30462D - Cowan

'CAMA / DREDGE & FILL N? 3�1462`'�
GENERAL PERMIT Previous permit#
j New' Modification Complete Reissue Partial Reissue Date previous permit issued
.thorized by th State of North Carolina, Department of Environment and Natural Resources
the Coa:.tal Resources Commission in an area of environmental concern pursuant to I 5A NCAC )L .I,(.
Rules attached.
r
plicant Name rjA (2 U NN y! O WF^ Project Location: County I' 1L`J[.,dress /VA I 3? U IStreet Address/State Road/ Lot#(s)ty e�� j State NC ZIP �� _
Phone#( ) "5 - k-(L'7 #( ) Subdivision
Authorized Agent (L ' n�f/��4 S'et' City ' 7QS - ( /-JJ/���' r/{ ZIP J6/�tit/S-
C3�CW (j.EH/ PTA LIES CPTS Phone # ( ) River Basin I, ri)l-
Affected OEA ❑HHF ❑IH ❑UBA C N/A r"
AEC(s): Adj. Wtr. Body ,/ S 0 v -
1'L i) na an /unkn)
ORW: yes /no., PNA yes /o� Crit. Hab. yes / no Closest Maj.Wtr. Body UUi1 1)
Type of Project/Activity b /((4-i1 tiG C>(--( 4(,/)/-6,fA- 111) 1� ,f''S-h N({ Nf r"
r
. (Scale: / - 50 )
Pier(dock)length -
Platform(s) I - 1 , _ `
Finger pier(s)
H 4 - .'----• - ' 3 15\(\I I r'; - - - --- ' "-
Groin length _ - -..-'"'
number
i r l t - 1
I
Bulkhead/Riprap length - ---i1 — Y-1 1 14 j-__I -i ii I .
avg distance offshore j _ i_.
max distance offshore S.1.• A 17 4- i.
j.
Basin,channel —, `Q ` 1 j
- r —
1_ �..,,_ .. c�Ct 1
cubic yards = Y f/ — e
t a o -,- ' ) -1-_ ,---_
Boat ramp 1 + j y 4 -
Boathouse/Boatlift , 1 I G l
jj I
Beach Bulldozing r i ' T 11 __- _� t - I -- I i
Other r(OP 1 fi/& 1 -I- - I k
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1 i
2;6722‘11°''
Shoreline Length/40/ 5 7 - i- . .--4-- - .. �._ i i
SAV: not sure yes no t I t- __
Sandbags: not sure yes no '— 1 — i, I
Moratorium: n/a yes no - - {
1 �T
1
Photos: yes no - — I #j#
Waiver Attached: yes no - L -
A building permit may be required by: "' i1 ?; Q�T[ { . See note on back regarding River Basin rules.
Notes/Special Conditions
�jr.
I
` � i
{ ir, nn ✓ j '� 4>Agent or Applicant Printed Name Permit icer's Signature'
1--'i (I" Gi S• try. i. ),(-- /-_ - �'-'" / ifs C.)Signature Please read compliance statement on back of permit Issuing Date / Expiration Date
Application Fee(s) Lir(,(}, Check# // t/ 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 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 / I-888-4RCOAST Morehead City District Wilmington District
Fax: [phone] 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: [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 I0/05/0I

CODES FOR AEC DESIGNATIONS
• "OH" - Ocean Heard "PT" - Public Trust
"EW" - Estuarine Waters "CW"- Coastal Wetlands
"ES" - Estuarine Shoreline "FC" - Fragile Coastal Natural/Cultural
"PW"- Public Water Supply "OR" - Outstanding Resource Water
CODES FOR PROJECT
"P"- Private-usually an individual "F" - Federal
"C" - Commercial "L" - Local Government
"U" - Utility "H"- Housing Development
"S" - State "0" - Other
# CODES FOR PROJ DESCRIPTION
"11" - Bulkheads,Riprap "16" - Utility Lines
"12" - Piers,Docks Boathouses "17" Emergency Repairs
"13" - Boat Ramps "18" - Beach Bulldozing
"14" - Wooden Groins "19" - Temporary Structures
• . "15" - Maintenance of Basins, Channels,Ditches -- - - — - - -
GENERAL PERMIT COMPUTER FORM
APPLICANT NAME: ,.d 12,16 VIVA` 0(A)/-1
ADDITIONAL NAMES: J24/V d 1. NOSk-
// _ : y35z,6 =D=oa 2
AEC DESIG: -' ( P DEVELOP AREA:U,O/_ PROJ DESC: P_ 42,
(Will only take 6) (Will only take 1)
WORK: 76 X /(
), (Will only take 4)
WONT: -
•• (Will only take 4)
•
IMP:
(will only take 6)
ACTION EXPIRATION
DREDGE&FILL REQUIRED:
CAMA MAJOR DEVEL REQUIRED: p-/5 O Z if-/5-6 Z

