30949D - Phillips

LAMA / DREDGE & FILL N? 3094-9-D
�GEtJE'RAL PERMIT Previous permit #
) . New Modification Complete Reissue Partial Reissue Date previous permit issued
As authorizecty 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 SA NCAC /--7 ' ( LS7y .
L Rules attached. `
Applicant Name f T c - ,1 I i f•r..v_ Project Location: County N (A ..Address 'ig--2`t'b •R t 4.0-e rr- e,..0ALA, Street Address/State Road/Lot#(s) 0-j 5 0 9-01f4.
City 1,10,Liv State WC, ZIP 2 1.4 W tL AI• ' ►I C
Phone# (1 I 0 ) t ,,Fax#( ) Subdivision 0/4
Authorized Agent L.` City Lek--A ty".-J ' ZIP 4
❑CW ,EW XPTA ❑ES L.PTS Phone# ( ) River Basin
Affected •
❑OEA HHF IH ❑UBA N/A
AEC(s): Adj.Wtr. BodyF--11'ee._ n t man /unkn)
PWS: AFC:
ORW: yes / no PNA yes / no Crk.Hab. yes / no Closest Maj.Wtr. Body �—G►`.�_
r
Type of Project/Activity "Pfv/ -' �1 ,r-
,i i
' (Scale: ` '- 4c )
Pier(dock)length C._,TC ' -- ?'` ,R
Platform(s) V
Finger pier(s) -
Groin length
number -___ .
M FT
Bulkhead/Riprap length - . 11
$all,,
avgdistance offshore i 4I/X t-�
�.
max distance offshore .
Basin,channel -
' - r
cubic yards 100 X i
Boat ramp + 1,..... ,._c!- --- i I-----_ ...._.l _._::
—
Boathouse/Boatlift ' t
- ;- t----- i--j- I j
Beach Bulldozing_ - l
i
Other ( -_ _. �
1"ufl'r l Zxti z. • _ .- 1 _ :._t_+ w_.
__..
Shoreline Length 0
SAV: not sure yes 4b1 i
Sandbags: not sure yes it"
es . ±, .
Moratorium: n/a -
r 0451izId i i I '
Photos: �ye .
Waiver Attached: yes no r - ---- I
A building permit may be required by: Nt�G� Ik r1I J t/t. r CC , . See note on back regarding River Basin rules.
Notes/Special Conditions
Agent or Applicant Printed Name P., s Permit Officers Signature
.,� _,,,\,-' -�� :-- I - 0 a.. S` 1 — p
gnatSl ure 414 Please read compliance statement on back of permit** Issuing Date Expiration Date
4 °r, 9 -) a 4-4 Co - b- o 2r'}i i b i6c
Application Fee(s) Check it 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:
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(252-946-648 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 252-264-390 I 252-946-648 I
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] 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 I0/05/01

i
• CODES FOR AEC DESIGNATIONS
"OH" - Ocean Hazard "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
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"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
© f
APPLICANT NAME: QA 1�'E I!1 (.
ADDITIONAL NAMES:
AEC DESIG: F_,UJ psr' DEVELOP AREA:__._ PROJ DESC: P - ra
(Will only take 6) (Will only take 1)
WORK: cm. im f(0
(Will only take 4) \.
MAINT:
• (Will only take 4)
: \ L
(will only take 6)
ACTION EXPERATION
DREDGE&FILL REQUIRED: 1- 1 -O.2
`"�CAMA MAJOR DEVEL REQUIRED: it •

lin-31-02 01 :51P RICHARD R LACY 480 575-6957 P.02
Jan--31-02 12:33P Mid--East q rvice 314d 119
2 I8 7� .!?2
. NaThe Of Individual Applying n For Permit;
Address Of Propertv, 1CQO's
i10c Ur tit~Mat Street or Road: City & Co,IYIry)
•
hereby certify fy that I own property adjatent
fw,-enced property.
rcy. The ;*�^iv c'tual apply .z9 for this permit rat
descbed ro r re s shown on the azt a hhad drawing the a deq, l }�z »i�
they. gr proposing. A description aa.ou or drawing, with dimensions,should be oro9v'ided with his
•
c rx� I have la* ohjttiuns thia t3r*_J;sal. .
d.- >F,�i'�'f"'r�ny.. r'• '}� �w��°'C5�94'j'j.` K Y � �^ }y ���
+ . ri�7 s�TY�w �_ f T9 • E*zca 7
NUMELSWOOLar
'1 cciti s"+..aut" that a pier., C±Dr. .. 4710faring `.l� 9�i+^
_ .._
b.use mr boat :vast he set bGcNF w Wimmu distant-le `. NW' F .
/Yten area. a: riparian ucmesV - unless waived
waive 7..he ae..4.._ ack,, you r Y ti:�i lthe avoropriate bItant below.]
do wish to era- the 1 d' setba^
1 dm nnr wish to waive ray i T =s requirement..mil rr i�+.`13�� �"�'""�+remeT7li.
T'�®�'7r` ,. N'.1 G;" with th .rea code
ro w

F - Jan-23-02 05: 10P Mid-East Services 910 892 1897 P_02
DIVISION OE_COASTAL_NalibraMMKT
ZJI/ACENT..RZL' zAN..P.R FS.OATIONLWAIYER_EORM
Name Of Individual Applying For Permit: {)/�e 2% ,�/�G r/a 5
Address Of Property: '$ ZS z) `,K t OF re. ' OAb
(Lot or Street 4#, Street or Road, Ci~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.
1 I have no objections to this proposal.
If you_have objerrihns Cn what is heaing .prapos ,__plc.,3.GP writ
Div_j ci nn, of ,.Coastal ManaggmPnt 127 cardinal D vo
U ExtQns.LQn,-
Wi l mi n-t nn, North rarol i na., _2114,QS_0r na11 910 3°5- 1ao wi thiII 1Q
S3ayS nt r_eroint of thi c_ nor_i r_e_ No r ponSQ i 5 rn dPred the_same
as_ro ohjertinr if you have h en fnt-ifipcy CottifjPc? Mail
-SEcTIDN — —
I understand that a pier, dock, mooring pilings, breakwater, boat
house or boat lift 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.
T dot wish to waive the 15 'setback requirement.
Sign Name n 44.ei
Date
v Print Name 4 e
fr
Telephone Number With Area Code
NCDENR
MCA L AFT
Nv1R;awy=n—wiu NcTLIRA. P__a:WV

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ROBERT L PHILLIPS 0978
PO BOX 1477
DUNN, NC 28335
/-6eR
DATE 66-1233/537
PAY TO THE
ORDER OF
IMENIUM_ of ram 9 V
DOLLARS
W -Cent('
B 4�rrr;.
FOUNDER
Ban
Dunn.NC 28334
FOR � Sr t \_ \
I:05311 23304: 300 /005i' 09�g •
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