31058D - Kelly

erCAMA / DREDGE & FILL Ni: 31058--D
GEWERAL PERMIT Previous permit #
> Z :_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 7+\ • 12-UV .
x,Rules attached.
Applicant Name 1(',„ -A_ T. kijrp U Project Location: County r1 f 0, sf,,J, L.I'`..
Address 114 6 O w`i�(14e--�C .5��� 1 Street Address/State Road/ Lot#(s) " 2_
City G\k"...S'E''A State GA_ZIP30'10(1 Li c A->,,k.)
Phone#(10(0)/J1(O-fat02[D Fax#(jjp)"nu-Cor?4-°[ Subdivision
Authorized Agent L\S A V tre A r \ City Hu l d -1?:)E'-1 c r\ ZIP
Affected CI CW KEW "(PTA ❑ES ❑PTS Phone # ( )_ River Basin Lu m ..r 6e
❑OEA ❑HHF ❑IH ❑UBA ❑N/A
AEC(s): Adj. Wtr. Body -_C riff (not man /unkn)
❑PWS: ❑FC: p ,• ' , j
ORW: yes / no PNA yes I t�o Crit.Hab. yes r no Closest Maj.Wtr. Body _ _R I ul.!
Type of Project/Activity \\JJ �....'►c'�
YP 1 Unc Uve,,r�c� �aA'�"
(Scale: NOT T )
Pier(dock)length
Platform(s) I7j t,Sj-;r• Oft }
Finger pier(s) �� 11 -1
Groin length ---- I -
number f
:
Bulkhead/Riprap length I I. j
avg distance offshore
max distance offshore i
Basin,channel
i
cubic yards .--_}_.� --
Boat ramp _ _
Boathouse oatlift \. ..141 i A_
Beach Bulldozing . i - — Ili 1 L►F,
Other
I
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Shoreline Length 5 0 i 10• 16-0
SAV: not sure yes .C.SLt`- + ___.. •
Sandbags: not sure yes (no ' - ,
Moratorium: �n/a yes no - '--
Photos: yes no
Waiver Attached: e no I w LOT. _ - . .C iir c.1'c if i htr 1t ,...5 hL,re.11{1CJ
S I p1
A building permit may be required by: flo ld C-n Qif1 C Li See note on back regarding River Basin rules. 11.•-
Notes/Special Conditions �Q r' 3VE..i too R+ r1e.,psi,5 of--, Op k f'c _-' Sid ci/ �,,,,.,i s Uc- c'io t
* A Ii'P1 , ,;\uw\ m 2 hnM. . jv11%v1 \IeJ ter-d ) 1+ �-I'uck-ult.J
ae.e../ 14 C.o,nd'il-1,0ns o . ecJ-4 0r\ 1+1 , 12-00
Li SA YPrf-NPdY1 //� onc + 1
Agent or Applicant Printed Name Permit Officer's Signature
-,�.,-"� v' "� V�;t, Tc F c i 19 , ;tQL a. J nC.1 1 9 t UZ-
Signature **Please read compliance statement on back of permit** Issuing Date Expiration Date
- 4 (i 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:
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 252-946-648 I
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 I0/05/01

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DIVISION OE COASTAL MANkCEMgN'r
. ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
•
Name Of Individual Applying For Permit: t t--�-1,l z.� S _ iCLSLL J
Address Of Property: ! I Lf o S PA-4".1 \UtL
& --. , AL e . 6 U(,W s IAA 01
(Lot or Street #, 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.
. ri • .
I have no objections to this proposal .
If you have objections to what is _being proposed, please write the,
Division of. Coastal Management, 127 Cardinal Drive Extension.
Wilmington, North Carolina . 28405 or call 910 395-3900 within 10 .
• days of receipt of this no_tic-e_._No_response isconsidered the same'
as no objection. if youJiave been ,notified by CertifiedMail • '
•
—. _ _
wavER stCTION -
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. )
' 9e-2 : - .
I do wish to waive the 15'setback requirement.
I do not wish to waive the 15'setback requirement..
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Signatur / • Date ArArA•
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Telephone Number With Area Code .

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86 VARNAMTOWN RD SW .',,X .V,,,*‘://‘,../,/,‘../,`,,/,,<\: ..,
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BB&T..„.t,'1\, ,,..../• . BRANCH BANKING AND TRUST COMPANY
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