31804D - Odom

CAMA / DREDGE & FILL 1�?. 3i804
- 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 r' 0 . 0 or
L.Rules attached.
Applicant Name PI,U . 0 d O 1 Project Location: County 3 r N IN S tA. '1 G k"---
Address �`U 7_, (.j ?or“-. DLO i G" st t t L'E-. Street Address/State Road/Lot#(s) 5 U -7
City Su.r`V .T AAc 'L State ^k./ZIP 8 . jury `S1-orC'J Tr , uc
Phone# ('it )-"1ck- 2Ie1 V Fax#( ) Subdivision
Authorized Agent \1( t.y-A.-, P e City SIJIr\St_.-T >>)P.(1 C le. ZIP .9t j q(1
Affected ACW $EW ``§ PTA ❑ES L PTS Phone # ( ) River Basin Lu'f"1 VI �
❑OEA ❑HHF ❑_IH ❑UBA C N/A
AEC(s): Adj.Wtr. Body '' A 0(,..J L.4 -e 4— (nat /man /unkn)
❑ PWS: FC:
ORW: yes / no PNA 'yes, / no Crit. Hab. yes / no Closest Maj. Wtr. Body FYI W
Type of Project/Activity F'e..�1Ar� dee v.,, o,-,c. xtS`t t_n. 91 e�' 1 [' A l,l C E_.,, T,/ p1A�4 i`u f (y1
,I' `( 1 I ir-r C\ P1 c1 cA ')(.. 11- -C l U fi i(\S C)o t:L. (Scale: NUT TC- )
Pier(dock)length
Platform(s) G' IC 1._ { v w.cl
Finger pier(s) ,`21,4 1 N. i (o PI i
Groin length t ,qLF T
number
Bulkhead/Riprap length
avg distance offshorei
max distance offshore —I
Basin,channel
J A
i j
cubic yards .5.1 Y r/ aw ,�
Boat ramp '-'--•j ! r j y" is
/�
Boathouse/Boatlift_ ,` � ' V it
(
!('' ) `
f
Beach Bulldozing _ �,t; 1I V / tt :,� �4 ; L
Other M �.
- tom 1
Shoreline Length .- _ { .17 v. r V \
•
SAV: not sure yes "no • 1 - -- - - - -- - -- - ------ --
Sandbags: V -�{. -
Sandbags: not sure yes no •';(�1' i V Y
Moratorium: n/a y es no / Lfi
Photos: .....1yes (nod • _
Waiver Attached: 1 ryes '., �\noo ^�- - - I —
A building permit may be required{by: St,�f\Se T 11c^f1c-k j '1 L See note on rback regarding River Basin runes.
Notes/Special Conditions `1t�A k M�n n Vi- €- x«'-r'c i I 'Er1l -%',r c G'te( T !ail ` . ,
,/ '- ::..A -or '-= - ..z.,.C__O -- .
Agent or Applicant Prin//f Name �J , Permit Officer's Signature e)
Signature **'Please read compliance statement on back of permit** Issuing Date Expiration Date
1 t n t
``ti..t V',Ch� C bC. \C 1 p
O -' . ;
Application Fee(s) Check# Local PlanningJurisdiction 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:
L_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 252-946-6481
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] 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

GEN.ERALTERVELT COMPUTER FORM
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ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/UNCOVERED BOAT LIFT)
ImoI,,�,,
I hereby certify that I own property adjacent to4.77- ittE .d7�- 's
(Name of Property Owner)
property located at 02 . -- a
(Lot, Block, Road, etc.)
on n3E..- ,
(Waterbody) (Town and/or County) ,2 fy4,7
He has described to me, as shown below, the development he is proposing at that
location, and, I have no objections to his proposal. I understand that a pier/uncovered boat lift
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 the setback requirement.
I do wish to waive that setback requirement.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
5771-/10-8
1/3"
•
-216 �'Lofri,T
gnature
Print or Type Name
7/71-> 7it- 3?? - Z77/
Telephone Number
Date: Z1 5 2,

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/UNCOVERED BOAT LIFT)
I hereby certify that I own property adjacent to /9Z— a Sc 's-
(Name of Property Owner)
property located at £ ©�
(Lot, Block, Road, etc.)
on ,&4 5 , �7- g , N.C.
(Waterbody) (Town an or County) P" 7
He has described to me, as shown below, the development he is proposing at that
location, and, I have no objections to his proposal. I understand that a pier/uncovered boat lift
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 the setback requirement.
I do wish to waive that setback requirement.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
4
1222,//� ExeSr/ i
S UAL z T '7 ' 24,-/cp71/
c �GoIT
Signature
Print or Type Name
to41- 3 -- 47Z8
Telephone Number
Date: c=55 - G

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