33336D - Minshew

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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 n /Z cV)
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and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC
Rules attached.
Applicant Name r` !E}� 114/, 'N`NS/16 - Project Location: County 0/S L-0
Address '3 co (��✓� I_Z.//V de,"4'h1 Ta Street Address/State Road/ Lot#(s)
City Pa-14'ae`fYlr) State 1 ZIP ' y9 . 5f
Phone# ( 9(l3S 6 1('Fax# ( ) Subdivision _
Authorized Agent )4 Z Fee /(/ E Tl- ' /(,f City J u 2 F a+ /, ' ZIP 76,V/.5
Affected ❑CW W LA
EPTA ❑ES ❑PTS Phone# ( _) River Basin C'/ Z
AEC(s): ❑OEA ❑HHF ❑IH ❑USA ❑WA Adj.Wtr. Body A4Am #,417E 0/1.64L (nat /r6n jnkn)
❑PWS: ❑FC: 2-0 —
7 it .SO4N-1
ORW: yes / no PNA yes / no Crit.Hab. yes / no Closest Maj.Wtr. Body. !J
Type of Project/Activity /3 X l 3 B d AT L /FT To EX I s TI lV e.-)
pit IuA7r p/erz/Ft-AT Fd 1Zvvi (Scale: / I/: ?o')
Pier(dock)length
Platform(s) - I ! ( _ ........_ ? I- i
Finger pier(s) I i f ( I ' I t 1
Groin length { /j f I.
number /rJ/✓ �' I ( : I
i
Bulkhead/Riprap length i } 4 I I `
avg distance offshore 1 '; _ I ._— _ I l._ "� ,'.—....--_-. {.__. _, -.
max distance offshore .—_t_ .-.--. - I j i i 1 — —+- -- � - -
i
Basin,channel I I T (�
o I 3I
l fiGi FT I-
cubic yards f -I 4 —
Boat ramp r........... �- _ `
i
Boathouse/Boatlift" i'3.k P3 I { I - I I I �( L © I I
1
I
II— I i T I I 1 - •
Beach Bulldozing U� c-L i "' T�ls A * a I t I I I
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Other y �..", l
i Co 14-r Aid.4 _ _
Leo
A a I _
— I
Shoreline Length i t __I ..A1 c12 $u�Xgief.g ^ ...._ j
SAV: not sure yes no i ii i
Sandbags: not sure yes no i ------ I I
L i
—.- • l 1 _1. I ^+_. •_.�� --_
Moratorium: n/a yes no I t i
Photos: yes no , 1 , I 1 •
i pi). 1 i
Waiver Attached: yes no � ,
A building permit may be required by: Suer 0 ( . I See note on back regarding River Basin rules.
Notes/Special Conditions 141AY tiI 0 CA D Li C.0 I`= 0 F C/9N-) c/SrII,,
tiE It r•ieALi L—(NQ, wfr-11 0 C' ►2 i,S i o(E 12ESTiz1CT, ue.
:9 a Y r viA et. ►� �_ 1:i 3 —— --'0.-- 40' :tlaii....._,14=
Agent or AppliFant Printed Name / Permit Officer's Signature
Signature "Please read compliance statement on back of permit►w Issuing Date Expiration Date
Application Fee(s) Check# Local PlanningJurisdiction Rover File Name

a
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 27699-1 638 252-264-390 I 252-946-648 I
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: [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 1 0/05/0 1

UENE.KAL PERMIT COMPUTER FORM
_APPLICANT N : k tk) I /US tf-E --(-) -
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_ADDITIONAL NAIN S: tVig-22 G l/ ►2 N y
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AEC DESIG: L-:[-LJ PT DEVELOP AR •
(WM only lake 6) L..OL PROJ DISC - I Z—
(WM=If ia,G 1)
WORK: !�L /3 /3 _ .
'. (Will� 4) /
. MAI s:
(W only lake 4)
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(all]g•K 6)
ACTION
M'T�''.ATTON
DR)M&FILL R Qtm : 3— Z --OS 6 — ZO —U2
CAMA MAJOR DLL .,REQUIRE: 3 —Z) '-03 6 —tj —c.i3 ;

MAR-17 03 08:06 FROM:RA JEFFREYS D_IST. 9197359057 TO:19103c'84852 PAGE:01
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Name Of Individual Applying For Permit: _ er,,0w �: _ . •
Address Of Property: 104 5
,g•Anc C.v.%
(Lot or Street#, Street or Road, City & County)
I hereby certify that I own property adjacent to the above-referenced property.
applying for this permit hasdescribed to the as shown on the attached raThe individual
they are proposing. A description or drawing, the development
with dimensions, should be provided with this
letter. ,/'�
'� I have no objections to this proposal.
an r
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�� �wimni u Y5[ mt of t7T1S Ilf�'i"r` i n �hQP i5 Cd2IL th
F Mail S1fIEL�t1 game as,n�nh, 9octihst
WATVVR fit~ram)
I understand that a pier, dock:, mooring pilings, breakwater, boat house, lift or sandbags
be
set back a minimum distance of 15' myarse ofmust you
riparian�.�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.
I do not wish to waive the 15' setback requirement.
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Print Name +
NCDENR
Telephone Number With Area Code N , Job ,CMS ov
ENvtgbNMEN?JWb /441./R,`RESMUR-zri
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ADZACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER)
I hereby certify that I - own property adjcent to
Vs;Il;am . 7 c:!cs r,. 's property located at 7°24 7 -(
(Name of Property Owner
Slocx. Road, age.)
On '7-�F. �,,u vi :z ( in 644 r f (1: f ' > N. C.
(Waterbody) (Town and/Or County)
He has described to me, as shown below, the developement he is
proposing at that location, and , I have no objections to his
proposal. I understand that a pier must be set back a minimum
distance of fifteen feet (15') from my area of riparian access
unless waived by me.
I do not wish to waive that setback. requirement.
W 4 T v do wish to waive that setback requirement.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
Note: Ti you have any questions, please contact:
Darrell Erny (910) 328-4852
7eoff'
Signature
wit Ta ckS o f
CERTIFIED MAIL Pri t or Type Na s
RETURN RECEIPT REQUESTED /7.
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