30334D - Sisson

0 . CA a/ DREDGE & FILL N9 30334'J
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 j H Zp c:: ;.) .
L Rules attached. •
Applicant Name ,}_i(si,. _ >(S$N Project Location: County Klgt..J i 4 A'IVGt/�K •
Address I L .5 k 0+r f, D FP. • Street Address/State Road/ Lot#(s) ( (0 :S H G(<t Di.z .
City W ti qr,.. 'SV a 64\State JC ZIP Zell}SC
Phone # (-(v..,;) (/).Q 9 ).j Fax # ( ) Subdivision N(-\ (�v R. t.�L p't-t.,
Authorized Agent{rI' ,Aw R'. (11-QOptilekgiVVk City Vim+-.t6 HT"S.V 1 1( eo &Ac.'-zip_ s 4 Q
:
❑CW .EW *TA ❑ES PTS Phone # ( ) N-V F.` River Basin riA I 'E
Affected
❑OEA : HHF IH UBA N/A� ) Adj. ac man /unkn�AEC s : Ad . Wtr. Bodym 0 us C-(tktvNP1C..
❑ PWS: ❑FC:
ORW: yes / no PNA yes / fio Crit. Hab. yes / no Closest Maj.Wtr. Body UJ I -t Vl t t SG(a.IQA
Type of Project/Activity &:L-O P.1.9 N-{" C-LQAT I 1)O K -- tZ 6pU4 Gf_, .B0ecT U F T
(Scale: I I( 73 O 1 )
Pier(dock)length �� _____-__
Platform(s)
Finger pier(s) - )� ,.4;4_,r-t.i(, 1504 to i 1
t .
Groin length Yet}aw-lhl(i 9-5--,1. . , �. .'- r' K I 1.
:�
number i
�.—
f. 1
: Le
i-_asin,channel vP i 116 -L�r:CL. Q �T /o v ( f
1 b
cubic yards
Boat ramp t
2 t
Boathouse/Boatlif I�? y 13 .•_—__..-.__------ ---------- -- .- ------ -_.-. :_ -- !a`4/i },
Beach Bulldozing
12L I
Other
_1
Shoreline Length • j I I 1___
SAV: not sure yes o — — 1-- - 1
Sandbags: not sure yes no { j I l i
Moratorium: n/a yes (no)
Photos: yew no
Waiver Attached: yes ® ``� _ j
A building permit may be required by: I, .�f�1�- N'�-S V t�� F A c-L . r
) See note on back regarding River Basin rules.
Notes/Special Conditions
0-.)A-'•?=‘ ,-..(4.. iftY".1 . 1`-lT <- cf, )--12-Th (\s, ,,,...0 ,,.___. .........
Agent or Applicant Printed Name Permit Officer's Signature
`=� � � .---- ( 1 - 1 +� Cl 9 - I Q-, - o
Signatur - . eas compliance statement on back of permit** Issuing Date Expiration Date
Application Fee(s) Check# Local Planning Jurisdiction 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(252-946-648 I)or the Wilmington
Regional Office(9 I 0-395-3900)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] 151-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

GENERAL PERMIT COMPUTER FORM
APPLICANT NAME: B IJIJL 5 s c7."
ADDITIONAL NAMES:
AEC DESIG: E k ?T DEVELOP AREA: . I PROJ DESC: P - L a
- (Will only take 6) (Will only take 1)
WORK: (,l.. 3 , i 3
(Will only take 4)
MAINT:
(Will only take 4)
IMP: 0w Gol
(will only take 6)
ACTION EXPIRATION
8
DREDGE&FILL REQUIRED: l4 ` I 'S
CAMA MAJOR DEVEL REQUIRED: 1 i l

. . •os a -rvIce
CERTIFIED MAIL RECEIPT
(Domestic Mail Only: No Insurance Coverage Provided)
I—
II
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I.E.
U Postage $ 3 rQ- fr, 20
/�''
Certified Fee �� �0 4 ,
-- -.._ I ' di9i;i9ostmar „�
n Return Receipt Fee l - _ He C.,
(Endorsement Required)
7 Restricted Delivery Fee
J (Endorsement Required) • --
D Total Postage&Fees $ 3 •EM
r
f Sent To
Street,Apt.No.;
or PO B No. ¢ram
city S to ZIP+4 , / ie/-ie

Certified 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
Important Reminders:
•Certified Mail may ONLY be combined with First-Class Mail or Priority Mail.
•Certified Mail is not available for any class of international mail.
■ NO INSURANCE COVERAGE IS PROVIDED with Certified Mail. Fa
valuables,please consider Insured or Registered Mail.
•For an additional fee,a Return Receipt may be requested to provide proof c
delivery.To obtain Return Receipt service,please complete and attach a Retun
Receipt(PS Form 3811)to the article and add applicable postage to cover th,
fee.Endorse mailpiece"Return Receipt Requested".To receive a fee waiver fc
a duplicate return receipt,a USPS postmark on your Certified Mail receipt i
required.
■For an additional fee, delivery may be restricted to the addressee c
addressee's authorized agent.Advise the clerk or mark the mailpiece with th,
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 Ma
receipt is not needed,detach and affix label with postage and mail.
IMPORTANT:Save this receipt and present it when making an inquiry.

