34219D - Heath

CAMA/ L]DREDGE & FILL ',` JY 342193)
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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 15A NCAC f/ t 20C.)
E Rules attached.
Applicant Name C.t Ej /4A` !1L` - /J Project Location: County a/V SL a
Address 2-8 Z. f yz h -3 -hCA-'1f�l - Street Address/State Road/ Lot#(s)
City j'2Aik /- State/or ZIP Z v � 4O a wl (/ 5Phone#( 254 6,g, —_5y] c#( ) Subdivision OLD ,S.e /TL[-iv S ,r�►j er'
Authorized Agent 57616 A WT l NU1(I • City ,jU I'LF ` a /T? Zip 2-5'c74 of S
Affected Le CW 4EW .1PTA AS ❑PTS Phone # ( ) River Basin 0 4?[- 4ell/Z-
AEC(s): ❑OEA El HHF E IH ❑UBA ❑N/A Adj. Wtr. Body M/41)`f'k1 7 CO Hw/f C (nat /unkn)
❑PWS: ❑FC:
ORW: yes / no PNA yes / no Crit. Hab. yes / no Closest Maj.Wtr. Body T0, ` , e-- ,Sou N b
Type of Project/Activity fzemouc A seeraui o P EA! sr//uel pad,ke (e., y'k Atr'/? q Z/ /k 7
tt
ej-r' <.,.; d F O OYI LANpt )/9-reDS/P . - FjN�rvt. /7ZErt V- RDL (Scale: / ZO/
7 )
Pier(dock)length g,, ('/G-T
Platform(s) /14P/7 /h 3 t , 1. ` I .c '6 0 F/-ArAori'APe r C�l,A4 i- Lr)
Finger pier(s) Z X L/ 2 �' r , e �bMv�� !
7d w />ri 6/t'r
Groin length i ' I I
i
number I r 4ti
Bulkhead/Riprap length 6, 1 _A., le t► ,
avg distance offshore it: 'tit'. i f
max distance offshore f.�� __.
L
n r 4,,,) - 1 Basin,channel - ♦ 6 t Y
cubic yards ■ 1 u j� 1 L r
Boat ramp - l ( -...__
Boathouse/Boatliftj / )(/2 _ 'r
r
Beach Bulldozing AD1) j 2 s 1 •
Other 1 j }
Shoreline Length _` I it !t r 1 I -
SAV: not sure yes no ,e SS / ... ,
Sandbags: not sure yes no t I l c. _
-* I r _
Moratorium: n/a yes no pL I Il j i ,
Photos: yes no _ 1 17-P013/42- + ' —
Waiver Attached: yes no I i }
A building permit may be required by ,jlt/Qk--" 0/7--(7- . n See note on back regarding River Basin rules.
Notes/Special Conditions AA A/ IO7 ("x76,V D P�?t- /Dec(� Fu KT1r-i-c. Th'�.�v y G{)A reskt
15QV - LA), 6/7 r-J•
544140/1,/'(174-iri-/tJ .
,(,(J2_ -‘k-,__-
Agent or Applicant Printed Name Perm Officer's Signature
ut_e___,. �i -- ../.y"-- c13 /6 - 7y-03
Signature *1 Please read compliance statement on back of permit** Issuing Date Expiration Date
, Y6
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 252-946-6481
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
9I9 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)
Revised 10/05/01
www.nccoastalmanagement.net

