36964D - West

CAMA / DREDGE & FILL ,; 0 3 964 D
GENERAL PERMIT Previous permit#
>' lew 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 I5A NCAC /t7
1-i•I "2-0U .
{ Rules attached.
VCi
Applicant Name hn LUe54 Project Location: County Baff-L i;c-
Address 51, eonCOrd Sfi'e.C.t Street Address/State Road/Lot#(s) i-(p
City Omit n /5 fc5c..6J) State/VG ZIP A g*</ C_'0/7COrd
Phone # ( -R62)/r-441b6K5 Fax# ( ) Subdivision
Authorized Agent 5 -e✓e / 5 A er City OCP0/11IC Beach ZIP , 45.4(,,,r/
Cw W %PTA ❑ES ❑PTS Phone# ( ) River Basin I i bCI--
Affected DEA ❑HHF ❑Ili ❑UBA 7 N/A �+
AEC(s): Adj.Wtr. Body (�Cc-r e4--1 (natiman)nkn)
❑PWS: ❑FC:
ORW: yes /) n PNA yes o Crit. Hab. yes / no Closest Maj. Wtr. Body ��
Type of Project/Activity /pep/Ci Ge C�LI5h, [ C)C:-i _
U (Scale: / ' 7))' )
Pier(dock)lengtheo mp)
Platform(s) '3 %Zd
Finger pier(s)
Groin length l CO.
number (i n('
Bulkhead/Riprap length
avg distance offshore *--------
max distance offshore
Basin,channel 1
r_._21a______
cubic yards I
Boat ramp --.---
Boathouse/Boatlift
Beach Bulldozing I .I -- i
Other
_ 1
Sv f 13k l <hcac)eC1 I i
Shoreline Length :TO I Cca'1G
• 1.
SAV: not sure yes no 4UWc.l,ILQ..
Sandbags: not sure yes no U..
Moratorium: n/a yes I } i
Photos: yes kap i1.
Waiver Attached: yes C►� I 1 , 1 ,
A building permit may be required by: "---7-6-Lv e7�C�GPG i) 6/ _ 5'G c/i n See note on back regarding River Basin rules.
Notes/Special Conditions //( p- `iC✓i 7'z_c'Y75 G/' '7/y 4.70U 61/)13- ci
S7-c �5 tie;-- 6-4-4-cc;��- 5�{.C,.�
Agent or Asrinted N e _ Permit Officer's Signature
�" , it-,�'2 all +.��i 0. .
Signaturese read compliance statement on back of permit** IS Date Expiration Date
/{0 6 O 40`1- On'G/7 /5(C 15GG- n 1.1 '2 e I ,/
Application Fee(s) Check# Local Planningf urisdiction 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
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 10/05/0I

GENERAL PERMIT COMPUTER FORM
APPLICANT NAME: C :4/7 lcie -
ADDITIONAL NAMES:
AEC DESIG: P T DEVELOP AREA: PROJ DESC: ( -
(Will only take 6) ———— (Will only take 1)
WORK: /(',
(Will only take 4)
S) ZU
MAINT:
(Will only take 4)
IMP: 0 W 22�
(will only take 6)
ACTION EXPIRATION
DREDGE&FILL REQUIRED: ((Z 7 /U`i 4 f Z7 l d 0
CAMA MAJOR DEVEL REQUIRED: l/2,-7 (o`/ 4'l Z ?/Dt-(

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DIVI.SIO OF COASIAL_LANA(tF.MRNT
ADJAC:FNT RIPARIAN PROPERTY OWE HOTIFIC ATION/V AI R FO$M
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Name Of Individual Applying For Permit : ..�tt K L f c
Address Of Property: Copt C athV -
0c , I i ece.c.4 /•C, ez'ccrestizld5
(Lot- or-Street- ,---Sttee or Road 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 attached drawing the development
they are proposing_ A description or drawing, with dimensions,
should be provided with this letter.
XI have no objections to this proposal .
Tf you have objprri ens to what- is hei ng _nroposnd, Dl Pase wri re tha
TZivision of J'Qsas. al Management , 123 Cardinal Drive Rxtension,
Wilmington, AIorth S'aroliia., 2R405 or call 910 -0? _";gon within _2Q
days of recpint of this notire No re_ .nnse is considered the same
as no ohj ert i on if you have been notified by Corr i f i ad Mai i
WAIVER SECTION
I mnderstand that a pier, dock, mooring pilings, breakwater, boat
house or boat lift must be set back a minimum distance of 15 ' from
my area of riparian access - unless waived by me. (If you wish to
waive the setback, you erns;- initial the aparopriate bl a k below. )
i do wish to waive the 15 ' setback requirement_
I do not wish to waive the 15 ' setback requirement .
Sign Name Date
VI// / /,-) /27 /.27/ed 3 - A
Print Name
949 6-9
Telephone Number With Area Code
NCDERR.
ND-rt+ :o OUNA DEY'.a„^-rri1K Or
iNV $4.4 AND nuznipmL f JR'"..Ss

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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. � El Agent
■ Print your name and address on the reverse Ayf _ALA '� ❑Addressee
so that we can return the card to you. • eived byPrinted -
■ Attach this card to the back of the mailpiece, , e+ �. �ate of Delbery
or on the front if space permits. J • ' `/ kta2 U' &
D. Is d-;very address different from ite '1?ri Ye-
1. Article Addressed to:
GIf YES,enter delivery address below 0 N.
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3. Certified Mail ❑ Express Mail
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❑ Registered 0 Return Receipt for Merchar
❑ Insured Mail 0 C.O.D.
4. Restricted Delivery?(Extra Fee) 0 Yes
Article Number 7003 1680 0002 2836 6578 7g
(Transfer from service IabeJ
3 Form 3811,August 2001 Domestic Return Receipt 102595-02-M-1540

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WEST ENTERPRISES, INC. - 531
P.O. BOX 990 704-525-5466 281044141
+ CONCORD, NC 28026 / �/
t DATE*�• / -/Q 7
A' 111
PAY TO T11E jOk!!/A
c ORDGR OP //NNLL I $ 200, °°
g 7i.-70 1-{ut+cevek ?6o/(ate
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DOLLARS 8 ,.,�""'".,," as
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Central Carolina Bank 665 +
Concord,North Carolina 2R025 �3,,y 6/7
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