33517D - Drake

0 CAMA / DREDGE & FILL NS 33517D
GENERAL PERMIT Previous permit#
)�
N•aw 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 /7 D C- .
El Rules attached.
ApplicantName &v ' - /4.K C - Project Location: County
��..-id,o-
Address /7/7 E 'PE l-i'Q�, a( rC I/ --Q Street Address/State Road/Lot #(s)
City S1 /g.vr? - y�State aliZIP 99 O L07 -i# 3
Phone # ( ) 330 -33Z Fax#( ) Subdivision 8/_//-/ 1 c . - ,Afr' '7 r,S
Authorized Agent / Aid.- 03/C 4 City •SU KZ.F C_'c - ZIP U 7 N
Cw I4EW ...ETA i ES - PTS Phone# ( _) - River Basin j
Affected
AEC s : u OEA ❑HHF ❑IH UBA N/A Adj.Wtr. BodyJD�O$,Q i ��U I. an unkn
O ❑PWS: '7FC: ' l
ORW: yes / no PNA yes / no Crit. Hab. yes / no
Closest Maj. Wtr. Body_- . -«�W
Type of Project/Activity pa(Vf; - Vo0.-4 Mei
/ r
(Scale: //=-*' )
Pier(dock)length q(J ACO
I Platforms) IZx/ . { �.-._I
I- j
Finger pier(s) I ! ! I
! ! I — I i
Groin length 1 l -- I I i I — !- • i
number I 4 � N t
' S�9 x I e�Arr�
Bulkhead/Riprap length i ! V,�yCy�
7.
avg distance offshore ! 1' i I
max distance offshore
Basin,channel I , 7
, , ' ' P'. --ir/ ' ' ,
cubic yards L
i
Boat ramp _.I _
1
Boathouse/Boatlift 1 i 1
-i —
Beach Bulldozing I
— 1 -- i
.
I
` l IOther S,x I L! ' F cAT - . � , - - . .I uV
, I i, _- ` -
Si _
40: v
Shoreline Length Liu / • • .1 : 4' ' I -
SAV: not sure yes no I 1
Sandbags: not sure yes n j ---.•_--- . P. I _ ' I 1
I 17 r- Q
Moratorium: n/a yes n 1 607 (
Photos: yes no I ,
- ,GRN.- 5 R` rt ;
Waiver Attached: yes no �i F' n �,/
A building permit may be required by: , C-1 12 O.. ( / 7 . ❑See note on back regarding River Basin rules.
Notes/Special Conditions {1/I/g-j/ /U 0ST L X 7E4111 DGI% itA)Y FcA 1 HEfL- 7 //q N 77,/
,c,sl/9 61-13 1-1 pie-2 1--/ N1
P„.II i. /►leA,/
Agent or Applicant Printed N Perm, e'• cer's Signature
/ _1—(114/0 WaS 17
a n) 3
Signature read compliaf e statement on back of permit Issuing Date Exp ion Date
M SCO2r (11
Application Fee(s) Check# Local Planning jurisdiction Q ( vdrJi

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 252-946-648 I
Location: Fax: [phone] Fax: [phone]
(Serves:Camden,Chowan,Currituck, (Serves: Beaufort, Berrie, 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: 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)
www.nccoastalmanagement.net Revised 10/05/01

GENERAL PERMIT COND TTER FORM
APPLICANT NAlvtc: d Al N/ E Orz
•
ADDITIONAL NAAvS: 12/�Nc M.os/E y
AEC DESIG: C cc A--) P7 DEVELOP AREA: Ot 7-PROJ DES C: �- /z t
(will only take 6)
(wal only take 1)
WORK: P 2. .76 a
(will only take
4)
EL._. /2, /C,.
(Will may, 4)
. t
i•
JJv1P: b LL) -4 6,8
(will only take 6)
•
.
ACTION EXPIRATION
•
DREDGE&FTT J REQUIRED:
CAMA MAJOR DEVEL REQUIR-'D: I —cJ —U 3 L-/ -7 -�� i

