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0 CAMA / DREDGE & FILL N9 30361-1.)
GENERAL PERMIT
C 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 15A NCAC ,4 /„)0 .
,Rules attached.
Applicant Name C >MYve R f dvYl A N Project Location: County 0 fv 5 i U`^J
Address 1 Lip( Z Jv I' k Street Address/State Road/Lot#(s) r 01
City _- (c-1&izo R u State M' ZIP D 3 v igi G4 CAA y j- I/V e /j
Phone # (+ /y) b fj-060 Fax#( ) Subdivision PA--&-es z L S ' o . A_ /2-4)
Authorized Agent &LA , r\ (o, AAA 6 ( f\-9 City �j � c a y ZIP :.)6 G
Cw i.,EW si,rfA ES C PTS Phone # ( ) _ River Basin 409 (I ':
Affected
AEC(s): OEA HHF CI IH UBA - N/A Adj. Wtr. Body ►l �iat�man /unkn)
E PWS: ❑FC: (�
r., Closest Maj.Wtr. Body .3 w t^-'
ORW: ae no PNA yes / no Crit. Flab. yes / no
Type of Project/Activity A0A I L,r I-I ftbr--. un. '--ro 1�XIS-71,n 6. a oc IL
(Scale: / 3o )
Pier(dock)length T
Platform(s) PS_.
Finger pier(s)
Groin length
number -_
Bulkhead/Riprap length _ - o' Q,
avg distance offshore _ L k T
max distance offshore _
D. C): -'----
Basin,channel —_--
I
cubic yards _
Boat ramp
Boathous oadift, Imo] yI- I . ._ ___ .
- t I - -- _ -ti �.�"
Beach Bulldozing-____ __ __ _ -_-- i i�
Other 1( _
4
i y • ,
Shoreline Length - — -1,f
SAV: not sure yes (62.
Sandbags: not sure yes n) - ' 1--_I_ i i i ~�
Moratorium: n/a yes no I S-ee e,A k
Photos: yes no
Waiver Attached: _
yes
no _ — — -
A building permit may be required by: (1tV SJ O-J .( 0 . I i See note on back regarding River Basin rules,
Notes/Special Conditions '5 ( L.r t 1 Ari-d) D - (t us(,.-I Y1 eel- (4,S ' illifiv (CiY1 PS 0/
r3,r•eePI SfthA'ti& or-i- ww C IANAE'
. r
Agent or Applicant Printed Name ermitcer'sSignature
(-/- /K- v-)- D7-iei--- G. —
Signature **Please read compliance statement on back of permit** Issuing Date Expiration Date
c) �j Jib ��}
LocalPlannin urisdiction Rover File Name
Application Fee(s) f�C d Check# 2j5 3 g)
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 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 252-946-648I
Location: Fax: 252-264-3723 Fax: 252-948-0478
(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 9 I 0-395-3900
202-808-2808 Fax: 910-350-2004
Fax: 252-247-3330 (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
GEi1ERkLTERRNar COMPUTER FORM
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ADJACENT. RIEALLIWPRoPRRTY_._QtLNER_liOTIFICATIONJNAIVER._FORM
Name Of Individual Applying For Permit : bjel/Wcfr.Ler..SAAA
Address Of Property: , j 4 / k-L4 J A./.
'1-)(-4176A-4-- - k c,
(Lot or Street #, Str v t 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.
•
X ( /e I have nc Objections to this proposal . ii..4 C26
_________________
.=f._vov.._hame_ob .ecc i;ona .tn wnat i 1€ ing proposed, pieasPMri t P rho
Divisinn..._o.f_ rnAs tAl # r),airmenr,_ 127_-.`ardinal. Drive Extension,
Wilmington, . North Ca p1 in, 2s405 Jar cal 1 _..gIQ 195_3900 within la
days _at__.reng,ipr_ of t.Z.a .urine Nr. rsponse_is considered the Game
as_no__nh_j.ecr ion if you }sva bppn not i f i edgy rprr i f_7_ed mail.
