34120D - Kirby

0 CAMA / DREDGE & FILL €3 34�J.2 o
GENERAL PERMIT Previous permit#
�G New r 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 /P /ZdC .
_ ]Rules attached.
Applicant Name ,.10N✓c.6 't / /N A��! (n 9T Project Location: County ce,j7 i�_
Street Address/State Road/Lot#(s)
Ta 6p#c eco C ty -A 1e/h H State NLZIP Zyyys' r.g vac LQo & 54
Phone#(q/t ) Fax#( ) Subdivision p /
Authorized Agent �LI CON r w A( City To)0,SA I I �Q/1 Ct ZIP , p y�'7J5-
Affected cw 'EW TA pfES C:PTS Phone # ( ) - River Basin a 4E re 4/2
AEC(s): OEA HHF ❑IH ❑UBA L N/A Adj. Wtr. Body AAA A N- )MADE QAk)t L (nat n ra /unkn)
❑PWS: ❑FC:
ORW: yes /ncr PNA yes / no Crit. Hab. yes / no Closest Maj.Wtr. Body. �AN IDS �KANN t L
Type of Project/Activity 4Y1c)Are 11)OGC AN'1) piEIt- ),1ST 1v4Ci -- � ADD FLdnT 24 AT 4-1Fr
1r (Scale: / I'= Zv ' )
Pier dock length i
�7 I
Platform(s) - r-. 1 / { I -- j
-]---
Finger pier(s) i , i {
Groin length I ,
number Ce..,3 ;Ifi1 .
'Bulkhead/Riprap length O �.■ ■■
avg distance offshore 4 -
max distance offshore I -41:■ }
-Basin,channel - I•
cubic yards Im MI •
Boat ramp mo I ___ .....__ 1
Boathouse/a /SX/3 I1 �K cK
Rp
i _ Xf� srnr� ►� -
Beach Bulldozing - --N. .__.-- -
1 i
Other
rt.OA4T
- i ` I •l (r
Shoreline Length _ Ivy a 015 i ' �Ti J f 1,Nk IAi'1d '' i -
SAV: not sure yes no ������p ` Q'x I� 1 I - `A J -
Sandbags: not sure yes no t• --- , Vo"� A \t
Moratorium: n/a yes no - S j
Photos: yes no -1- v•. f Let) e�
I y�,� I
Waiver Attached: yes no � 1�8 C�,
A building permit may be required by: 77)93A IL E,E19CN E1 See note on back regarding River Basin rules.
Notes/Special Conditions AJOT 7V ' tXL!Q.2 V 0.4-Am t C.t.)/D 7 -/
51- t,-e„I f&, Col Ai
Agen r pH t Printed Name CI a it c e r's Signature
r 7 -23—O3 /0'z3-d3
Signature **Please read compliance tement on back of permit** Issuing Date Expiration Date
/00 ,00 --. / 96 3 -rop /1_ 8pAe-H Gio 2Z3/V'A
Application Fee(s) Check# Local Planning jurisdiction y' [ Rover File Name
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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:
n 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]
Parker Lincoln Building (Serves:Camden,Chowan,Currituck, (Serves: Beaufort, Bertie, Hertford, Hyde,
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: 9 I 0-350-2004
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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DJACENT R PAR N ON 0 COASTAL MANAG N
PROPER OWNER NOT FICATION WAIVER FORM
Name Of Individual Applying For Permit:
ert Trt
Address Of Property:y: 1;te Mc
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(Lot o_ street , street or
Road, _City & County)
I hereby certify that I ownpropertyreferenced property. adjacent to the above- i.described to me as shown onn the attacdividual hed draw?or this
they areevelon has
proposing. p_des.-ription--or drawing, the dimensions, - ='--
should- a provided with this letter. g� with dimensions,
I have no objections to this proposal.
•
f v u ave objections to what s being nr000sed leas
v coon oa a - wrote t e
Wi m ' atop N -z aQemen 7 Car 'na
th Carolina 405 ea l rove t on
days of e e of 0 55- 00 w't p
o fb 'e^t ' tn s o ice. No response s cons 'der d the came
you have been noti ied by Ce tif'ed a '
WAIVER SECTION
I understand that a pier,
house, lift dock, mooring pilings, breakwater, boat
must be set back a minimum distance of 15'
from my area of riparian access unless waived by me.
to waive the s tback, you ust initial the appropriatIf ed blank •.
below. ) _ 01,/
•
__ -_ _ __ _ _ _ �- I do wish to waive the I51setback_ r. ,_,;,-e;�.�., ___ _ _
-- I do got wish to waive the 15'setback requirement.
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te �-�' JS natur ate e�,..,,,,. = i ;n Name
, _
_zh � ��Te ber With Area Code

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DJACENT R PAR N PROPERTY
COOWN RL NOTN FICA ION
WAIVER- FORM
•
Name Of Individual Applying For Permit: .r- ` •,
Address Of Property: �� ��
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(Lot o Stree t, St eet or Road,
City & County)
I hereby certify that I ownproperty
referenced property. The individual applying scent thisto the above described to me as shown on the attached g
they arepermit has
hld be proposing. A description or drawing,drawing the development
J Provided with this l .r_ _, with _dim.e =_� s�-
Z____ I have no objections
to this proposal.
.
f v u eve ob 'ect 'ons to what s being orotosed
s �°n oa to .ease Write t e
Wi m ' crton N •a aaemen 7 Car 'na
Wi of or a rst th Car 'ne 405 o calVe to on
h s no ice. 395- 0 wit 0
as no ob 'e�t 'on N response s consider d th same
you have been not f'ed by Ce
• •Ed a .
RA ER SECTION '
I understand that a pier,
house, lift dock, mooring pilings, breakwater, boat
from my area of riparian maccess unless ust be set cwak ivednbyumme.
distanceIy of wish
to waive the setback, you ust initial the byyappropriateo blank
below. )
I do wish to waive the 15'setback requirement.
-- � �� '-wish to waive the 15/se` �_ ^--� -- - -tback requirement.
. LA (pi,) ,,„_____„
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Signature •
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Print Name
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Telephone Number With Area Code CD �N

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