01/07/2003 10:41 3303322233 SALEM WOMEN'S CARE PAGE 01/02
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•
•
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Individual Applying For Permit: -Bawd l e -DlzRJk-t
Address of Property: L o 7 3 < o1„,06,› j'{A4 S'Lan
(Lot or Street#, Street or Road)
•
Sv1-4 C;� PEMoek
(City and 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.
kI 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, NC 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
I understand that a pier,dock,mooring pilings,breakwater,boat house or boat lift must be set
bck 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.
i/yi3
Si Name 44-47(21— Date ATIA
Al ce � 4 i NCDENR Print Name
Now.CMOUHA fEY1 h r Of
Emvnacootearr awo Nb7Aai.REOcal.ca.
7/0 �G2' f53 / ?
Telephone Number with Area Code S:lcamalshells\riparianproperty.frm
90/00 39dd MVO S,N3WOM W31VS ££ZZZ££0££ £b:OT £00Z/L0/T0

01/07/2003 10:43 3303322233 SALEM WOMEN'S CARE PAGE 05/05
76P, iL SouN D I I
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01/07/2003 10:43 3303322233 SALEM WOMEN'S CARE PAGE 01/05
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FAX COVER SHEET
•
SALEM WOMEN'S CARE
2094 E. STATE ST., SUITE B
SALEM, OR 44460
PHONE: [phone]
FAX: [phone]
9JP,A . 613e2
TO: 4 RAN* FAX#:
OF;
FROM: M:S
•
c
DATE/TI.ME: • .
RE:
******************************************************************
CONFIDENTIALITY NOTE
THE INFORMATION CONTAINED IN THE FACSIMILE MESSAGE IS
LEGALLY PRIVILEGED AND CONFIDENTIAL INFORMATION INTENDED
ONLY FOR THE USE OF THE INDIVIDUAL OF ENTITLED NAME ABOVE. IF
THE READER OF THE MESSAGE IS NOT THE INTENDED RECIPIENT,YOU
ARE HEREBY NOTIFIED THAT ANY DISSEMINATION,DISTRIBUTION, OR
COPY OF THIS TELECOPY IS STRICTLY PROHIBITED. IF YOU HAVE
RECEIVED THIS TELECOPY IN ERROR,PLEASE IMMEDIATELY NOTIFY US
BY TELEPHONE. THANK YOU.

01/07/2003 10:43 3303322233 SALEM WOMEN'S CARE PAGE 02/05
t, T t. 1Hs � I�hli2d¢_ --- .,5
sl-��►..
q i t7 34 0 •q5'2" • DIVISION OF COASTAL.MANAOE NT
JACENT RIPA, IA PERTY OVJR NQT ExiimmajVIZI1 FORM
'--8Name of individual Applying For Permit: n f ie 1 r 2 kc ,
Address of Property: Li 3 131.11J. .SL ore . OleitAd., 1),... .
_
(Lot or Street#,Street or Road)
. . &If . •• Cill . Tervier .
•
(City and County) ,
T hereby certify that I own property adjacent to the above-referenced property. The individual
applying for this permit has described me as shown on the attached drawing the development they
.. are proposing. A description or drawing,with dimensions,_shnuld 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 EYteasion,Wilmington,NC 28405 or call 910-395-3980 •
within 10 days of receipt of this notice. No response is considered the same as no objection if
you bave been notified by Certified MaiL •
• 'WAIVER SECTION
•
•
I understand that a pier.dock,mooring-pilings,breakwater,boat house or boat lift Must beset
bck a minimum distance of 15'from my area of riparian access-wilco waived by me. (If you
wish to waive the setback,you mast initial the appropriate blank below.)
I do wish to waive the 15'setback requirement.
. . I do nod wish to waive the 15'setback requirement • . .
•
' (--_-1,if l't CVE//1 ----- (03 .
,A
--"'-gli, ame Date
5m Pc ,.J C. W,/LL.eoCC
. 4iff .
•
Print Name
910—31- _6 Ll,/`7 . • . . • 0..........,.....
Telephone Number with Area Code SAcamalshellArlpattanproperty.frm
E 'd RISS C1,6 016 scm aueIleM 3 S dOC:E0 CO 90 uer

