30495D - Village

CAMA/ ❑DREDGE & FILL N? 30495- ;')
411 GEIVIERAL 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 15A NCAC .
GRules attached.
Applicant Name j, (14r0-01 V T= Sty S RA 1 6 ) 011 Project Location: County ()t1 Si.)w
Address I sS" 01 D Vl 1( -G-P ` 0 Street Address/State Road/Lot#(s) 5A rr—E
"V` C C)
City /VO tt! f'll State/V ZIP Du /b
Phone# ( ) Fax#( ) Subdivision li k(( 'J e c f14 014 . r)
Authorized Agent L.je)A-f A 0 i., I`-r City O1Q —7-dPC7A-1 j JAI ►T ZIP cc k`/b U
Affected Cw IIPTA II)ES ❑PTS Phone # ( ) River Basin_a,pi--
OEA ❑HHF ❑IH • ❑UBA N/A
AEC(s): Adj.Wtr. Body 17l Svvi& '1 (natl/man /unkn)
PWS: ❑FC:
ORW: yes./ no PNA y no Crit. Hab. yes ! no ' Closest Maj.Wtr. Body c' S dirt&
Type of Project/Activity
(Scale: / _ 30�, )
Pier(dock)length t/ (55 _
t
Platform(s)_-7_' / 4 CirV)1r` ��,
Finger iers
Groin length) > : _ - -
_ I
number + I 1 . _-
Bulkhead/Riprap length
avg distance offshore —
max distance offshore — •
Basin,channel -` "
i
/
cubic yards {
i
Boat ramp .. .
j i
Boathouse/Boatlift
1
Beach Bulldozing ' - - 1I
I
Other l
1
+ l
Shoreline Length i__ 1I - t-�'
SAV: not sure yes no ' A� - �
Sandbags: not sure yes no '..i ,N..:Moratorium: n/a yes no c JJ'sr 11\
Photos: yes no r f t1 ' tt
Waiver Attached: yes no — — —
A building permit may be required by: 4/6 Rig'7. + I 2 3.4'Y ~ See note on back regarding River Basin rules.
Notes/Special Conditions
Agent or Applicant Printed Name ,. `1 /"J Permit Officer's Signature
c 2?— ( '5' b a 0 7._ l - t% -_-
Signature **Please read compliance statement on back of permit's* Is.U1r 11Date Expiration Date
' r Ili'-1 Ali/ -cps E ( ' 4'
Application Fee(s) „,!/r% 0'' Check#1 t(J¶ . Local PlanningJurisdiction verFile Name

w
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:
PI 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
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: [phone] 15 I-B Hwy. 24 127 Cardinal Drive Ext.
Hestron Plaza 11 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 10/05/01

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Name Of Individual implying Per Permit: 4.0Me U+if A o
Address Of Property:
Soffit-d amVe ® 's .a C iAti
shy l civ o�c � �
I bo.-Sby unify that I own props ty?djaanl to the above-referono d pruperty. The individual
applying for this permit has described eine as shown on the attached drawing the development
they are proposin . A description or drawieg, with dimensions. should be prt vided with this
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I hate Sao itectioris to this proposal.
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that a per, mooring pilings,breakwater,boat house, Iift or sandbags trastZ set hack a minion=distance of 1.5'from
wish'TO waive tie toya�of�ass s waived by me. (If youyou must t initial the approprla blank below.)
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il';I LIGHTHOUSE MARINE CONSTRUCTION
P.O.BOX 2532 910-328-4852 1425
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