33574D - Rose

0 AMA / DREDGE & FILL Nt' 33574D
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 I 5A NCAC j z G (";
[Eules attached.
Applicant Name (7 ea r� e 'Kos Project Location: County -5 r U o 5 W rt c kC
Address 'DX 5 y f Street Address/State Road/Lot#(s) / 2 v b o if,/-I i r1
y e"HP✓1//a
City State N' ZIP "? 3c-J 5
Phone # ( ' "$ 5 _58-` Fax # ( ) Subdivision
Authorized Agent - City r 10 I d c-el 2Cl L 1-7 ZIP
]CW A 4TA ❑ES ❑PTS Phone# ( ) River Basin LCU ill b P r'
Affected
AEC(s): ❑OEA ❑HHF ElIH ❑UIBA ❑N/A Adj.Wtr. Body -__ C . 0-7 a-( (nat /m unkn)
❑PWS: ❑FC: /q/!cJ (Ai
Maj.Wtr. Body
ORW: yes / no PNA yes / no Crit. Hab. yes i no 1
Type of Project/Activity Ne cA) Re M p 0 id i-I c.)� " cic lc,
�i.D
c , (Scale: N 7 5 )
Pier(dock)length, , NNN U .■ I -
Platform(s) A ZO
Finger pier(s) NNN NNNNPJN�1N1.NNNNNNNNNNNNNNN . -
■111111N11111MNIIivN■NNNNNNN■NNN■■NN■N N
Groin length NNNN10M11NNNNiM101V12NNNNNNNNNNNNN
Bulkhead/R pray length IHHIHHI __ t HIHHIIIHHIHIIiIII
avg distance offshore1.11.111.111111111.111 �- ■••• - U. Infulli
max distance offshore N N •
NNN NNN i
Basin,channel NNN� N.iUNN t
. ,_ Ili
I
cubic yards 1- k N N:NNN��NBoat ramp - ■ o �� .' .11�.11��1
—11rant"
■N■N - ■ .flN■u I. NNNNN.....•
Boathouse/Boatlift ■.■.
NN■N�N ■■NNi IN ■NNU.000UN
Beach Bulldozing _,���,�1 + 1..... ■■■®■■■.....
■.■■
�N■NN■NNN■NNNNNNN�
Other NNNNNNNN N j MI :NNNNN
�.U.U■NNN NI NNNNNNNNNNNN■NNN■ _.
— .111.11111.11111.11111111
�c ■ ■ NNNNNNNNN■NN-
Shoreline Length _
o -.. :.NNNNN:NIN I
SAV: not sure yes //) fi■ �ii 1111
��
Sandbags: not sure yes 11� _ :: uun: i!
�� _� ����,�,�, H
,� I
L
Mo rat onum: n/a yes r wPhotos: yes Mao/ NN IMP .L, M d,- -- 'l 111111
® 1
Waiver Attached: yes -
A building permit may be required by: fib/e 'e . cc-.h . r I See note on back regarding River Basin rules.
Notes/Special Conditions fGe 4// Co v)c/,--JJ a r2.s cif. 7 y . /Z O C.)
Lir7 c G_,/i) W /A 7'_7OG 4i7G G71 /22 .00 /✓)
L,CorGi e M • ""e�5e ea.. I c(Gs..e. tc�C-c-y
Agent or Applicant Prin71,2"74" 07f2/t), Permit Officer's Signature
, /: aC.)..) S11I. c>613
Signature **Please read compliance statement on back of permit
Issuing Date Expiration Date
fi /'- u . J 3[J / (p './4/,= t//e./J �GC.C.4 PG Z/ z/S 4
Application Fee(s) Check# Local Planningiurisdiction Rover File
. -- _i7•Mfa®ILsr- - •--1.....1..' - —.Hri4wilt, ....W.A.441.614.1Aiiii.[....... Y,-al@ .1.

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:
I I 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 252-946-648I
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)
www.nccoastalmanagement.net Revised 10/05/01

GENERAL PERMIT COMPUTER FORM
d "
APPLICANT NAME: et Co rw M. . (Kos •
e�
ADDITIONAL NAMES: •
AEC DESIG: P '(' to DEVELOP AREA:_ 0 I PROJ DESC: P - (Z
•
(Will only take 6) (Will only take 1)
WORK: p
(Will only take 4)
TE I0%. zv
MAINT:
(Will only take 4)
IMP: O tk) 6 2.
(will only take 6)
W ZOO
ACTION EXPIRATION
DREDGE&FILL REQUIRED: 2 "(Z, -O 3 .5 -I 2-03
CAMA MAJOR DEVEL REQUIRED: Z" 12- 0 3 Jf " 12- o3

DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
. Name Of Individual Applying For Permit : j .
Address-Of Property: l'l0 POl4WI4 '/
{ renAnE 1 Ibis- ela4b ,4414,k Count` y
(Lot or Street #, Street or Road, City & County)
I hereby certify that I own property adjacent to the above-
referenced property. The individual applying for this permit has
described to me as shown on the attached drawing the development they are proposing. A descriptio
n or drawing, with dimensions
should be provided with this letter. '
I have no objections to this proposal .
•
If You have ob;ections to what is beinc Proposed . Please write the
Division. of Coastal Manacement . 127 Cardinal Drive Extension ,
Wi lminctcn Carolina .
. North 28405 Or call 91_ - 0 95 3 .,-3940 within 10
days of receipt of this notice. No response is considered the same
as no cb-iection i= you have been n notified by CertiF1Cd Mail
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boat"
house, lift must be set back a minimum distance -
m n-mum cr 15'
from my area of riparian access unless waived by (If
me. 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 i_ve
the 15'setback requirement.
•
4//t1211.4S4J /MAA .e �.C��� DateA - A
Pr�'n`a lei ,d4/VDLaic-z L- rime -.
Telephone Number With Area Code �I HN11

DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER. FORM
. Name Of Individual Applying For Permit: 60-0145 bA. j
Address' Of Property: cAuve
I.12/544. B Nr bV--u►46W►&t-CA.t1- 'Cs(
(Lot or Street #, Street or Pad, City & County)
I hereby certify that I own property adjacent to the above-
referenced property. 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 beep provided with this letter.
I have no objections to this proposal.
If you have objections to what is beinC Proposed . please write the
Division of Coastal Manacement . 127 Cardinal r
�y_1mnCL^n . North C''crOli.^. 28405Drive Extension,' i a or call 910 395-3900 within 10
days of receipt of this notice. No response is considered the same
as no cb iectjon if you have been notified by Certified Mail
w.IV=-. SECTION
I understand that a pier, dock, mooring pilings, breakwater, boat
house, lift must be set back 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
k requirement.
•gyp_ t - - o
Si•l-tve 3
Date
OarmNc. Chave nne- AIVA
Print Nam,e(CVO 433 3‘40% �.�.•
Telephone Number With Area Code �� �H � �`

I, GEORGE M. ROSE, CERTIFY THAT olleeeeei
' THIS MAP MEETS THE N.C. STANDARDS o�o,'`('NA CAR '',
- N OF PRACTICE AND THE ERROR OF oe•0.p ... �!os
CLOSURE IS 1:10,000 + (SEE NOTE
/ FOR REFERENCES), AND TAT THERE �� Q 0FES3�� '%���',Z Ma
a P6 le
ARE NO VISIBLE EASEMENTS OTHER ?:lj4' �(:�
m THAN THOSE ON THIS SURVEY. SEAL o ea
SITE s •
L-27?_9
e o
_ $r2 9E MILES `e • •, 911� kC¢' �5/
1 _ OCEAN BLVD WEST J coE ' E M. E °0�'' . SURNI.0.•Pj •
PRO'ESSIONA LAND SURVEYOR, L-2721 0�, ( /•.......,•..• Coo
ATLANTIC OCEAN 110'1 0E e' 9 \1
In ln
U 0
VICINITY MAP 4 4 a
o fi
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fL 0 1 EL V
ii
CANAL E
15' 15' -I
19 _� — 15' _-y PROPOSED
FLOATING I7OGK i T FLOATING POCK.
1 r—, I 11.1113
= Io x 20
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1=
FLATTED LINE + 5 OI°I,'00" IN50.00' ,I,'
S 00°I6'I4"E 49.9-1'
5.0'T '® EIS
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EXISTING F 0 O
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ANTHONY OHAVoNNE O
N/F JEFFRY GUNNINGHAM 1152132 Lo LONGLEAF DRIVE
410 DUNES DRIVE FAYETTEVILLE,No 25505 0
MYRTLE BEACH,SC 2.1512 E J Q
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rrrrr rr rr n TT rnrnrl MS 8 PG 13 RUBY BROADWELL TRUST
1 1 1 1 1 1 1 1 1 1 1 11 1 1111111 994 OCEAN BLVD WEST
IJ JJ111L.LJ1I1J1L1 Ill 120 DOLPHIN DRIVE HOLDEN BEACH,NG 25462
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N o0'1614"IN6 5 OI°Iq'Oo" W 50.00' EIS
EIS 400' TO OCEAN
•
DOLPHIN DRIVE BOULEVARD WEST---=-
OWNER: GEORGE ROSE BUILDER INC.
WIFE:
c1.I r I ,IclnKI. 11Aar_1".a A/CMG AAA ID WWII( 8 PACG IS

•
•
- _ os 3876
George M. Rose NCDL 2591548 ss sol
Ann 13. Rose NCDL 5804262
1206 Longleaf Thive 485-5592
Fayetteville,NC 28305 DATE
PAY TO THE � w��_
ORDER OF ------- -------
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