01/07/2003 10:43 3303322233 SALEM WOMEN'S CARE PAGE 03/05
- r r eu Is Lopp DD5 336-B52-9652
p. i
01/06/2003 15:00 Q.8. DEPARTMENT.9 913368529E52 NO.797 QB2
1114, i Skits- Air,
Loop N\"°1'4- A15t1StQ I O COASTAL MANAGEMENT
336 0s_9t ADIACEMT j1IZARIANJ kOPERTY OXhI gTI1iC TION/WAWE_FORME
Name of Individual Applying For Penn& Bonn;a w.Jr ?L
Address of Property:, . L O 3 Vahti 3kj,rc ore$„(4+►- D*'
. .(Lot or Street B,Stroctor R44) •. •
- S VC-c - . C;. 'Pewter. •
(City and County).
1
I hereby certify that I own property adjacent to the above-referenced property. The individual
applying for tius.p itbaides&fbedtumeasshowtrontheattaeheddrawingtbedcvclepmetitthey
.. etc proposing,.A description or drawing,with dimensions,.should be ptuvidcd with this letter.
1 have no objections to this proposal. '
If you have.objections to what i9 being proposed, please.write the Division of Coastal
Management, 127 Cordinsl Drive Extension,WNmiugtoa,NC-28405 or EPA 910-395-3911e-
wiiithin 10 days of receipt of this attire. No responro is-ea■sideredthesameas no objeetionA
you.have been notified.by Certitled Mail, .
•
WAIVER SECTION •
I understand that a pier,dolt,onorin=pfIogs,breakwater,hoot heureor boat lift Must b
esek
bek a.minWHIM dict:nc0 Of 15°from ray area of riparian-access.-unless waivcd.by me. (Ifyvo
wish to waive the setback,you must initial the appropriate blank below.)
1 do wish to waive the 15'setback requirement .
•
• ; : ' I do not wish to.waive the 13'setback requirement. •
•
• Sign Name Date
NCDENR, —
Print Mime rd.w.ors,uwr.e+r..s•
J 36 - c95,--"? ..9 s', ' _ •
Telephone Number with Area Code 3:tcarnatahellsIt padianpropeaty.frm'•..•

01/07/2003 10:41 3303322233 SALEM WOMEN'S CARE PAGE 02/02
DIVISION OF COASTAL,MANAGEMENT
• ADJACENT I,ZIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Individual Applying For Permit: -Boum►e -bRg)c
Address of Property: L o T 3 ojex~Qu? j 14 , fc
(Lot or Street#, Street or Road)
c,� RiuDek
(City and County)
•
I hereby certify that I own property adjacent to the above-referenced property. The individual
applying for this permit has described tome 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 white the Division of Coastal
Management, 127 Cardinal Drive Extension, Wilmington, NC 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
I understand that a pier,dock,mooringpilings,breakwater,boat house or boat lift must be set
bck 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.
1/4 3
Si Nance DateA14, -
71
Print Name NCDENR
No ri C.Roues.OtPwmAcnr OP
9�0 �r; � � � r 9 Ew����rwo NAIAAL��ce,
Telephone Number with Area Code S:\cama\shells\riparianproperty.frm

•
•
Bank of'Ainerica Advantage"
,.....�-RANDALL B. MOSLEY oa-o, .«_�.��u. ....�_v. _.. .... ._..._....M.....__.._._....�.. --- 1285
910-328-5071
P.O. BOX 3463 66-19/530 NC
1018 S.ANDERSON DRIVE. 702
TOPSAIL BEACH,NC 28D445-6852 Date I/lJ c' 3
Pay 4/( g1/t i $
to the order of /
4)7e L-ri'A / Dollars
Bank of America. P 335)
ACH R/f 0530 198
Memo r 4, h
1:053000 L961: 000684 ?Li 547711' 285