31838D - Carlson

CAMA / DREDGE & FILL Na 3A03$-r
GENERAL PERMIT Previous permit# if,��,
New Modification Complete Reissue Partial Reissue Date previous permit issued ,n,l
fs 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 ' r 2 C)C..)
C Rules attached.
Applicant Name . .l at S( h O. L 'x)(-) Project Location: County ki e.V✓ HO-AA 0 b``6'\
Address IJI NF r p t U C. Street Address/State Road/Lot#(s)
City ..k) 1 L 111 16,C;i Zi ►\J State f VC ZIP ?2;`i i 5
Phone' ( l Iu) (52 V -(,0 ("-Faxn#( ) Subdivision f ( ).0.(..44 L FtellAQ e f4et y L' - 1�
Authorized Agent C kAa % �J1th C Ve_y IAA_(� City ( L Y� ) ZIP 2 Ss \-( I calk'I
Cw 9EW Cl TA i S L PTS Phone # ( "-"—"- River Basin �'t�_�Q
Affected OEA ❑HHF ❑IH ❑UBA N/A 1
AEC(s): Adj.Wtr. Body ► a h 6)(i (lily 111.o it (nat man unkn)
PWS: ❑FC:
ORW: yes / r. . PNA yes no Crit. Hab. yes / n Closest Maj.Wtr. Body I w w
Type of Project/Activity
-l- (Scale: )
Pier(dock)length �Q/t .f r Iw'w
Platform(s) 10 f
Finger piers) S f X 1.0
Groin length -
number -
Bulkhead/Riprap length i I . . . ! • __
avg distance offshore
max distance offshore
Basin,channel -_
cubic yards
Boat ramp
e a HO C Ikt i N.)
Boathouse/iBoatlift) t S XI2
Beach Bulldozing
Other 2 X t - S vol ,
01 '71 vv‘ H--fHH -
- . . . . .
Shoreline Length --°,hi)
SAV: not sure yes Co }
Sandbags: not sure yes �o ' 1 I
Moratorium: n/a yes no
Photos: yes no
Waiver Attached: yes C ' ' ,,I 1• `
A building permit may be required by: N - I �� 1 n•- 'V 1— See note on back regarding River Basin rules.
Notes/Special Conditions
i-1`q f?1,_i1 s k • t, ,z.,z b4=Ci< 1-12 LL_. rC� "
Agent or Applicant Printed Name Permit Officer's Signature
(....-\\::\
\ J c, -- , - Q Z- I 1 -( VI _ 0s-
Signture 'N"s Please read compliance statement on back of permit Issuing Date Expiration Date
1/ ' 1 0 C !t- (--- (,_ _C--4\-t t_.\( e.A. :-) (e i INI1 e W 4(0005\0, -. EDC 5 I zi I M
Application Fee(s) Check# Local Planning jurisdiction Rover File Name

a
IJ
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 252-264-3901 252-946-648I
Location: Fax: [phone] Fax: [phone]
(Serves:Camden,Chowan,Currituck, (Serves: Beaufort, Bertie, Hertford, Hyde,
Parker Lincoln Building
2728 Capital Blvd. Dare,Gates, Pasquotank and Perquimans Tyrrell and Washington Counties)
Counties)
Raleigh, NC 27604
9I 9 733 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)
Revised 10/C

GENERAL PERMIT COMPUTER FORM
APPLICANT NAME: C.trk Qt S SE>t)
ADDITIONAL NAMES: OAAAc3 ' 66-di "l
CW Ei1 PTA,ES
AEC DESIG: EVELOP AREA: is PROJ DESC:
70 ' Fs 71 20 ) 8L t21Sj 0
12- T al8
WORK: t R J
MAINT:
IMP: 1%1\ 5SOv Off. g
I
ACTION EXPIRATION
DREDGE &FILL REQUIRED: ►'—^
CAMA MAJOR DEVEL REQUIRED: l k

2-1 a3Bed i u= iay., .,J.I. I•..ice W....,- ...�.. ..... _ .
_Ju1 10 02 09:00a p=. i
f`
•
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER- FORM
•
Name Of Individual Applying For Permit: C+(tis Cm-as-0 l(
Address Of Property: '--P'Ne_-A (oLd E)
i��tNCkTb 1 N iP'J. ft-NoYE
(Lot or Street t, 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 description or drawing, with dimensions,
• should be provided with this letter.
C. I have no objections to this proposal. .
•
If you have objections to what is beina oronosed,-_please write the
Division- of Coastal]. "Manaaement;- 127" Cardinal D i e_Extension.
• Wilmington, North Carolina . 28405 or call 910" 395-3900 -within 10 .
days of receipt of this notice. No response is considered the same
as no abiection if you have been--notified by Certified Mail
- WAIVER SECTION
I understand that a pier, dock, mooring pilings, .breakwater, boat
house, lift or sandbags 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.
_.._.. At
• ..� fd �
• - (211aL ' • (9104 um
y\I
(1444-) ._ .
liarir
Armature nature _. Date . • = _
g lie,
print Name
- Telephone Number With Area Code - .
_ --. �.,,...a T.,.a Tom., . cr,e., 4 WAGE:1-1

Troneadvertising Inc. p.o. box 35565
greensboro,nc 27425-5565
tel [phone]
fax [phone]
park avenue atrium
237 park avenue,21st floor
new york,ny 10017
tel [phone]
fax [phone]

" Jul 10 02 09:09a p. l
. _
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVES_ F''ORM
'Name Of Individual Applying For Permit: CHS elqk LSZW
Address Of Property: 'Pj NF --Pica-. (6(d k6I $e)
- l tmf NC ri - Ni C ,•7-$`H �f W { OVER
(Lot or Street , Streeet 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 description or drawing, with dimensions,
should be provided with this letter.
,s I. have no objections to this proposal.
If you have objections to what is being nro0osedc- please write the •
Di ' .o of Coasts anaae ant ' 127 Cardinal D ive Extension,
Wilmincton, North Carolina, 28405 or call 910 395-3900 yithin 10
days of receipt of this notice. No restonse is considered the same
_ as no obiection if you have been-notified by Certified Mail •
•
WAIVER SECTION
I understand that a pier, dock, mooring pilings, .breakwater, boat
house, lift or sandbags must be set back a minimum distance of 157
-from any area of riparian access unless waived by me. .(If you wish •
to waive .the setback, you must. Initial the appropriate blank
below. )
•
• M ♦ -
�,,,yy
I .do wish to waive the 151setback requirement.
✓At45 I do not wish to waive the 15'setback requirement.
. t91Q1
•
•
. A
- e/JAW•t ... 37Leget--- 7/14
PCIFA . . , .
P
ature Bate s
Print Name - • �r.
Iri-Divic-.- i NA
• Telephone Number With Area 6ode -
_11 A -1Gt-=12(CJ I.FCTI M IRO.0 O I Tn.i Ton ~tirem►I __� _

Troneadvertising inc.
p.o.box 35565
greensboro,nc 27425-5565
tel [phone]
fax [phone]
park avenue atrium
237 park avenue,21st floor
new york, ny 10017
tel [phone]
fax [phone]

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