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PERMIT
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No. 75103
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ENER/AL PERMIT
Xomptete Reissue -Partial Reissue
st^t rl)Or
Previous permit #ab bo?"O D
ENew IModification
As authorized by the State of North Carolina, Department of Environmental Quality
and the Coastal Resources Commission in an of environmental concern pursuant to I 5A NCAC
Date previou t e"rffi ;tt"a SfAlZD', //0F t 7L/-rq
Applicant
Address
Name
City
Phone # (-{h 2l/'/0'l/ ,-r^u
Project Location: County
Street Address/ State Road/ Lot #(s)
Subdivision 9+&-
Phone # (_)
Authorized Agent
Affected tr cw MW r-t PTAatrHHF trIH ffstr UBA
ztP
River Basintr PTS
NN/Anici'i' troEA
tr PWS:
Adl. Wtr
Closest Maj. Wtr. Body
nat
ORW: yes I PNA yes I
Agent or Applicant Printed Name
Signature *x Please read compliance statement on back of permit **
TW
Signature
Type of ProjecU Activity
(Scale:L(,)
Pier (dock) length
Fixed Platform(s)
--'t
Floating Platform(s)+
Finger pier(s).
Groin length
number rtiltt
Nt*i,/frV>Wt--J- r----J--
--->Bulkhead/ Riprap length_
L
avg distance offshore
max distance offshore
IBasin, channer /nU tri 4el,
I
d €Y
'rqxcubic yards w\$
Boat ramp
,(L-r-r-il f--t-t-f-
Boathouse/ Boatlift
t_+
Beach Bulldozing_
Other_
Shoreline Length
J
SAV: not sure
Moratorium: nla
Photos:
Waiver Attached:
yes @
,6p"
1 +--t+
A building permit may be required by:
( Note Local Planning Jurisdiction)
[f S"" note on back regarding River Basin rules.
Notes/ Special Conditions
4
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Check #lssuing Date
3
Date
No. 75103
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Statement of Compliance and Consistency
This permit is subiect 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 proiect site and accessible to the permit officerwhen the project is inspected for compliance. The
applicant cenifies by signingthis permit that l) prior to undenaking 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 issuinS this permit under the best available
information and beliel certifythatthis proiect is consistentwith the North Carolina Coastal Management Program.
River Basin RulesApplicable To Your Proiect:
- Tar- Pamlico River Basin Buffer Rules
Neuse River Basin Buffer Rules
E othe.,
lf indicated on front of permit, your proiect is subiect 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 Resources. Contact the Division of Water Resources at the Washington Regional Office (252-946-6481) or the
Wilmington RegionalOffice (91 0-796-7215)Ior more information on howto comply with these buffer rules.
Division of Coastal Management Of,ices
Morehead City Headquarters
400 Commerce Ave
Morehead City, NC 28557
2s2-808-2808/ l -888-4RCOAST
Fax: [phone]
(Serves: Caneret, Craven, Onslow -
North of New River lnlet- and Pamlico
Counties)
Elizabeth City District
401 S. Griffin St.
Ste. 300
Elizabeth City, NC 27909
252-264-3901
Fax: [phone]
(Serves: Camden, Chowan, Currituck,
Dare, Gates, Pasquotank and Perquimans
Counties)
Washington District
943 Washington Square Mall
Washington, NC 27889
2s2-946-6481
Fax:[phone]
(Serves: Beaufon, Bertie, Hertford, Hyde,
Tyrrell and Washington Counties)
