32555D - Simmons

0 CAMA/ J DREDGE & FILL '�� '; 32555 J
GENERAL PERMIT Previous permit #
)C -- 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 15A NCAC ')-}-1 , 12 0 L .
Rules attached.
Applicant Namee Q G .s% N1 rTho 0 s Project Location: County f&h 5 .) t C .--•
Address .59 v t IF e..1
SA--( .t Street Address/State Road/Lot#(s) ` 3 I j
City State _.;ICE ZIP a? ?&. 014 - c!'dfr( LA''dr r5 Tee,tA..a
Phone#(-lIr1) 2T1)•C1(. -1(c Fax # ( ) Subdivision
Authorized Agent 3.-fi\A Si fr1ITN v{\S City \)1hi)P\ -\ ZIP
2-�34(0Z
Affected &CW )$,EW )(PTA ❑ES ❑PTS Phone # ( ) River Basin L u• b
s ; ❑OEA IDHHF ❑IH ❑UBA ❑N/A
AEC Adj.Wtr. Body � kJ- -�❑PWS: C FC: {not l=J/unkn)
ORW: yes /(io PNA /©o JM'writ. Flab. yes / no Closest Maj.Wtr. Body ilr_ vJ
Type of Project/Activity NeivJ PS e-C, CA U( -- , pine t toA'['r) d o
(Scale: J c T "TB )
Pier(dock)length 100' .
Platform(s) MIX 1 J V",�IPt:Vi- r —___ . t__ . I I _. ,
Finger piers) -A... I O C i on,- i
! 1 . _
Groin length ( i 1
number i f
t : — >
Bulkhead/Riprap length — -1 { L 1 10 I -. < - > e t I _ I
avgdistance offshore
max distance offshore t . `
I
` S
Basin,channel 1 1l' I —t--- y" '
— } 1
._._
cubic yards
Boat ramp —1-1 } 1 ..I t.... i
I
Boathouse/Boatlift i I f f
I
_ _-. , -} } --i 1 i
—1
Beach Bulldozing i - V V v V r i Y
Other y :V -- ' - t
Y
y `tom V : - V �,y i ll ". 1
Shoreline Length 531 Y �j f V �! �/ �- �( l v v dt • l
• Y lts `,/ V —
SAV: not sure yes �..J V '� 9 �' '
Sandbags: not sure yes n• i 1
c ( i i
es
Moratorium: n/a
y Alt : S 3' . u c�C Styr e 1',nc. -
Photos: yes m
Waiver Attached: yes no J. i
A building permit may be required by: �`U.(\Sly‘Cik- C Q Uvv\`-4- p v�. H See note on back regarding River Basin rules.
Notes/Special Conditions (3QC�S MUSA ' fie
Pe-4 - & ' Sei t r tYoM +e_ edc e
cc + re., F 1 vs)uJ 1ri nu i fl 1 so bL i' or-c o( e.f\c I,-. C i Pf ,rn I I n e_.
6e2 A \\ c u r\r-V -k .\u of `Y'c i • tv-\ 71' • 12 oo
sip -------\G . • ‘,4,.1--\orN c) '0'1
Agent or Applicaht Printed Dame i Permit O ter's Signature
_ j j I or V U V\A rc..i.. I2,.1-('t)
Signature Please readcplian statement on back of permit* Issuing Date Expiration Date
1000 ,, _ Er U 1. SliltiLk-- l' 1 -j 2}r1 F \
Application Fee(s) Check# Local Planning Jurisdiction Rover File Name
!w""Wiaa 00---r-,.,..r`xra"tit+.neahay*:ir�.iidir r ..,,.. - - -. '-iirrb.irc=- 4. -..........,, - -----

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:
j 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(252-946-648 I)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 252-946-648 I
Location: Fax: [phone] Fax: [phone]
Parker Lincoln Building (Serves:Camden,Chowan,Currituck, (Serves: Beaufort, Bertie, Hertford,Hyde,
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 9 I 0-395-3900
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 10/05/01
www.nccoastalmanagement.net

GENERAL PERMIT COMPUTER FORM
APPLICANT NAME: J A1.1 G- , 51 m w,o n5
ADDITIONAL NAMES:
AEC DESIG: P T DEVELOP AREA: .0 2- PROJ DESC: T- 12 •
(Will only take 6) ---- (Will only take 1)
•
WORK: P I (x l u0' E. 1_ IC'
•
(Will only take 4)
TE 1Dx I
MAINT:
(Will only take 4)
•
IMP: 0 J (coo ow 80
(will only take 6)
D 1.0E�O `
ACTION EXPIRATION
DREDGE&FILL REQUIRED: I,Z-12.-U 2 _ 3-12--03
CAMA MAJOR DEVEL REQUIRED: 12- 1 a-02- 3- 12-0

.ENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY
■ Complete items 1,2, and 3.Also complete A. Sign.
item 4 if Restricted Delivery is desired. '1 �/��/•• t
■ print your name and address on the reverse X % It� `.:L.0.• - e
so that we can return the card to you. •-ceived by(Printeedd Name C. D.te of Deliver
•'Attach this card to the back of the mailpiece, 1 1
or on the front if space permits. r1 . )
D. Is delivery address different from item 1? ❑ Yes
1. Article Addressed to: If YES,enter delivery address below: 0 No
Z-Alicithly31'tt 1. --Yr_
I �401(� Cht (IPR
CN� 3. Service Type
I , �IJJ ❑ CertiTied Mail ❑ Express Mail
___)LAVl epl , ❑ Registered 0 Return Receipt for Merchandis4
❑ Insured Mail 0 C.O.D.
4. Restricted Delivery?(Extra Fee) ❑ Yes
?. Article Number 7001 1140 0002 0722 0227
(Transfer from sen..-,
'S Form 3811,August 2001 Domestic Return Receipt 102595-02-M-15

UNITED STATES POSTAL SERVICE First-Class Mail
11 Postage& Fees Paid
USPS
Permit No. G-10
•
• Sender: Please print your name, address, and ZIP+4 in this box •
(f; . j1TrnaflS
'39 01 C6 CCE)
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.
` Intracoastal Waterway
15' — I d*:.(. 10' .�,tt•i.•4. 51 41 8' 4 ; le41 , 1�:�,,.;,•.,1_ ;:1wyS tlooting ' C
.Dock e}1''•� R { o...F.
a °' �V' .,,,is limp 7;5 cock
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r R om. J Owners Address:
1.4 I n. 1a G.Simmons
Pir5909 Co(fey Street`td, yp Raleigh,NC 27604
�a'd: (919] 291-96%
f3 w�, •
0 ll'
Shoreline 53.34'
•
•
Jay G. Simmons Dock Plan
1371 Cedar Landing Road
Supply North Carolina
Z0 `�
� Y ��'�V''�') sign to acknowledge that I have
seen the above Dock plan for Jay 6_ Simmons(Neighbor), and it has
no encroachment on my property_
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THIS NOTE IS LEGALTENDRR �.Y ��
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FOR ALL DEWS.PUBLIC AND PRIVATE LI p
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