30914D - Blackmon

CAMA / DREDGE & FILL N? 3091 4 b
to Y
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 /2 Ud
and the Coastal Resources Commission in an area of environmental concern pursuant to I 5A NCAC /'i •
IX,Rules attached.
Applicant Name _ ZG C'-1-1 („4...+• bier c d ry lQ r) Project Location: County ,_'/ aTz -
i it)/C/
Address 2 Oaq g 6 c-kl!v rci 5'f rec f Street Address/State Road/ Lot#(s) 4/
city ti,I+. Pw cl State NC ZIP.276,30 Miry)[ ill I(sr) 5�'ee7`
Phone# ( '78 1 - 5%?(#ax#( )_ _ Subdivision
Authorized Agent City ©CeO1) 151 c (3 c_A ZIP ;8ll e'q
Affected ❑CW EW XTA ❑ES L.PTS Phone# ( ) River Basin 1-, /r�L( b r•r'
❑OEA HHF 01H ❑UBA N/A
AEC(s): Adj.Wtr. Body e6 nCC ( - _ (nat /a�unkn)
❑ PWS: ❑FC: `� �/
ORW: yes / no PNA yes /' ) Crit.Hab. yes / no Closest Maj.Wtr. Body Ai!!U/4..>
Type of Project/Activity AC)1Yk c 4 1B'0('L +tom'
(Scale: / Pt., 2 G 1)
Pier(dock)length 3f X
Platform(s) ,re.._, /16 R�qC, ; ' r.
�Ox
Finger pier(s)_
,
Groin length
number i-- j - '__.
//wrj Cr'
Bulkhead/Riprap length j ^---
avg distance offshore _
max distance offshore _ _ �__ 15/(,? 3
Basin,channel i i i c �- _ f�(,
cubic yards — —._..'t�L.-.1 'L(+Ik !E,� ,.. /rL-47 r JL // -pal (L7Ca'
Boat ramp // __.. . . .ice.. �0 �/L
Boathouse/`Boatlif /..Y Z- •
q r �'
P i 6'
Beach Bulldozing __ — f I. .` 1__ ' — i :____ j 1-
Other -_ fir. j �; I i
... . x- -
I — J._ - L V t fC 1 >V w _
- / �, -
Shoreline Length 50 i �/ .1 �G
SAY not sure yes (no
Sandbags: not sure yes Cno 4 / ,
Moratorium: n/a yes co I Aft:L Nt
yes !no 1 — 1 I.--
Photos: —
i i � PL I , rib
Waiver Attached: yes no —_._ ._�.—. —....
A building permit may be required by: / cF t� e-• G •
See note on back regarding River Basin rules.
Notes/Special Conditions / , ./chi v'S o j 7// /L e
Agent or Applicant Printed Name '�� Permit Officer's Signature
-+ —�, -r. `/, L`/.v._) • (3
Signature **Please read compliance statement on back of permit** Issuing Date Expiration Date
.�_ _ _ _ /5/c o'Gc' Air/_ 77/4
Application Fee(s) Check# Local Planning Jurisdiction Rover File Name

t �
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:
I I Tar-Pamlico River Basin Buffer Rules Other:
n 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
9I9 733 2293 / 1 888 4RCOAST Morehead City District Wilmington District
Fax: 9 19 733 I495 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)
Revised 10/05/01

GENERAL PERMIT COMPUTER FORM
APPLICANT NAME: Za-c-A G(2, &( �man
ADDITIONAL NAMES:
AEC DESIG: /--)T DEVELOP AREA: .O/ PROJ DESC: P- •
(Will only take 6) — (Will only take 1)
WORK: ,6L /z,/z •
(Will only take 4)
MAINT:
(Will only take 4)
IMP: 0 )
(will only take 6)
ACTION EXPIRATION
DREDGE&FILL REQUIRED: '7• Z ci • 0_3 /0 • Z 9 .03
CAMA MAJOR DEVEL REQUIRED: 7 Z 7. 03 /O' Z9.03

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DIVISION 0P COASTAL MANAGEMENT
• ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER PnR
Name Of Individual Applying For Permit : ZA ( �,� C,K
Address Of Property: i -f: f I.41I L.r C Tci• p
(Lot or Street #, Street 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.
I have no objections to this proposal .
Tf von have objPcti oms to what is being nroposefl, please wri to the
Division of Coastal Management- , 127 Cardinal Drive Extension,
Wilmington, North Carolina, 2R40 or call 910 -49,-R900 within 10
days of rpreint of this notice No response is ronsidPred the same
as no objection if you have been notified _by rcertified Mail
WAIVER SECTION
I understand a pier, dock, mooring pilings, breakwater, boat
house or boat lift must be set back a minimum distance of 15 ' from
Try area of .riparian access - unless waived by me. (If you wish to
waive the /setback, you must initial the appropriate blank below. )
V I do wish to waive the 15 ' setback ra
requi_�ment.
1 do not wish to waive the 15 ' setback requirement.
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Sign N rc1/e I h Date• =
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Print Name � -_
Telephone Number With Area Code z
N D EN
N}-:m CAROLINA D?M"Tt 'Ni O=
ENVIRDN MEAT AND NATURAL PESOUR"-s •
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For perm-i t= C S.'3
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Address Of prone=ty: h
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Street o-r Road, City(Lot Or S i r�t #r � W > / Q
adj aceni to the ahoy--
own property_ s
- 7 hereby cent_=y that I applying for this permit has
r =oreY!-C�d property. `i'T1n -individual �Q ���T;ng the dt'vol p_JILI?Il�-
deSCrined =0 me as sbo'm on the attached
description. or d=awi-fl , with dimensions,
-- - - y are -soposi�ng---- - s - - - -
th�
-should be provided with this letter.
I have no objections to this proposal _
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mooring pilings, brae . J'e, boai
Sao Se. O_ bo-a: lift must be Set back a mir..Itim1% G=S_r.z ce of 17 ` ...Cam.
zuy area of =pa_ian access - unless waived by ma. (1-5 you =sh -o
waive .he se-tb ..k, -you mnat initial tip the aooroor iste blank. J?ZQ4?.)
i do wish to waive the 1 5' set back =ecrivi-r m -ril . -
i fin "nflt Wish to waive the 17 ' sm.e-:oack =eq Ii-r- m n
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Ai ZACK W. BLACKMON
129 CROSS CREEK CR.
" / • MOUNT AIRY, NC 27030
" / q 66-1181/531
.11•, 1. )1 4K f CIII4 4‘,4,).y, ,.r. i
„ ).. � 05000478
Z 'D e orderof_ ‘ I $ ( t 0 4 'N"
g, , ri-•-•4(.2-,..ii isLe_____AL ctt.
THE COMMUNITY BANK Mount Airy,NC 27030li
I cnv 1.-, fger 6N 3 69/g _./0000-___ __ _ _ _ ___ .AP
0000045L611' • I:053LLLa &op: 050r-- ' ,II