Wilmington District
127 Cardinal Drive Ext.
Wilmington, NC 28405-3845
910-796-7215
Fax: 9 I 0-395-3954
(Serves: Brunswick, New Hanover,
Onslow - South of New River lnlet-
and Pender Counties)
http://portal.ncdenr.org/web/cm/dcm-home
Revised 7/05/ I 7
Sceruar floneoeE&FILLEF/AL PERMIT
:lModification r lComplete Reissue :l'lPanhl Reissue
As authorized by the State of Nor$ C,ardirn DePanment of Envirorunental Qualrty
and the Coastal Resourcs Commission in an area of erwkonnrental conem pursuant to I5A
Applicant Name l+
Date previors permit issued-
oo
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Praious permit
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Pxriect Location: county- -t}>.i=tI}d e-
Street Address/ Sate Road/ Lot #(s)7 Ee
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Es :-PTS
l
City
Phone #
Authorized Agent
ORW: yes PNA yes @
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tjuBA i-'lNlA
SubdMsion
Phone # (--
.Adi. Wtr.
Clocest Mai. Wtr. Body
cirr- Nvatfott-7)?
Basin. :rcYv lED r;PrA
Tff :roEA irHHF .rHAtsU{S):.i P{u!i:
Type of ProjecV Activitf
(s..t"'f ,9D )
Prer (dock)
FkedPhdorm(s) - --:-
Floating Platform(s)./<Y
Finger pie(s)-
Groin length
\r^
cp,^ryr
l\o'tt
i
r"rs.t-T0
ayg disrance o$shore
tx-.9
orbicylrdr_
Bo*ramp ,J
IBoathousef Boadilt,,|-v-_
Beach Bulldozing I
Orher._--.
-7-
't
Shoreline Length
SAV: rrte.srr
Moratoriun: qh
Photoe:
Waiv€rA$adr6d:
F3
)'e3
ves
G
ag -l+xt
N-
Y'>hu.flL fli
no
A buildirg permt rrray be rcguired bp l-i S." note on back regardlng River Basin ruhs.
( Note Local
Notesr Special Conditions
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Fee(s)Che*#
PermitOfi<er's
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I hereby certify that I own property adjacenl to //44 ,r4Lr't
property located at 6* s/-z o4d .4.(" (Nameof Prop€rtvowner)
on CatA/ O#/?(Address, Lot,B ,w:h etc.)
,tn , N.C(Waterbody) (City/Town and/or Countyl
The adplicant has described to me, as shown below, the development proposed at the above
locatiop\7
\XJ I have no obiection to this proposal.
----r4(\ I have objections to this proposal.
DESCRIPTION AND'OR DRAWNG OF PROPOSED DEVELOPHENT
(lndividual prcgcing develqnqt mus/ frt ln dBctiption ,€,ow or atr,ch a site dnwlng)
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WAIVER SECTION
I understand that a pier, dock, mooring pilings, boat ramp, breakwater, boathouse, lift, or groin
must b€ set back a minimum distance of 15'from my area of riparian ac@ss unless waived by
(lf you wish lo 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
(Pro Owner I n)(A Property Owner lnformation)
)
Signat
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Print or6vt Type Name/3 .rZ 4C torPdn
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Maititn Address
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City/State/Zip
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Citylslate/Zip
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Telephone Number /
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Telephone Number /email address
, I ' ,, /.
Date
'Valid for one calendar year after signature'
(Revised Aug. 2o14)
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
Daler
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to ,4/rrX ?2. ,4--uzzl
(Name of Property Owner)
s
property located at
on C6/d/ O{ZA<
(Address, Lot, B ";, ,8?,tn , N.C
The a
(Waterbody) (City/Town and/or County)
cant has described to me, as shown below, the development proposed at the above
locati
I have no objection to this proposal.
I have objections to this proposal.
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Sltsldk7 -2, uQc/ Q,/;zrnJ 0F rq/tr-Z 7Vz f u4 {
/KEilGA EKz;y'a -dru 77/E td"t4/R'
WAIVER SECTION
I understand that a pier, dock, mooring pilings, boat ramp, breakwater, boathouse, lift, or groin
ust be set back a minimum distance of 15'from my area of riparian access unless waived by
(lf 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.
