35064D - Potter

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CAMA / DREDGE & FILL L,. 35064D
GENERAL PERMIT Previous permit#
/1" % New 7Modification 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/-1 • 2..00 0
%Rules attached.
Applicant Name be-.;7rfc� ?QfVer yie ) Project Location: County 8(I(1)SLc...)/C.6
Address /,;z;t ? CA..f` f /,-- eY i✓C,. Street Address/State Road/ Lot#(s) 42 2.
City -5[stt• ►j,e.,-14 State MC ZIP Z8y6 / 1GGht basin 57'7'ce f
Phone # (WO ) 41 3 30 Z(, Fax#( ) Subdivision
Authorized Agent City SOL.lie liel AS e'r ZIP 2 Rit(n 1
Affected CW W TA DES Errs Phone # ( ) River Basin dape i r'
OEA L HHF ]IH 7UBA ❑N/A
AEC(s): Adj. Wtr. Body G/QG{2.>L BCc5i/' (nat / unkn)
PWS: FC:
ORW: yes / no PNA yes / no Crit. Hab. yes / no
Closest Maj.Wtr. Body _ Cape �t'a /1/e(-
Type of Project/Activity Cor7Sh-i,4cr ( field) (,tj4(kuJct✓,a Nr- Cc CCc..5 S Irk �K/S'15/1
7' /7 jCr' p-, C/ (Scale: ("1, 7r,' )
Pier(dock)length Sc ,J
Platform(s) - ' 7� /(, �1`7Cfi`% �/'�a//v ` '
i
Finger pier(s) 51 ,3i
Groin length
number , .
Bulkhead/Riprap length j IA Q)VAL Watt
avg distance offshore j�
max distance offshore `1 i
Basin,channel -
cubic yards I �
Boat ramp ___ M,L I _ ,
Boathouse/Boatlift t,V, "'-- I ( "•
r
Beach Bulldozing 7 2`_
V
Other J Ejr t ?L/S 7/Vj ` L
6 St{o
, 'GrG4.f.;
Shoreline Length . //2 /__
SAV: not sure yes
Sandbags: not sure yes 0 +
Moratorium: n/a yes 0 //2 ,1j7yG(i/,) e •
.—.
r
Photos: es no y
Waiver Attached: yes CD
A building permit may be required by: edll a 14 5e t.�71-1A.}a dr i . See note on back regarding River Basin rules.
Notes/Special Conditions ,qi4. GcrYtC3 c c yt.j l 41/4 '7/V 2,OG74) p ,
vs
•
44-0 Ai-Tee • 6,--c z1t.z..._ . r_i=7 ..ems
Age t or Applicantan Prin Name Permit Officer's Signature
/ ( �( A/w S, t .2oz23 "6 S o
Signature *'"Please read compliance statement on back of permit*" Issuing Date Expiration Date /j75
0
1 07) /406.2- Sett 5/z7 dY14' /S///0 S/5-4 ( )
Application Fee(s) Check# Local Plannin urisdiction 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(910-395-3900)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
919 733 2293 / 1 888 4RCOAST Morehead City District Wilmington District
Fax: [phone] I5 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

GENERAL PERMIT COMPUTER FORM
ha.e d
APPLICANT NAME: -
ADDITIONAL NAMES:
AEC DESIG: DEVELOP AREA:_ PROJ DESC: .0 - Il
(Will only take 6) (Will only lake 1)
WORK: / 5 , 3
(Will only take 4)
MALKT:
(Will only take 4)
IMP: Uw 2.1 •
(will only take 6)
ACTION EXPIRATION
DREDGE&FILL REQUIRED: v- 1 .. •
CAMA MAJOR DEVEL REQUIRED: /

DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Individual Applying For Permit: DCr)A-U)
Address of Property: j;Za yip} rn
(Lot or Street#, Street or Road)
e" U11+6e--i I•C 0i1.6t ICK.
(City and County)
I hereby certify that I own property adjacent to the above-referenced-property.applying for this permit has described to me as shown on the attached drawing the deve o y
pment the individual
are proposing. A description or drawing, with dimensions, should be provided with this letter.
I have no objections to this proposal.
If you have objections to what is being ro osed, please write the Division of Coas
Management, 127 Cardinal Drive Extension, Wilmington, NC 28405 or call 910- tal
395-39
within 10 days of receipt of this notice. No response is considered the same as no objection00 if
you have been notified by Certified Mail.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boat house or boat set bck a minimum distance of 15' from my area of riparian access-unless waivedlft b must I
you wish to waive the setback, you must initial the appropriate y me. �f
blank
✓ 1
I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
Sign Name Date
Print Name mIA
��- r/ NCDENRAillarammi
5_/ NOF rH GFOLINA DEPARTMENT OF
Telephone Number with Area Code ENVIRONMENT AND NQUgKWFC�
S:\cama\shells\riparianproperty.frm

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JE I MA' OF I ''�' : AC UNIT
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Wit
\ / BEGINNING ER
.1.' E. NAIL LINE AGREEMENT RECORDED
)FESSIO D S RVEYOR L • S I N DEED BOOK 498, PAGE 426.
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rn
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BOARDWALK ABOVE .I.P.
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0' 20' 40' 60'

DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Individual Applying For Permit: lt, j ��,
Address of Property: P 2 . t 1 AS I c ST12
(Lot or Street#, Street or Road)
-TWOr2 1J C 2E34 I 13r j rjW2
(City and County)
I hereby certify that I own property adjacent to the above-referenced-property.e The individual
applying for this permit has described to me as shown on the attached drawing the development they
are proposing. A description or drawing, with dimensions, should be provided with this letter.
I have no objections to this ro osal.
P P
If you have objections to what is being proposed, please write the Division of Coastal
Management, 127 Cardinal Drive Extension, Wilmington, NC 28405 or call 910-395-3900 -
within 10 days of receipt of this notice. No response is considered the same as no objection if
you have been notified by Certified Mail.
WAIVER SECTION . .
I understand that a pier, dock, mooring pilings, breakwater, boat house or boat lift must be
set bck a minimum distance of 15' from my area of riparian access-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.
•
Sign Name 3
ate
bdtc—Str
iO'tet/
Print Name / AT5liralS,
NCDENR
NORTH GROUNA DEPARTMENT OF
Telephone Number with Area Code ENVIRONMENT AND NATURAL RESOURCES
S:\cama\shells\riparianproperty.flm

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•
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1�/ �.���:� E. NAIL II! DEED BOOK 498, PAGE 426.
IFESSIO ' v' D S RVEYOR L
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—----- ---1
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1002
THE DOCK BOX ss-�,43/253,
122 YACHT ,NCSIN ST
50UTHPORT NC 28461 DATE
$ `C�, III
PAY TO THE —�\ ' \
ORDER 1 .� DOLLARS E
I� SECURITY
': S u poSAV n`NC 28461
a FOR , - .
, I: 253 L7 L4301: L30 L00 L0007 18' L00 2 r am :: •y
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