33592D - Fowler

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GENERAL PERMIT
-:New Modification Complete Reissue Partial Reissue Previous permit#
['
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 -7 f-1 // Xi
Rules attached.
Applicant Name 'B u r-r s kEAJNe o,,J i r Projecte. Location: County ty f7�rvZJr-iZ
Address -s/ . 40 / br0 )k A/ Street Address/State Road/Lot #(s)
City LA) r 1 Ai 1 iJ q State t' - ZIP o�8(- /t- ?d Z __,_c7A E IP
Phone #( ) / 7 1716 Z.Fax#( ) Subdivision T o ro u o h BARE
Authorized Agent N!4 City ATKifVSUY1 C ZIP
Affected 0 Cw DEW JPTA ❑ES PTS Phone# ( _) River Basin C1,ff FFy jZ
AEC(s): ElOEA ❑HHF ElIH ❑UBA N/A
❑PWS FC: Adj. Wtr. Body 'eLf]C-iG k l U E)r O/man /unkn'
ORW: yes / no PNA yes / no Crit. Hab. yes / no Closest Maj.Wtr. Body GACk /(JP r
Type of Project/Activity 142(UFl 7 ")%l Ea. 4 FGDf)-r
(Scale: I
Pier(dock)length V (Scale: )
A ZS'
Platform(s) ��
TOO
pier(s)— �•� (T !IO e a[ 1 im. 1 131-Ao. 4 �' .`.�.: --._I -� -.... --■
Groin length — ENIENEE
11111MIN�]nUp'.'13 _ /6 k �1 .r.• 'I,- - _ _ .. ' Mi = MI
number ��� �M ` MI NM
Bulkhead/Riprap length 11111 , � ,, —t—`_ a ! • N I ._1..1:..�.
avg distance offshore _ N '
--1 maxdistancehore =-
• - _ , ��Basin,channel pro i„„ rDi:Ijii:
II 111
cubic yards , ■■-Mailjaillil ' t �' � , ,i .
- +..
Boat ramp ! j �- . '-� I � } ".
Boathouse/Boatlift ' ::::i HIL. + .
-JII1L :itII
� I I Beach Budozing IM� ����
erum
...� .. . _ vim.= _ 111110
IShoreline Length -9 8 1 1 III SAV: not sure yes no , _ i I 11"1
1 II Sandbags: not sure yes no i I
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Moratorium: n/a yes no III .■. ��
Photos: yes no MIN •• -I �� =1 Waiver Attached: yes no 1 T I . , .■■
A building permit may be required by: 900 DER- nou Y _ See note on back regarding River Basin rules.
Notes/Special Conditions NOT 7D &--Teiti D pi Y fu/7 P /2 T/r9+v -6 (A)) d4 OF--
0 f-IANNQL sot ,
Agent or Applicant Printed Name Permit Signature
Signature **Please read compliance statement on back of permit'"* Issuing Date Expiration Date
Application Fee(s) Check it L26JOe1rlanning Jurisdiction Rover le 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:
j 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(252-946-648 I)or the Wilmington
Regional Office(9 I 0-395-3900)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
Fax: [phone] Fax: [phone]
Location: (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
919-733-2293 / I-888-4RCOAST Morehead City District Wilmington District
Fax: [phone] I5 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 10/05/0
www.nccoastalmanagement.net

GENERAL PERMIT COMPUTER FOR ',
:APPLICANT N_4IE': f30. r r r s �ru N e 44,1 Fv i tJ
ADDIDON L NAMES: •
AEC DESIG:��oah•iakr 6) -=—��L PRO].Disc: jJ _ J Z
(WMi only'1)
WORK: J q
(Cal osily lak:4) /
onir takr 4) i
six.::6)
ACTION 'DRATION
Dior& T REQUIRE): -/ y_v3 G _/y_d3
:AMAMAJOR. REQUIP 3-- 1 y `03 6 — /y-•D 3 •

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DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Individual Applying For Permit:1-3 w- i e,to AJe.,
Address of Property: b S t.5 -tqr\-e_ `.,1'.
(Lot or Street#, Street or Road).
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I?rl, 1t.i Q/0 ei,A&•
(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 de cription 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, 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.
-PI— I do not wish to waive the 15' setback requirement. . . - -
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Sign Name Date/ Aigr7A
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Print Name NCDENR
Name c-7,,, A DEFMRTP4D T or
ENVRONMD 1 ANO NRUILL RE5OUJ CES
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Telephone Number with Area Code S:\cama\shells\riparianproperty.fim

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DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Individual Applying For Permit: ‘1j,n, .c, 1\e,N„1 ckC\ °IAAe.,4
Address of Property: a•o Ve,
(Lot or Street#, Street or Road)
('-1 l p.5b e3 "Qc a V e-( ••
(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.
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, 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.
C),_3 , ,e - I do not wish to waive the 15' setback requirement.... .
• _ sue,.- / 4
Sign Narlfe Date Ar rmA
Print Name _ NCDENR
NORTH CARouNA DEPARTMENT OF
ENV RONMENT AND NA7uRAL RESOURCES
Telephone Number with Area Code S:\cama\shells\riparianproperty.fi1u

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wiiiiimolousloolliall— 2563
BURRIS K. FOWLER 88-783/531 3
AMY ELAINE FOWLER
515 CC
WILMIN T HOLBROOK NC E2 1�4„w_�/!.� 2 -4' pate
WILMINGTON,NC 28412
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O i $ /OO°-
Order Of G1,-11y'pe 72 O e F::
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Wecbovle Rank N.A.
NP
1:053 L076331: 86 L6 536 L 2611' 2563