33326D - Gray

0, _CAMA/ DREDGE & FILL .Fv':, 33326-D
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
and the Coastal Resources Commission in an area of environmental concern pursuant to I5A NCAC i,f
Rules attached.
Applicant Name ‘C\fr CA \hJ '--7-le h u\ i J t Project Location: County 6(•U r' s IA) t C.
Address , v-7 0 -3 \or•, ,(\(. L.,F- f 4 Street Address/State Road/Lot#(s) I t LI-
City C (KC 10 A k-c State NC.iZIP '. 43eT .) ,._ fGQA(\5 t O f o `J'4-'Y'�P't-
Phone#(')t'i .-/3-2.- a')0 Fax#( ) Subdivisiont -1 U�dc-V1 e-19C.� --A I) r baf
Authorized Agent 30e 1 \ I\�.S City 41 Li<\ j cA ZIP 2. L}(p 2-
Affected Li Cw ' EW .PTA ❑ES C-PTS Phone # ( ) River Basin Ll l Int-3e r
COEA HHF ❑IH ❑UBA E.
AEC(s): ❑PWS. ❑� Adj.Wtr. Body Lac"r\fQ \ (nat /man lunkn)
ORW: yes /•no' PNA yes I`no) Crit. Hab. yes / no Closest Maj.Wtr. Body $ w
Type of Project/Activity _IU eAAJ I V X o�'Jc r" a b o‘61/4+ 1 L- t 6 -X t S-T 1
f_)K,
dotn .'k'`<-tACA ArE..,../ (Scale: ��f� 1 )
Pier(dock)length I wT
Platform(s) I ^�^ , ' -
i
Finger pier(s) 1 I - f
Groin length = I
.
number , , , , : ,
1 i j
Bulkhead/Riprap length — —� iH 1
. _
avg distance offshore _, ., I i _i 1...`...
max distance offshore �__— _ f I l
_ --
Basin,channel I 1 '`
cubic yards i t I_ t ` ;_ ._ ` o
Boat ramp I------ — ' i 0I
::::°::
g °Or i tiCI I ,..--tr t i W A t J ea
Other 0I r\ 1, Oa � � ® 0
I
r
Shoreline Length `—�0 i Pi 1 _
SAV: not sure yes no j I
! I j � � � ` uT
Sandbags: not sure yes
— ._.. 1 I
Moratorium: n/a yes no (....-•`
Photos: yes no I i I '_ 1
i
Waiver Attached: yes no l � : 1 f
A building permit may be required by:11�i?vJ(�()1 d e �"11 t o\de.' '-G. Hi See note on back regarding River Basin rules.
�
Notes/Special Conditions ,\ C C1() t 3r it v r 5 cle 'Sec -11 , o YZ r(- • 12Q- PT? \ •
i v:., v ;u, +L 2 b0{V\ V\A-1 \C_ \u(Y 'Ci — ON-) rti 106
e\d c)(\ci \A boc\ 1 ,.0 +-
Agent or Applicant Printed ame Perm' Officer's re
-2 0 - 3 6o-20 -- c•-
Signature **Please read compliance statement on back of permit** Issuing Date Expiration Date
Application Fee(s) Check# Local Planning Jurisdiction 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(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 252-946-648 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: 9I 9 733 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 I0/05/0I

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GENERAL PERMIT COMPUTER FORM
APPLICANT NAME: j cJr A- `Ct ,
ADDITIONAL NAMES:
AEC DESIG: P T DEVELOP AREA:_ ,0 PROJ DESC: P- (2.
(Will only take 6) (Will only take 1) -
WORK: b ' x 131
(Will only take 4)
MAINT:
(Will only take 4)
IMP: o li1/4) 1(0 q .
(will only take 6)
ACTION EXPIRATION
DREDGE&FILL REQUIRED: 3-20-Cj3 Co- U -03
CAMA MAJOR DEVEL REQUIRED: CQ- 20-0 3 Co""20"' S

