Smith, Isaiah 78359C

❑CAFE
/ ❑DREDGE & FILL N° 78359 A B D
GERAL PERMIT Previous permit#
❑NewModification ❑Complete Reissue ❑Partial Reissue Date previous permit issued
AZ authorized by the State of North Carolina, Department of Environmental Quality
and the Coastal Resources Commission an area o environmental concern pursuant to I SA NCAC ¢f
/� Rules a ched.
Applicant Name :Tie_ I r ✓� t ` Project Location: County. C r�
Address (/ C G�� JJ IA Street Address/ Sta a oad/ Lot #(s)
City �e* U °" , T J i� Statge u ZI RP J V / C �7 / i r� N /
Phone # ()
E-Mail
Authorized Agent
�A^
DCW
5iEW`_,,PwrA ❑ES ❑PTs
Affected
AEC(s): 0 OEA
❑ HHF ❑ IH ❑ UBA ❑ WA
❑ PWS:
ORW:% yes /)no PNA/ yes// no
Type of Project/ Activity
Pier (dock) length
Fixed Platform(s)
Floating Platform(s) T
Finger pier(s)
Groin length
number
Bulkhead/ Riprap length
"avg distance offshore
max distance offshore
Basin, channel
cubic yards
Boat ramp
BoAkhouse/ Boadift
i
Beach Bulldozing�
Other
Shoreline Length �)-
SAV: not sure yes
Moratorium: n/a yes
Photos: yes
Waiver Attached: yes
A building permit may be required by:
( Note Local Planning jurisdiction)
Notes/ Special Conditions
or
City C r, ZIP
Phone # ( ) River1
Adj. Wtr. Body
Closest Maj. Wtr. Body
V
❑ See note on back regarding River Basin rules.
Signa '** Please read compliance statement on back of permit•
Aoollcation Fee(s) Check #

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 ❑
❑ 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 Resources. Contact the Division of Water Resources at the Washington Regional Office (252-946-6481) or the
Wilmington Regional Office (910-796-7215) for more information on howto complywith these buffer rules.
Division of Coastal Management Offices
Morehead City Headquarters
400 Commerce Ave
Morehead City, NC 28557
252-808-2808/1-888ARCOAST
Fax: [phone]
(Serves: Carteret, Craven, Onslow -
North of New River Inlet- and Pamlico
Counties)
Elizabeth City District
401 S. Griffin St.
Ste. 300
Elizabeth City, NC 27909
252-264-3901
Fax:[phone]
(Serves: Camden, Chowan, Currituck,
Dare, Gates, Pasquotank and Perquimans
Counties)
Washington District
943 Washington Square Mall
Washington, NC 27889
252-946-6481
Fax: [phone]
(Serves: Beaufort, Bartle, Hertford, Hyde,
Tyrrell and Washington Counties)
Wilmington District
127 Cardinal Drive Ext.
Wilmington, NC 28405-3845
910-796-7215
Fax:[phone]
(Serves: Brunswick, New Hanover,
Onslow - South of New River Inlet -
and Pander Counties)
httP:Hportal.ncdenr.org/web/cm/dcm-home
Revised 7/06/ 17

AGENCY AUTHORIZATION
I, Isaiah L. Smith, Owner, do hereby authorize Gary Mitchell and/or Don Quinn to act as my
agent in any and all transactions, communications and interactions, as deemed necessary, with
all federal and state regulatory agencies regarding the property located at 2926 Cedar Island
Rd, Cedar Island in Carteret County, North Carolina and as describe in the Carteret County GIS
PIN 840602554005000.
Signed: "�'....
A
Date: �

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to Isaiah L. Smith s
(Name of Property Owner)
property located at 2962 Cedar Island Rd
(Address, Lot, Block, Road, etc,)
on Cedar Island Bay in Cedar Island N.C.
(Waterbody) (Cityrrown andlor County)
The applicant has described to me, as shown below, the development proposed at the above
to
I have no objection to this proposal.
1 have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(individual proposing development must fill in description below or attach a site drawing)
(See attached drawing for maintenance of existing boat basin and channel.)
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boathouse, lift, or groin 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 requirement.
(Property Owner Information)
.. ..
Signature
Isaiah L. Smith
Print or Type Name
2963 Cedar Island Rd
Mailing Address
Cedar Island, NC 28520
City/state2ip
TelephoneILL M
-ry
Date
(Adjacent Property Owner Infortation)
Telephof�1 ne I r
Dare
(Revised 6/18/2012)

ADJACENT RtPAR1AN PRbpER7Y OWNER STATEMENT
I hereby certify that I own property adjacent to Isaiah L. Smith 's
(Name of Property Owner)
property located at
, N.C.
on Cedar Island Bay in Cedar Island
(Waterbody) (City/Town and/or County)
The applicant has described to me, as shown below, the development proposed at the above
location,
a/ I have no objection to this proposal.
I have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(Individual proposing development must fill in description below or attach a site drawing)
(See attached drawing for maintenance of existing boat basin and channel.)
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boathouse, lift, or groin 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,)
*4-1 1 do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(Property Owner Information)
(Adjacent Property Owner information)
Signature
Signature
Isaiah L. Smith
Bernard Harris
Print or Type Name
Print or Type Name
2963 Cedar Island Rd
3813 Horseshoe Rd
Mailing Address
Mailing Address
Cedar Island. NC 28520
New Bern NC 28562
Cf S teFZi
City/State2ip
Telephone Number
Telephone Number
r (�
I
'T�7
Date
/1�
Date
(Revised 611812012)

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