Form to Be Used if Sending by US Postal Certified Mailing
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to 's
(Name of property owner.)
property,located at frXe Clvny /3bJ
r (Legal descriptionand/or street address.)
on Cin , in Topsail Beach,N.C.
(Affected waterbody.)
I have reviewed the site plan/survey and/or descriptive drawing(s) for the project
being pr posed, at the above noted location, and have no objections to this proposal.
Pate 24621� � �r�y,
( ignature) (Mailing Address)
. vv0oA)-)20 3 b --22 7D
(Print or Type Name) (Address) (Telephone Number)
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Attachments; Current site plan/survey or drawing .f proposed project&copy of permit.
Page 1 of 1

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U.S.Postal Service
CERTIFIED MAIL RECEIPT
(Domestic Mail Only; No Insurance Coverage Provided)
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.ernnea man rroviaes:
I A mailing receipt
A unique Identifier for your mailpiece
A signature upon delivery
I A record of delivery kept by the Postal Service for two years
nportant Reminders:
Certified Mail may ONLY be combined with First-Class Mail or Priority Mall.
I Certified Mail Is not available for any class of International mail.
I NO INSURANCE COVERAGE IS PROVIDED with Certified Mail. Fa
valuables,please consider Insured or Registered Mail.
I For an additional fee,a Return Receipt may be requested to provide proof o
delivery.To obtain Return Receipt service,please complete and attach a Returr
Receipt(PS Form 3811)to the article and add applicable postage to cover the
fee.Endorse mailpiece"Return Receipt Requested".To receive a fee waiver for
a duplicate return receipt,a LISPS postmark on your Certified Mail receipt is
required.
For an additional fee, delivery may be restricted to the addressee or
addressee's authorized agent.Advise the clerk or mark the mailpiece with the
endorsement"Restricted Delivery.
I If a postmark on the Certified Mall receipt Is desired,please present the arti-
cle at the post office for postmarking. If a postmark on the Certified Mail
receipt is not needed,detach and affix label with postage and mail.
r7PORTANT:Save this receipt and present it when making an Inquiry.
1 Farm 2111111_-12nu2rv -_--

U.S.Postal Service
CERTIFIED MAIL RECEIPT
(Domestic Mail Only: No Insurance Coverage Provided)
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✓ Certified Fee 6 OQ SAID BEqcy
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• Restricted Delivery Fee l 3 0 2002
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Street,Apt.No.;
or PO Box No. 11 CJ f
City,State,ZIP+4 -04 -L"LL.HJ

:edified Mail Provides:
■A mailing receipt
•A unique identifier for your mailpiece
■A signature upon delivery
■A record of delivery kept by the Postal Service for two years
mportant Reminders:
■Certified Mail may ONLY be combined with First-Class Mail or Priority Mail.
•Certified Mail Is not available for any class of International mall.
• NO INSURANCE COVERAGE IS PROVIDED with Certified Mail. For
valuables,please consider Insured or Registered Mail.
•For an additional fee,a Return Receipt may be requested to provide proof of
delivery.To obtain Return Receipt service,please complete and attach a Return
Receipt(PS Form 3811)to the article and add applicable postage to cover the
fee.Endorse mailpiece"Return Receipt Requested".To receive a fee waiver for
a duplicate return receipt,a USPS postmark on your Certified Mail receipt is
required.
■For an additional fee, delivery may be restricted to the addressee or
addressee's authorized agent.Advise the clerk or mark the mailpiece with the
endorsement"Restricted Delivery".
•If a postmark on the Certified Mail receipt is desired,please present the arti-
cle at the post office for postmarking. If a postmark on the Certified Mail
receipt is not needed,detach and affix label with postage and mail.
MPORTANT:Save this receipt and present it when making an inquiry.
S Form 3800,January 2001 (Reverse) 102595-01-M-1829

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Form to Be Used if Sending by US Postal Certified Mailing
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to m �� „ 's
(Name of property owner.)
property, located at C yK( 'Jp)
(Legal description and/or street address.)
on R & &e rtitli , in Topsail Beach,N.C. •
(Affected waterbody.)
I have reviewed the site plan/survey and/or descriptive drawing(s) for the project
being proposed_at the abov noted location, and have no objections to this proposal.
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(Signature) (Mailing Address) 211./_vlfr-'Yr\( v
7-016r c a l I/ (51:2.,ks-
(Print or Type Name) (Addy ss) /Zr
(Telephone Number)
Attachments; Current site plan/survey or drawing of proposed project& copy of permit.
•
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Page 1of1

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/ 0TOURNAMENT 4
PROMOTIONS
O. Box 6433, Raleigh, NC 27628 • 800.824.8113

•
RANDALL B. MOSLEY 04-01 1194
910-328-5071
P.O. BOX 3463 66-191530 NC
TOPS S.ANDERSON DRIVE. <7/9/a
/ 702
TOPSAIL BEACHACH,, NC 28445-6852 Date
Pay / - vb1WZ// $ /00
to the order of /
�f Dollars 8
Bank of America.
ACH R!hT73j?4J lr✓7 3r1, LV 6 /
Memo `rJ �vdY`.l /�� - l!
1:053000196i: 00068474547711' L L94