GENERAL PERNirT COMPUTER FORM •
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QOASTAL MANAGEMENT
ADJACENT RIPA4Via -1,-,Ig
. 4 i" Ty OWNER NOTIFICATION/WAIVER. FORM
Name Of Individual :Applying For Permit: 4445- 4,c7./;4/
Address Of Property: y08y yv-�i.C-7-
-Jur -eei i C- ��v--�pv-
(Lo :ar street #, st /zreet or Road, City & County)
I hereby certify I own property adjacent to the above-
referenced property,`. ' 'tie individual applying for this permit has
described to me as ,St4.0 Tt'-0ii the attached drawing the development ..
they are propcsi,ng . ;;description or drawing, with dimensions,
should be provided with: this letter.
.i" X ,�� !,yL� have no_ objections to this proposal.
If you have obiec' ,it p ::,w.batJ,s being proposed, please write the
Divis ion of Coal ' ,, :tF ': tgilt, 1z7 Cardinal Drive Extension ,
Wilmington, North:, i ,. _2)405 or call 910 395-3900 within 10
days of receipt of:' ''. 4..:tOr cp, /lc response is considered the sane
�s no objection i., ry .
'Ii*'Ye }been notified by Certified Mail
WAIy R SECTION
I understand that a p.e-., dock, mooring pilings, breakwater, boat
:-souse, lift or sandt ag:e:rit lst be set back a minimum distance of 15 '
from my area of riNal;ian access unless waived by me. (If you wish
to waive the setback, 'you Must initial the appropriate blank
below_ )
f. i.V1 '( _Zei3i_._ I do t�i•th ;to: waive the 15 'setback requirement.
I dp ,pelt !W sb: to waive the 15'setback requirement.
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Si ture Date '
Fri Tame ���`
Telephone Number Wi h:.� .'Code

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ADJACENT R112404 ' ':'-;'," r ATttitC' OWNER NOTIFICATION/WAIVER- FORM
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Name Of. Individ4al.*9044101,::.ror Permit:.
Address Of Proper#V.1-- -,:,,*.-;: . ,,
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. (Tov',-dick.:::,.,Ereet C. Street or Road, City & County)
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I hereby certify: 0ti,,,,.. --?-,*::-:(0/n,:•::property adjacent to the above-
referenced proPet:tkitk*-:.---:11:104*idual applying for this permit has
described to me2:4*:,..i:1400.**4.:',:•:the ,attached drawing the development
they are propop44-:::::: ;, 4440e$.0.tion or drawing, with dimensions-,
should be provide4"--:v4.*iii4-!#fil.::th -letter.
- .. : ..i',, : ;,. .',"?`:•,-•:.-'• : _ :
-W1 X a 1 1. a:710c:7)..)..s: .;,.4,,isotipris, to this proposal.
- . . ,,..-.,. . .
If'. you have obleCt0t9ittity44 -OV:As. being proposed, please write the
Division, of Cda*.tiO&Ififi,,WifOziti4:11#;f: 127 Cardinal Drive Extension .
if)
Wiliiinaton,' North -405:0 ;11144,f,•?.411495 or call 910 395-3900 within 10
,,,-, s ,.. ...,..,- .. .
days Of' receibtr-OVIII410,x: Ot1,0d:,..y,-- b response is considered the 'same
as no objection'4GYA4:4041. ibeAn,, notified by Certified. Mail
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f'-;-:: : ::::•;111 ikT VZR SECTION:
:. understand that.:,,:$1'.-ti-bli:W".4OC.15.;± mooring pilings, breakwater, boat
house, lift or Sa'..6044044$ :*:,.:set back a minimum distance of 15'
frOm my area of:-.t,,ifiti41 *2 .40:0'.-„Unless waived by me. (If you wish
to ,.,c,v ive-. the Setb4Cii•':'5VIOV:;:-*iist in it i a 1 the appropriate blank
belOW. ) .::. ;•;.,f,:.--.:-.=.::::,:.:.:;;; :,,,,:,,,,:,:,-... -;.,..
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-,-:'-: ertfu,114:.=4!4,P-,,-..yaive the 15 ' setback requirement.
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T do,: ./ittliiirib,:::to waive the 15'sethack requirement.
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Print Name : ' ,i•-:,c':-(f.'-:: :1t:1.:.-:'.::::•:“:-.:: mialrarmiff/samIla AmiiiMilmns.
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Telephone NumberyVi,t42::°11444f",e-odia-;r.
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