35158D - Clements

0 CAMA/ ❑DREDGE & FILL , 35158D
GENERAL PERMIT Previous permit #
) —% _.New ❑Modification Complete Reissue ElPartial 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 /4 /Z0 U .
GAtules attached.
Applicant Name M f re K 0 L EYyi& Al/ I `' Project Location: County pz--Ai 772
Address .. �- NO. , , /v (A) Street Address/State Road/ Lot#(s)
City 1> 07 f State )V(I ZIP 41 y S L O Y id a I ize re ar:
Phone # ( ';f f)) 4� �:)-9//O Fax # ( ) - Subdivision (Ai RS f-///UC T(J ) A ere S
Authorized Agent_ City E IA V/1ID S%z. 1 ZIP „la yy3
Affected Cw EW ..,‘'PTA . ES PTS Phone # ( ) River Basin 24 E F /Z
AEC(s): �OEA HHF IH UBA N/A Adj. Wtr. Body iitt4 N—w1ADE (1A/AL (nat / a, r /unkn)
-� PWS: FC: _
Closest Maj.Wtr. Body Top
ORW: yes / no PNA yes / no Crit. Flab. yes / no
SA/ . seuN�
Type of Project/Activity -10 &/LD �J/Z (uA71 j-1i 15.fa- `1 OoiE✓LE'D 64Zr'I o s/ reOA%
(Scale: //'- ZU )
Pier(dock)length
Platform(s) 6012117'ED
Finger pier(s)
Groin length
number
I
Bulkhead/Riprap length
avg distance offshore 4.-----------� .
max distance offshore ' MA 10 /Vt f) 7C £ /)/-A t .
Basin,channel •
cubic yards
Boat ramp - -
Boathouse/Boatlift
Beach Bulldozing
Other fi 6 >k/ .
rtOAT / k /(o f2
,
j 4 v _ I
Shoreline Length / 0 1 - f(/ I ( /7 A ,\ . I I
SAV: not sure yes no ,.,-y-
1
Sandbags: not sure yes no
Moratorium: n/a yes no i
Photos: yes no .
Waiver Attached: yes no ' fj� I - L
A building permit may be required by: 2EAWER.- 00(.1 7 . Pj See note on back regarding River Basin rules.
Notes/Special Conditions MAY >U07 E X e eQ1 ck M 1 7 I-i or 7 t E cAA /9 L
DLD rLoA73 C- S /T- etcu5T wrDvel) pri toil ,,,_ `
AZ,
Agent or Appll P' ame Pe •' Officer's Signa ure
/e,� i�_/5--o� s -/S -o4 .
Signature ** ease read ompliance statement on back of permit*I` Issuing Date Expiration Date
MO/ cX /off bA. Co Q /313
AoolicationFee(s) Check# L 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
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

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ENDER: COMPLETE THIS SECTIO' THIS SECTION ON DELIVERY
■ Complete items 1,2,and 3.Also complete A. Signature
item 4 if Restricted Delivery is desired. ent
■ Print your name and address on the reverse X "ram ❑Addressee
so that we can return the card to you. B. e Recei by "inted Name) C. Date•f D r)
II Attach this card to the back of the mailpiece, y
or on the front if space permits. _
D. Is delivery address different from item 1? ❑Yes
I. Article Addressed to: If YES,enter delivery address below: 0 No
cop Ye.r);\ 6347,
I .Z10006 p- _
j 1\) C-. 3. Service Type
i� �V / ❑Certified Mail ❑Express Mail
❑ Registered ❑ Return Receipt for Merchandise
❑ Insured Mail ❑C.O.D.
4. Restricted Delivery?(Extra Fee) 0 Yes
2. Article Number 7003 2260 0005 0062 5277
(Transfer from service lab
Form 3811,August 2001 Domestic Return Receipt 102595-02-M-154

UNITED STATES POSTAL SERVICE First-Class Mail
Postage&Fees Paid
LISPS
Permit No. G'10
• Sender: Please print t.tr Tn , address, and ZIP+4 in this box • •
Clements Marine Construction
577 HWY 210 west
Hampstead NC 28443

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DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
•
Name of individual applying for permit: Uir.),,c )O ) Co..-c4p AI(—
Address of property: /'Tet ),04 q L Z pv�,�
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.
If you have objections to what is being proposed, please write the Division of Coastal
Management, 127 Cardinal Drive Extension, Wilmington, North Carolina, 28405 or call (910)
395-3900 within 10 days of receipt of this notice. No response is considered the same as no
objection if you have been notified by Certified Mail.
• WAIVER SECTION
(Does not apply to bulkheads or rip rap)
I understand that a pier, dock, mooring pilings, breakwater, boat house, lift or sandbags 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 must initial the appropriate blank below.)
I do wish to waive the 15' setback requirement
I do not wish to waive the 15' setback requirement.
1 •
S thtu Date
V
/ Print Name
/ Telephone number with area code

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