Locality Permit Number
GENERAL INFORMATION
LAND OWNER
Name 241.411, `< G.�.�P,.z
Wiressq /'70 8 W.t e=?Aran Zw",e-
City a,o41-1 ye State /1/C- Zip Z 8Z77 Phone 70.V 7S -837cv
etc 7oy-eye-z8Z3 •
AUTHORIZED AGENT
. Name
Address
•
City State Zip Phone
LOCATION OF PROJECT (beach address' //9 G.cervSh.'o ..71'
r-f: 379 S c k vas r 460c.4 M 44.
(If not oceanfront,is waterbody natural or manmade?) A,..sh+:or C4 ,le#4,/
• DESCRIPTION OF PROJECT .440• f A•744
k.
AREAS OF ENVIRONMENTAL CONCERN (AEC) CLASSIFICATION
(To be filled in by the Local Permit Officer prior to completing application)
Ocean Hazard Estuarine.Shoreline ORW Shoreline Other
PROPOSED USE
Residential Commercial/Industrial Other
SQUARE FOOTAGE OF BUILDING FOOTPRINT AND OTHER IMPERVIOUS OR
BUILT-UPON SURFACES (such as driveways, etc.) within 75 feet of the shoreline (575 feet
of an ORW shoreline)
SQUARE FOOTAGE OF TOTAL FLOOR AREA OF BUILDING
•
SQUARE FOOTAGE OF SITE
OTHER PERMITS MAY BE REQUIRED: Zoning,Drinking Water Well, Septic Tank
(or other sanitary waste treatment system),
The activity you are planning may require Burning, Electrical, Plumbing, Heating and
permits other than the CAMA minor Air Conditioning, Insulation and Energy
development permit. As a service we have Conservation, FIA Certification, Sand Dune,
compiled a listing of the kinds of permits that Sediment Control, Subdivision Approval,
might be required. We suggest you check Mobile Home Park Approval, Highway
over the Iist with your LPO to determine if Connection,and others.
any of these apply to your project.
G 7gVA Nnr i_nnA Iemo r e 09EE9t'BOT6 0E:TZ E00Z/EVE0

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STATEMENT OF OWNERSHIP
I, the undersigned,an applicant for a CAMA minor development permit, being either the owner of property in
an AEC or a person authorized to act as an agent for purposes of applying for a CAMA minor development
permit,certify that the person listed as landowner on this application has a significant interest in the real
property described therein. This interest can be described as: (check one)
,c.A—'W
an owner or record titer Title is vested in , 174. see Deed Bookgii
page 33( in the F 4•6400..A. County Registry of Deeds.
an owner by virtue of inheritance. Applicant is an heir to the estate of
probate was in County.
if other interest, such as written contact or lease, explain below or use a separate sheet and attach to this •
application.
•
NOTIFICATION OF ADJACENT PROPERTY OWNERS
I furthermore certify that the following persons are owners of properties adjoining this property. I affirm that I
have given ACTUAL NOTICE to each of them concerning my intent to develop this property and to apply for
a.CAMA permit.
(Name) (Address)
(1) � ,�z.•�,✓ I. 604ao //6 S7;
(2) /eiike f' a�%'ex- //Z S7c
(3) .—
(4) —
FOR DEVELOPERS IN OCEAN HAZARD AND ESTUARINE HAZARD AREAS:
I acknowledge that the land owner is aware that the proposed development is planned for an area which may
be susceptible to erosion and/or flooding. I acknowledge that the local permit officer has explained to me the
particular hazard problems associated with this lot. This explanation was accompanied by recommendations
concerning stabilization and floodproofing techniques.
PERMISSION TO ENTER ON LAND
I furthermore certify that I am authorized to grant and do in fact grant permission to the local permit officer
and his agents to enter on the aforementioned lands in connection with evaluating information related to this
permit application.
This application includes: general information (this form), a site drawing as described on the back of this application,
the ownership statement, the AEC hazard notice where necessary, u check for SI00.00 made payable to the locality,
and any information as may he provided orally by the applicant. The details of the application as described by these
sources are incorporated without reference in an permit which may be issued. Deviation from these details will
constitute a violation of any permit. Any person developing in an AEC without permit is subject to civil, criminal
and administrative action.
This the/$ day of A ! 200.3 .
Gam.. ....
t'ti NOLL raLSNOO r E 09EE9t'B©TB ©E:TZ E©©Z/E©/E©

