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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 1J-J ' //OO Y -Ai '/2iUd •
E Rules attached.
Applicant Name HA NSO J H#47-ci-/ z Project Location: County 8T 1 FUSW/(2,K
Address p,O, 20 ,�,3 / Street Address/State Road/Lot#(s) - 4.OT /l
City Off}y, 37S LietIV D State N e ZIP p�96,5 _ 6Gt) Ci` 54
Phone#( ) Fax#( ) Subdivision p/NN EiZ polAir Authorized Agent ( r rTh 1 Ce-k.)P 4 }-( , City OA-i ISL,4fiV,3 ZIP a pp
y,./„`Sf
Affected E CW SLEW J PTA *ES PTS Phone # ( ) River Basin .u w)$g re--
AEC(s): ❑OEA ❑HHF ❑IH ❑UBA N/A Adj.Wtr. Body DA /.S C-f4 iV A L. (nat g/unkn)
E PWS: ❑FC:
ORW: yes / no PNA yes / no Crit. Hab. yes / no Closest Maj.Wtr. Body ���W
Type of Project/Activity fJE(c) 13UC K //SAD /4 pig i n44 it_ MAZAit) H/67.Fl i LJA TE17.-
!V E:•-.1 l�/62 rot G.V Doti 14, 4A)D F-L 0 F1 A 1 r ?n 0 4- (Scale: War 70 )
Pier(dock)length 6
• ,
Platform(s) a I )C /y
Finger pier(s) G 1)c /a ! r14R7
Groin length
number
VA i a A Aill L
Bulkhead/Riprap length t �-y��
od avg distance offshore I d. )' /9 + colt pod e.`.
max distance offshore ) Z. X I t// 6)F .5 1 E
Basin,channel -'
I cr...1��--. /2. 0 0
cubic yards 6'
Boat ramp 1 3. IV-h J
l2'x t2 &,TUFT
Boathouse/(�
O
Beach Bulldozing vc-' )
Other — 1?
v) v
J �ry r�
Shoreline Length — _ 1 V 1220 i✓'D`�s' 60 et"(/'i 17(f% t D / Ac.'..Y/O/vP1 Eetrr fjLJ/L,�
SAV: not sure yes Rio 8�_-..,57`A��I) A-F�2..-- LO _11-`-5- LL4AR E.
Sandbags: not sure yes no ' v -
Moratorium: a yes no
Photos: yes no . .
Waiver Attached: yes no -y- .•.._l I
A building permit may be required by: Q/}-{! rSLAtuD . L See note on back regarding River Basin rules.
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Notes/Special Conditions SEC 4 &4[z 7 17/T/(/Y75 of - - ///do `I /zoo, A)0 or
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(17 k it.' -% 11 e.-C if A f-4 -t - -4-2.- .''',01(1,"'" .., Alf-t-----411.
Agent or Applicant Printed Name Permit Officer's Signature
Signature **Please read compliance statement on back of permit Issuing Date Expiration Date
pco , i:wHk 1 .. 7 .tip
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:
I I 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
3-2293 / I-888-4RCOAST Morehead City District Wilmington District
Fax: 91
Fax: 9I 9 733 I495 151-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: 9 I 0-350-2004
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 I 0/C

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nTVISsO\OF(NI&STALMANAGEMENT
• An1ArJ NT RIPARIAN PROPERTY Og A/TON8vAIV v FORM
Name Of Individual Applying For Permit H 4 Sa 1 id4fri,g r.
Address Of Property: .S'( / :2 9 PA. S* C xSL,h,4,
lot IL ALK a 79 Set. „Jr )
(Lot or Street I,Street or(toad,City&County)
I hereby certify that I own property adjacent to the above-referenced property. The individual
applying for this permit has described to'the as shown on the attached drawing the development
they are proposing. A description or drawing, with dimensions, should be provided with this
letter.' /
_ I have no objections to this proposal.
If you have objectinns to what is being proposed please s i. the Division of Coastal
Management. 127 North Cardinal Drives Wilminrtpn,North Carr._i;n ptfpc or rs11 91019S-
1Q0f1 within Ways ofrer.ipt of*lie wrier No response is consideneLthr sarne nn nhiretin
if you have hen notified by Certified Mail n
WATVF'R SR('TfAN
I understand that a pier,dock,mooring pilings;breakwater,boat house,lift or e
set back a minimum dicta=of 15'from myarea ofd by mc. must u
wish to waive the setback, access unless waived by me. (If you
you must initial the appropriate blank below.)
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1 I do wish to waive the 15'setback requirement.
I dn.=wish to waive the 15'setback requirement.
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SHORELINE
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MARINE CONSTRUCTION 67-7235/2532
GREG PREVATTE �'
P•O. BOX 10671 3258000872 18 6 8
SOUTHPORT,
NC 28461
3 PAY TO THE
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ORDER OF 41
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