____ ---
-
Kamm SECTION
I understand that a pi or, dock, mooring pilings, breakwater, boat
house or boat lift ,fit be sot back a minimum distance of 15 ' from
my area of riparisa q* - unless waived by me. (If you wish to
waive zhe setback, yOu Mgt initial the appropriate blank below. )
I, X_ __ I do wish to waive the 15 ' setback requirement .
I do_mar. wish to waive the 15 ' setback requirement .
_---- ---- _ _ _ —.
--Clialt -gete=a— 52: Sii- drArr--
Si ame Date
CA4eZes-5- 47(0.acEr 0
. 41111
Prirlk Name f e
W6 - ye 8&" "`"_ _
fer
Telephone Number With Area Code NCDENR,
NoRn. CARDUNA DER RTFLN7 OF
..NVIRSNM:I.i ANC) NAQUR,o_RESDJR;".E'S
tNx.
ENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY
• Complete items 1, 2, and 3.Also complete A. Received by(Please Print Clearly) B. Date of Deliver
item 4 if Restricted Delivery is desired.
■ Print your name and address on the reverse
so that we can return the card to you. C. Signature
• Attach this card to the back of the mailpiece, 'n 0 Agent
or on the front if space permits. X�Yl � �Yl Ir-�— 0 Addressei
D. Is delivery address different from item 1? 0 Yes
1. Article Addressed to: If YES,enter delivery address below: 0 No
/ rd fi/-e 4) .
/y Grnce miyd L�J,
yi evS�,//( 'fr,L r 3. Service Type
7 0 Certified Mail 0 Express Mail
Z-7(c 6 3 ❑ Registered lalleiLrn Receipt for Merchandisc
0 Insured Mail ❑ C.O.D.
4. Restricted Delivery?(Extra Fee) 0 Yes
2. Article Number(Copy from service label)
P S Fnrm 2R1 1 .lulu 1000 nn,,,octi irn Rcrofnr noanc��„ilek[n
low
UNITED STATES POSTAL SERVI \NO J PJ 7-
PM ( --- sR-0a
• Sender: Please print n , address, and Zif 14 in_thisbox-•---
AWI i kl02 60n,57
6 y 2/D
2 9 Vb
az
ENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY
• Complete items 1,2,and 3.Also complete Al R=.-ived by(Please Prin •early) B. Date of Delive
item 4 if Restricted Delivery is desired. I L ^ O/ Z
• Print your name and address on the reverse
so that we can return the card to you. C. Sign
-
■ Attach this card to the back of the mailpiece, /' , Agent
or on the front if space permits. _ I. Addressi
D. Is delivery address different from item 1? ❑Yes
1. Article Addressed to:
If YES,enter delivery address below: ❑ No
G h, r/-i 5 ii°X r 8s
17513 h/or7X 0//77,qrc/AG,.tn, .ec/
Ravi Ve ,b:C,
3. Service Type
2E6 7 E. ❑ Certified Mail ❑ c ress Mail
❑ Registered LJ Return Receipt for Merchandi
❑ Insured Mail 0 C.O.D.
4. Restricted Delivery?(Extra Fee) 0 Yes
2. Article Number(Copy from service label)
PS Form 3811. .luly 1RRR Domestic Return Receint urosos-nn.u.nos:
UNITED STATES POSTAL SERVI First-Class Mail
M.__: �; 1 Postage&Fees Paid .
Y ..) _ USPS
• u ; Permit No. G-10
• Sender: Please print your'ame, address, and ZIP+4 in this box •
4 A.?IM.7Y/ /VC"
ell, 4"y .Z`b
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3253
ANTINORI CONSTRUCTION BANK OF AMERICA
896 HWY. 210 C'
HOLLY RIDGE, NC 28445 66-19/530 y- / 1''0 Z g
(910)327-3475
PAY 6
ORDERA i /1 ��J/� $ 20
ORDER OF �/ Cr /J /v
DOLLARS
G-P 3�03(0 -
MEMO
FZQ�[il/W 1/�. v �/O 3 42
AUTHORIZED SIGNATURE M'
II'00 3 2 5 311' 1:0 5 3000 L 9 61: 000650 5 2 L 9 9011'