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DIVISION OF COASTAL MANAC-Z 'EN
T
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WA VHR_ FORM
. Name Of Individual Applying For Permit: Ae
;;*y
Address' Of Property: // ' C�/lEFsacosa SST.
..,/ SwI a.c �O
- (Lot or Street c, Street or-Road, City
& County) .
I hereby certifythat property ad
r=-erenc=dproperty. I own. r Y , adjacent to ,the above-
referenced nce to The individual applying for this permit has
they are
me as hewn on the attached drawing the development.
should be prey dedQ with dh A ss rl ett eY or drawing, tr t,� cl i 1EnsiOn ,
•
I have no objections to this proposal.
T' you have obiQcti 1 •
D' v�-�uoh+ f coastal to what is beano tr000sed , please writ® e
r t}1.r
Div is - Manacemen_ 127 a,-dina-.l Drive i n Q
,ctoa n Carolina . 22405 or Twit si n . _
days oT rec=iat tars iotice. call 9.a 395-�gQO within ?Q
ac 710 Ob i act on - YOU beenNno as i �an$e i s considered the 5=me
ied by Certified M
AIV^R SECTION . .
house,I understand
lift that
a pi`- • dock, mooring pilings, breakwater, Gat •
li- ` must be sat back a minimum distanceb 15'
from my area of riparian access of
tto waive setback, you ,in initial
by pp` (If you wish
ru
. ) the appropriate at_ blank
•
I do wish to waive the 15 'setback requirement.
I do not wish to waive the 15 'setback requirement,
s •
ign u�z 3 a3
. I VI-4(
Da
e
P==nt Name N
Telephone NuMber . With Area Code 1-1N
50 39dd NOIlDflLSNOD r' g 09EE968016 OE:TZ Eeez/EeiEe

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•
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DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/wA=VEER_ FORM
. Name of Individual Applying For Permit:
Address' Of Property: // to <sieped .S
•
� i✓1'G✓/G`c Cp —
(Lot or Street r e �
r, See%. or Road, •
City & County) .
•
T- hereby certify that I own pronert
,- _a r - - YrPnt.....__..t�..._...the..__..�.��_.... ..... ............._. .... ....
referenced
ef eren edctomee ty. The individual applying for this pe
shownnt_t has
on the attached drawing the development
they, are proposing. A description or drawing, with dimens�.on5
should be prcvided, with this letter.•
'
I have no objections to this proposal.
•
Tf v6u have obi ec ions to what is beine 'proposed . please writeth
m
Division of Coastal Ma nacement Cardinal - Drive
127 Card i na l - Drive Fxtens ion .
�l l�;rC`O.-� :Y O�.�n ar01 ine 8=05 OT• C `.
dews o; receipt o` tr,rs ; once al 9 o 3 5- 5p0 wi= i 1
Nq rsponz is CQIlS i dEred the� e no ob; ecti on i = vcu rave been- by Cent; F; ad Ma; i
WAI7ER SECTION
•
I L'ilCE=Steal d that pier, .
IounE, lift - , dock, mooring pilings, breakwater, boat
must be sat back a minimumdistance '
froth my a,ea of riparia- unless w youf is '
Z access waived by (If wish
to waive the setback, r"e' ;
below. ) i you AiU<<. initial the appropriate blank
•
Akf"- I do wish to waive the 15 'setback requirement.
I do not wish to waive the 15 'setback requirement.
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SgnarfLipze
1 Date AAName
Telephone Number Gr'ith Ar-el. Code
/02 C 67rz' Of-0 -S e.
ekr CD
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3197
B. & J. CONSTRUCTION 08-00
910-846 3228 Z ']�, 66 191523 30 6C
998 CYPRESS LAKE CIRCLE S.E. Date / ?
BOLIVIA, NC 28422 /
Pay to the
order of r i1�
D71--- ( Dollars 8 0 ....
Bank ofAmerica.
• ACH R(f 053000106 ;e.
For 'r
.053000 L961: 000 68 3490 II' 3 L97 .. ,/
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