(Pro Owner lnfo on)(Adj Pro rty-Owner lnformation)
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Print or TvDe Name6st iE4 ..,./E 4
Mailino Address
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City/Statezip
Pint or Twe Name ^ht( boor"xrrz Uru-rcl*G 1o
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TeleDhone Number / email address' \\ t lolJ-
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Telephone Number //l 2- 2aza
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x'
Date
*Valid for one calendar year after signature"
Date*
(Revised Aug. 2014)
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DESCRIPTION AND/OR DRAWNG OF PROPOSED DEVELOPMENT
(lndividual prcpo-siry davdopment must frtl in dercrtption below or atbch a site dnwing)
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ADJACENT RIPARIAN PROP ERTY OWNER STATEMENT
I hereby certify that I own property adjacent to h.o<Y z. -?azz
property rocatedat 622 qad D4 frw2)2'+erWSwn*t
on M ck),z (Address , Loi, Block, Road, efc.lAtzz,tPory'.N ,c,tn
The appli
(Waterbody) (City/Town and/or County)
has described to me, as shown below, the development proposed at the above
I have no objection to this proposal.
I have objections to this proposal.
lo
DESCRIPTION AND/OR DRAWNG OF PROPOSED DEVELOPMENT
(lndividual prcpsing devdopment must fill in &scription below or alir,ch a site dnwing)
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S
WAIVER SECTION
I understand that a pier, dock, mooring pilings, boat ramp, breakwater, boathouse, lift, or groin
must be set back a minimum distance of '15'from my area of riparian access unless waived by
me.sh to waive the set back, 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
(Pro Owner lnformation)
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Prin
1o 7z "Y):!"ur,z a/<or
Mailing Address
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(Adj acent Pro perty lnformation
Sr e; t, P,'rter A*
Print or T 'Ndme
Mailing Addre
e
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Telephone Number /
,t,t-7- )oza
- . CMstate/Zip("1eh.f--{/a*,A5"-,--2
Teleohone Number / email address' l/'fr- 2-o 2-o
Date
*Valid for one calendar year after signature*
Date*
(Revised Aug. 2014)
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ADJACENT RIPARIAN PROPERW OWNER STATEI'ENT
I hereby certify that I own property adjacent to ,/ffi</ /.44//,v
rcut"a"t 1t2/ad er)
property
on k4 Lkk (Address, Lot, Block,
,tn
S
7(7 N.C
(City/fown and/or County)
The appli has described to me, as shown below, the developmenl proposed at the above
I have no objection to lhis proposal.
I have objections to this proposal.
DESCRIPTION AND'OR DRAWNG OF PROPOSED DEVELOPIIENT
(htdfttid,ie, pmpodag devetrpmert must fll ln des,ctiption bebw or elfarch e sito dnvlng)
4a,l^^te r-* / d/'" f-/"?72',"1v Dn{/c y' f;tztcs ra
l uffarJr- ElI a;fcc Cl/;aru uF '4'</-7 -4'- t)(-;
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WAIVER SECTION
I understand that a pier, dock, mooring pilings, boat ramp, breakwater, boathouse, lift, or groin
must be set back a minimum distance of 15'trom my area of nparian access unless waived by
me f yq wish
I do wish to waive the 15' setback requirement
I do not wish to waive the 15' setback requirement.
(Pro Owner lnformation)
alure 2
Prin or
Mailing Addrcss
(Ad ntP roperty lnformation)
.si lure*
Z.
lcfz 'Yff2,-z ,l<.Pint or
Mailing A
CityBtate/Zip
.c,2.d5/o/vc -7a
9? f*61e'1.f,,-d,-.-?-,-2
Telephone Numrer /
/,t-') - ,)a )- o
TeleDhone Number / email address' //-i-2-oLo
Dqte
"Valid for one calendar year after signaturet
Dale*
of
Road,
(Waterbody)
)
to waive the setback, you must initial the appropriate blank below.)
(Revised Aug. 2014)