31095D - Montgomery

0 CAMA / DREDGE & FILL .. N2. 310951
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 9 j• , 12)0 .
E Rules attached.
Applicant Name Jkt-.4JPrr+ 1'1')U I Ayrne".r l+ Project Location: County ID( �nst,j, CL.
Address es 20o N . 1( (t I v\ Ou(...(I(xl L. Street Address/State Road/ Lot #(s) - 11(p
City I )'‘\rv,,, 11 r,-I C%e--, State l\,lC_,) ZIP c;8'I( :? *, ,5 4, -
Phone# ( ) Fax#( ) - Subdivision
Authorized Agent Te• (c,1•'%c„ '1 \\( s City -\40,d b€,c c kr. ZIP
CW XEW 'I'PTA ES PTS Phone # ( ) River Basin LIA r(N6e--.r
Affected
__OEA ❑HHF ❑IH UBA N/A '�
AEC(s): Adj.Wtr. Body (\f‘ , (nat man unkn)
❑ PWS: ❑FC:
ORW: yes /(o\ PNA yes /%fio Crit. Hab. yes / no Closest Maj.Wtr. Body- 1.--) fit)
Type of Project/Activity K1C v._) `j 4_( er,,c1
(Scale: )
Pier(dock)length _ 35•t
Platform(s) `R*I:1‘ ,L ('} , ,� \
Finger pier(s) t\•/1 rn
Groin length
number ---'- -
Bulkhead/Riprap length I
avg distance offshore
max distance offshore
Basin,channel ----__ - -- — — — —
cubic yards
.-
Boat ramp T---i--
Boathouse/Boatlift -" � 1 lia?\ 6.: N Ct`c Ci .
.=111111
.1.
Beach BulldozingNt. ' v \ i v r__ _IIMIIIMIS
`r- 3 d kr f .4'4 !V MIME
Other -Y ., b r I - 'd I -'-,,
Shoreline Length -U 1 1 , `• Y . 5 6� M * T 4 i'C� `Y
SAV: not sure yes no
Sandbags: not sure yes no ' ' '
Moratorium: n/a yes no j
Photos: yes no i + -•
Waiver Attached: yes no 0-- I ___ _ yam I f �----
A building permit may be required by: u,6 J,(\ bc, C k . L See note on back regarding River Basin rules.
Notes/Special Conditions + `
' (NA 1 ,,,, r\ S c, , 14-` . l 2 U)
\ i r ._ t.....,-P\ / . ._. ...‘in k..,,a-Q-a) -I
Agent or Applicant Printed Name i P it Officer's Signature
- \..2 - 0"1. r?— i 2 - C) .2—
Signature **Please read compliance statement on back of permit* Issuing Date Expiration Date
Application Fee(s) Check# Local Planning Jurisdiction Rover File Name

I
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:
I 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(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
2728 Capital Blvd. Dare,Gates, Pasquotank and Perquimans Tyrrell and Washington Counties)
Counties)
Raleigh, NC 27604
9I9 733 2293 / 1 888 4RCOAST Morehead City District Wilmington District
Fax: 919 733 I495 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

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ADDITIONAL NAMES:
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SENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY
:. Complete items 1,2,and 3.Also complete .. SI .ature ,
Item
411 Restricted Delivery is desired. ' . 1 Or Agent .
• X Print your name and address on the reverse
0 Addressee
Aim _sotiat vVe can return the aid to yoU. •
e Pinta e) C. Date of Delivery
• Attach thle card c
to the back of the mailpiece, ceived by(
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or on the front if space permits:
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.. is delivery address different from Item 1? El Yes
1. Article Addressed to: • - .- If YE ,enter delivery address belo*: 0 No
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3. Service Type
, a ' X Certified Mail 0 Express Mall
3 V,V 3 S- t. El Registered 0 Return Receipt for Merchandise
0 Insured Mall El C.O.D.
4. Restricted Delivery?(Extra Fee) LI Yes
,
2. Article Number ..n_.;. i e.—,.1(Transfet frorniseivicdthtieig i i i/C)042 i i'1 aia50 iPPAP D
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PS Form 3811,August 2001 .., • Dornpi'l'tic Return Receipt .
102595-01-M-2509
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. .

DIVISION OF COASTAL MANAGEMENT .
AD.TACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WATVER. FORM
Name Of Individual applying For :Permit::. Tew -, '• e
o v►1e ds`i
Address: Of .Property k�(o I �.., I 1S I o c
- . � Ito e ry '' .� C�a NC
(Lot or Street 01; 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.
I have no objections to this proposal.
If you have obiections to what is being nron osed leas write the
pivision of Coastal Management, 127 Cardinal Drive Extension ,
Wilmincrton, North Carolina. 28405 or call 910 395-39Oo within 10
days of 'receipt of this notice. No'resnorlse is considered the sane
as no obiecti,on if You have been notified by Certified Mail ,
WAIyER fECTTON
S, understand that a pier, dock, mooring pilings, breakwater, boat.
house, lift must be sat back a minimum distance of .15'
from my area of riparian access, unless' waived by me. (If you wish
to
below waive the setback, you must initial the appropriate blank
•
. / I do' wish to waive the 15{setback 'requirement, •
I do not wish to waive the 15'setback requirement.
•
(da ` _ 03 -Z oz-
Signature Date Art4
o a
AAerr-e=?,Print Name - ------
/6f P67 /s's, . - d)I--IN l
Telephone Number With Area Coda .

6103
SEA CASTLES, INC. BANK OF AMERICA
128 OCEAN BLVD.WEST 02992 NNC f
HOLDEN BEACH,NC 28462 66-19-530 L/ 1 2 _0 Z
11
PAY TO THE E N R. ��ORDER OF I $ , DQ
OINO, Si6k4A4k.12.0 00 1 00 e
DOLLARS -3
2
MEMO 1 I`2 c6Cai epow, vo\s'(,.,,A _ ( .5V.dU 3-'
06006 L031• 1:0 5 3000 1961: 000 u■
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