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GENERAL PERMIT Previous permit# > IA—_
)C New r Modification Complete Reissue . Partial Reissue Date previous permit issued it/A—
As authorized by the State of North Carolina, Department of Environment and Natural Resources N O
and the Coastal Resources Commission in an area of environmental concern pursuant to I 5A NCAC
❑ lesChed.
Applicant Name e T � A-✓� r� _ Project Location: County � lµ-4N..
Address L,0 €6-Gre / K.` Street Address/State Road/Lot#(s
City hi f I l State li•C ZIP 6 v 7 30 c J ai ( V P S 7)lf- —
Phone#( ) 2_ I— b Ci Fax(#( ) Subdivision
Authorized Agent_ ) N s ' %i' - City Q/ )J-S g I lie PG, 4.ZIP 7614 (0
0. CW ❑EW ❑PTA /ES ❑PTS Phone# ( _)1;�1 v�� River Basin cif,it!, t).
Affected ❑OEA 0 HHF 0 IH '//// 0 UBA ❑N/A 1
AEC(s): 0 PWS: ❑FC: Adj. Wtr. Body IN)d ' �a , �Y`,6 (1 rL t/�G tl/ unkn)
� Closest Maj.Wtr. Body7( e n\f/Ile )b t A
ORW: yes /� PNA yes 0 Crit. Hab. yes / no
Type of Project/Activity lJ"' S (. ('-f- 117b- 6 ('-5--/) [/U/, .1
Pier(dock)length V(Scale: J /( : hl
e
Platform(s) 1 I _
Finger pier(s)
-
I1 I 1
Groin length
r I i _ l .
•
Bulkhead/Ripraplength , j E ! T
avg distance offshoreF 1_4
max distance offshore I , • i ' f,.. .,___2.., d _L
Basin,channel ( ,
cubic yards
Boat ramp
Boathouse/Boatlift
' i 1 . i ki\-• - _I( -I , --, . .
Beach Bulldozing ( ,
Other
t I
/ r 1 -- _ I -
Shoreline Length _n U fi I i
t
SAY: not sure yes no i
Sandbags: not sure yes - ' ' -
Moratorium: n/a yes I i j
Photos: yes • i i
Waiver Attached: yes no).- --- I I I
A building permit may be required by: IV E See note on back regarding River Basin rules.
Notes/Special Conditions ' c �e VI-, y,' ,ll /✓i 7 61 •I/Q 6-
0 , •\i i' .---
Agent or Applicant Printed Name ' . ,I.•' ear'ssC,21:--
L j� - (q - 03 ( /(- 0 63
Signatur€ "Pleade read compliance statement on back of permit** Issuing Date )r Expiration Date
{ 0 0 — i ‘.....(?Cl Neiv.) 1..v,„ 0 4(-V\
Application Fee(s) Check# Local Planning)urisdiction Rover File Name

e�
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 252-264-390 I 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: 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 10/05/01

• GENERAL PERIVIIT COMPUTER FORM
APPLICANT NAME: JEFF 1Alywo
ADDITIONAL NAMES: T mrt No I (61,3
rr
AEC DESIG: DEVELOP AREA:C o. 6I PROJ DESC: ? = ( / =
(Will only take 6) (Will only take 1)
WORK: 'BA- 8o
(V4 ill only take 4)• S
MA1NT':
(Will only take 4)
A
(will only take 6) 5
• ACTION EXPIRATION
•
DREDGE&FILL REQUIRED: - 1 (— I O — O_
CAMA MAJOR DEVEL REQUIRED: 8 - 1 "0 3 )1 19 --a 3

frz-
I ___y_) CERTIFICATION OF EXEMPTION
��% FROM REQUIRING A CAMA PERMIT •
as authorized by the State of North Carolina,
►,� Department of Environment,Health,and Natural Resources and the Coastal Resources Commission
•
'� in an area of environmental concern pursuant to 15 NC C Subchapter 7K.0203.
iJ Cat(<l
Applicant Name " . _ , .
Address ' • - • _
City •
State Zip
Project Location(County,State(load,Water Bod , etc.)
-
Type and Dimensions of Project IM
Pc4 I pS • -
:The proposed project to be located and constructed as described t This certification of exemption from requiring a CAMA permit is • ,,,, ,
above is hereby certified as exempt from the CAMA permit,re'- valid for 90 days from the date of issuance.Following expiration, -
quirement pursuant to 15 NCAC 7K .0203. This`exemption to a re-examination of the project and project site may be necessary
CAfuIA permit requirements does not alleviate the necessity of to continue this certification. , •
your obtaining any other State,Federal,or Local authorization. •
•
SKETCH . (SCALE: j I( 4e)I )
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Any person who proceeds with a development without the con- v •
i/
sent of a CAMA official under the mistaken assumption that the App' ' sig re ' •
development is exempted,will be in violation of the CAMA if there
..is a subsequent determination that a permit was required for the /
development: . CAMA Official' signature
•The applicant certifies by signing this exemption that(1)the ap- r
plicant has read and will abide.by the conditions of this exemp- Issuin data f�. .
Lion,and(2)a written statement has been obtained from adjacent . J— `
landowners: certifying that they have no objections to. the . Expiration date
'' proposed worii.- - . -
i.,� _ '. - Attachment: 15 North Carolina Administrative Code 7K•0203

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COASTAL MARINE CONSTRUCTION 12189
NCDL 3831595
6314 WRIGHTSVILLE AVE.,910-256-6357
WILMINGTON,NC 26403I�� ss-2v53a
R:� BRANCH 87884
-21 DATE ¶' 1S/o .31.
o ORDER OF i—' I
o A �d(.4__ -.1 , L64 /a`-- DOLLARS t
1 E
WACHOYIA
Wachovia Bank,N.A.
�, AGA Rif 053000219 ,,
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1 11.0 1 2 189" 40 5 3000 2 191: 2086 17 208 6 Iit.