I. . •os a ervice
CERTIFIED MAIL RECEIPT
(Domestic Mail Only: No Insurance Coverage Provided)
u
n
n - .cEADj 4,
Postage $ -3(--i II i
U ,q' 0
y
✓ 03
Certified Fee (-:, i-(C) -r-cl:
,
...... 41.
n Retum Receipt Fee
/..a 002 20
2 -so
D (Endorsement Required)
n Restricted Delivery Fee 1./Sp.i,_
7 (Endorsement Required)
D Total Postage&Fees $ 3 5 yo,
,
✓ Sent To
.1
-161411-t3.--- X11771f2-)
_3 Street,Apt.No.;
3 or PO Box No.
City,State,Z +
..._ .
. . .. •• .

Certified 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
Important Reminders:
■Certified Mail may ONLY be combined with First-Class Mail or Priority Mail.
■Certified Mail is not available for any class of international mail.
• NO INSURANCE COVERAGE IS PROVIDED with Certified Mail. Fc
valuables,please consider Insured or Registered Mail.
•For an additional fee,a Return Receipt may be requested to provide proof c
delivery.To obtain Return Receipt service,please complete and attach a Retur
Receipt(PS Form 3811)to the article and add applicable postage to cover th
fee.Endorse mailpiece"Return Receipt Requested".To receive a fee waiver fc
a duplicate return receipt,a USPS postmark on your Certified Mail receipt i
required.
•For an additional fee, delivery may be restricted to the addressee c
addressee's authorized agent.Advise the clerk or mark the mailpiece with th
endorsement"Restricted Delivery".
•If a postmark on the Certified Mail receipt is desired,please present the art
cle at the post office for postmarking. If a postmark on the Certified Ms
receipt is not needed,detach and affix label with postage and mail.
IMPORTANT: Save this receipt and present it when making an inquiry.

SENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY
• Complete items 1, 2,and 3.Also complete natur=
item 4 if Restricted Delivery is desired. 1� L ❑Agent
• Print your name and address on the reverse it 0 Address(
so that we can return the card to you. IR by�(Prd Na if live
• Attach this card to the back of the mailpiece, "" „\--.CCI 1L sl
or on the front if space permits. :.
D. Is deli/'ry address different from item 1? ■ es
1. Article Addressed to: If YES,enter delivery address below: 0 No
1)ikiVit7 I
criett. / 3.ji 3. Se Type
I
C ae461 Certified Mail 0 Express Mail
0 Registered 0 Return Receipt for Merchandis
0 Insured Mail 0 C.O.D.
4. Restricted Delivery?(Extra Fee) 0 Yes
2. Article Number 7001 1940 0005 1412 5569
(Transfer from service label)
PS Form 3811,August 2001 Domestic Return Receipt 102595-02-M-Of

UNITED STATES POSTAL SERVICE First-Class Mail
Postage&Fees Paid
LISPS
Permit No. G-10
• Sender: Please print your name, address, and ZIP+4 in this box •
C a)
ct.mki) c).
11

ENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY
• Complete items 1,2, and 3.Also complete A. Signature
item 4 if Restricted Delivery is desired. ❑Agent
• Print your name and address on the reverse X ,^ 1�2r) it]Address€
so that we can return the card to you. B. Received by(Printed Name) C. Date of Deliver
• Attach this card to the back of the mailpiece, O
or on the front if space permits. 2 7
D. Is delivery address different from item 1? ❑Yes
1. Article Addressed to: If YES,enter delivery address below: ❑ No
C .-
I C
fa&—ek-j_ I 3. Se C yd Express
P-17eD Regtified Mail ❑ ern Mail
❑ Registered CI Return Receipt for Merchandis
❑ Insured Mail Cl C.O.D.
4. Restricted Delivery?(Extra Fee) ❑Yes
2. Article Number 7001 1940 0005 1412 5552
(Transfer from service
'S Form 3811,August 2001 Domestic Return Receipt 102595-02-M-08

UNITED STATES POSTAL SERVICE NO U 1 T _ First-Class Mail
P M1111 Postage&Fees Paid
�) USPS
0 Permit No. G-10
I
• Sender: Please printle ` address, and ZIP+4 in this box •
577 Nc, 0210
GQ_gipp3
a-t I+,itll►�I��I��I,I�t1��11�„II��L�i,I��L�11,f���11���1,��Iff

•
•
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of individual applying for permit: me S 53-eri
ArldrPcc of property:/6 54,lye 0. ,✓14� Ile 4al ,lam
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.
X.'
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 notice. No response is considered the same as no
objection if you have been notified by Certified Mail.
WAIVER SECTION
(Does not apply to bulkheads or rip rap)
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.)
I do wish to waive the 15' setback requirement
I do not wish to waive the 15' setback requirement.
I-AL4-4—Z--1.. ji-if-11 S4-(---4,11-4".... teel.--#----4—/
Signature Date
ANN/G Gj (PA_Liiety,u .64-111- ,
Print Name
Asa- 457a967
Telephone number with area code

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elements Mara,e Construction 4907
910 270-9110 Nene 4356789
577 NeJ1i9ieway 210 W ! � 56-3a53 i
_Hampstead,JVG' 28443 DareO7 365
Pay to the CA MA- - .
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FIRST CITIZENS 365 t
BANKF,�•��,��=�„a.,� a5 �
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COASTAL VIEWS"WOCV