 and 3 Also complete ra Svgn, •
dem 4 tf Restricted Delivery is desired X ❑Agent
r Pint your name and address on the reverse D Addressee
so that We can return the card to you B' Received by�Prmted Name) C Date of Delivery
Attach this card to the back of the mailprece,` I)�
or.on the,front d space permits t '' _,U ; .- ,
1 Artfdle Addressed3o' D.is delwery address different . rtem7? 0 Yes
p f' If YES enter deliveryyaddress below 0 No
s-
L t/t •
($ l3Cemfied Mail D Express Mails
�. GJ>� 0 Registered' ❑Retum Receipt for Merchandise: yJ
-.� ��Jnsured�vla!1 ❑c C.O.D.
4 Restncted Delivery'(Extra Fee) a 0 Yes
2 Anc�feNumber 7003 1680 0002 2836 6554
(Transferfrorrrservlce%aben
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PS Form 38 ';Augu.s{t 2001 7oinestic Return Recevpt 1o25ss o2 M is w

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s 665 2046 ..n =1
WEST ENTERPRISES, INC. 531
P.O. BOX 990 704-525-5466 281044141
CONCORD, NC 28026 DATE4.oI72r/"
• t. PAY TO THE � KLL N�ici _
ORD^ER-OF I�u MM I $ 2oo °
/
f Z7 L(G+CQV O (cr �e}U DOLLARS LJ
g ccB Central Carolina Bank 66ns I'
Concord,North Carolina 28025 6?-1) J
MEMO CA 0.. perwl 2 S'4S/LCV;((r.t7f ?I-5—
1:053 i0046El: 28 L041. 14 iII' 2046 - -