34118D - Beverage

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GENERAL PERMIT Previous permit#
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__Nev, Modification Complete Reissue Partial Reissue Date previous permit issued
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As authorized by the State of North Carolina, Department of Environment and Natural Resources 7
and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC ! ,L. 0 , .
3Rules attached.
Applicant Name (,AJ r ////1-W1 Se()eVA9,t./ J y Project Location: County pEl'.),DL IL
Address 2?'/5 N/e2fJMJJl9''Y SO W.0,51 Street Address/State Road/Lot#(s)
City -S t-1 (6,A(•L) vo State Pe ZIP p2,9 y2 -s- '; AN d /C, cl(
Phone#( 7/C 2-C c/' 98 Fax#( ) _ _
Subdivision 0 �Q
Authorized Agent City 5[.l rzF l ZIP ,2 q y/
Affected -�CW ` EW fa PTA pis ❑PTS Phone # ( ) River Basin 0A pE f It
0 DEA OHHF ❑IH ❑UBA E N/A
AEC(s): D PWs: Ems; Adj. Wtr. Body FEAR rt/- M/ 1X U'.4N unkn
�4 L (nat / / )
ORW: yes / no PNA yes / no Crit. Hab. yes / no Closest Maj.Wtr. Body PS/ /C SOLI AID
Type of Project/Activity ?(/OA 7E 17U+^k / p/e7z
If /
(Scale: ( = )
Pier(dock)length G N/2 s- f.Z
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Platform(s) I f
Finger pier(s)
Groin length � i I a .-L_-
\) .
number__ ' I f i i i I
i f i
Bulkhead/Riprap length
avg distance offshore t _
max distance offshore I !k* "--
. .-._ �J I '' ©r -All 4 4 Di �f�N4Z
Basin,channel 1 i i " 1 01/1# ! C,r"S c TO r�59rS
I
j
__.... �-_� i _
cubic yards I i
Boat ramp - j
Boathouse/Boatlift F
i - -._ it u'w-
Beach Bulldozing / I i B>~ �} 4.V u �r4
as
Other L-oA
1- Y i i 1, L .� 1: � _ f
• --... vwc e ' � v -,6- I
- - f rail ;EJ� -- t
Shoreline Length 0 j - I
-I '
SAV: not sure yes no �� _ '
1
Sandbags: not sure yes no )
Moratorium: n/a yes no ! 1 i
Photos: yes no I
Waiver Attached: yes no - - 1
A building permit may be required by: 5U ale- @./ . ❑See note on back regarding River Basin rules.
Notes/Special Conditions p/#Iz (h) .ie ry1 A'i" NOT rXJ7 /7) Arv;' fie 7z q6/z AA/ 7774�
Gv A i e.i'L. /31DfJ y LA)/ Y- Nd IM o KC 77/4 N Z $DAT Sc-1 )Z /!-1E Fc5lr6//IT&_7
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bd/'i 1 'i Am &veto \e (>yt.A.4, L...„....,
Agent or Applicant Printed Name rc cer's Signature
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Signature "Please read compliance statement on back of permit** Issuing Date Expiration Date
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Application Fee(s) Check# Local Planning Jurisdiction Rover File Name
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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
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]
(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
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 I0/05/01

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_APPLICANT NAME:
AEC DESIG: a 6- t' pr DEV D - Q
1_ PR.OJ Z :
(WO only 4) T� l Z/
ACTION 2.ATION
DR�ur REQUIRED: —�Z_U 3 . :.
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AMA N_4TOR.Dirt PEQUEI:D: f1 Z -(Z - ° 3 ;

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/UNCOVERED BOAT LIFT)
I hereby certify that I own property adjacent to \ -\\\Ik
(Name of Property Owner)
property located at 3 I LckA
•
(Lot, Block, Road, etc.)
on , in P-t' ) , N.C.
(Waterbody) (Town and/or County)
He has described to me, as shown below, the development he is proposing at that location,
and, I have no objections to his proposal. I understand that a pier/uncovered boat lift must be set
back a minimum distance of fifteen feet (15') from my area of riparian access unless waived by
me.
I do not wish to waive the setback requirement.
I Lb wish to waive that setback requirement.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
6itk •
✓'�--_.._1�� yam-`__ `o ' �•__ _ '
,6et,/ <
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Si ature
Print or Type Name
'9/O 32?-/�
Telephone Number
Date: ,/' g Og
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1 08/27/2003 15:22 FAX [phone] BtTRGASV FARM BUREAU 10001
Farm Bureau Insurance Services
P.O. Box 975 6urgow, N.C. 28425
(9 i 0)259-5725 [phone] FAX [phone]
i
' This Fax is :
To:____)oars 5-+6,.\Th sv, From:
( 2.) 1.Vi al-. fib eu..e.Lc±:_v_
Attn:
Date: 1- a S `° ' Time:
Fax 3� -,a OQ`t
Re: .
Number of pages Including cover page_
if any document is not received, please call us as soon as possible.
Comments:
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08/27/2003 15:22 FAX [phone]{3 BURGAW FARM BUREAU 0 002
- ;. '
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/UNCOVERED BOAT LIFT)
I hereby certify that I own property adjacent to
trek t 's
(Name of Property Owne
- property located at 3 1 0.A L C`.NP
(Lot, Blobk, Road, etc.)
11 i Ste; C_t� , N.C.
on 5e-'&�1 , in' x
(Waterbody) (Town anchor County)
He has described to me, as shown below, the development he is proposing at that location,
and, I have no objections to his proposal. I understand that a pier/uncovered boat lift must be set
back a minimum distance of fifteen feet (15') from my area of riparian access unless waived by
me.
I do not wish to waive the setback requirement.
I da wish to waive that setback requirement.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
v
G
. f `( 7 r
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Signature
Cfree-i-Es L. f.Ja CLc�
Print or Type Name
Telephone Number
_
Date: g 6133
-30-

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'y, WILLIAM W BEVERAGE
,j PO BOX 975 1107 I"j
I, BURGAW,NC 28425
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[phone] f` / O3 88-7172/2531 p
111
DATE r
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PAY TO F: 4,1
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BANK
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WILMINGTON,NC
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'; : 253 17 L 7 281: 160009830 100 1107 1a1
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