Jackson, Gene 79545C

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Applicant
Address
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ii/trDREDGE&FILL
ERAL PERMIT
EModification ECompleteReissue IPartial Reissue
As authorized by the state of North carolina, Department of Environmental euality
and the Coastal Resources Commission in an concern pursuant to I 5A
N9 79545 AB c D
Previous permit #
Date previous permit issued
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Name
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Subdivision
Phone # (_)
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Authorized Ag"nt City
Phone #
Affected
AEC(s):
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tr PTS
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ORW:yes /PNA /no Closest Maj. Wtr. Body
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Type of ProjecU Activity ()er/
Pier (dock) length-..-
(Scale:)
Fixed Platform(s)
Floating Platform(s)
Groin length
length
distance offshore
max distance offshore
Basin, channel
cubic yards
Boat ramp
Boathouse/ Boatlift
Beach
Other
Shoreline Length
SAV: not sure yes
Moratorium:
Photos:
Waiver Aftached:
nla yes
yes
i yes
no
'-r-)A building permit may be required by:
( Note Local Planning Jurisdiction)
E S"" note on back River Basin rules.
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Agent or Name Permit
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Application Fee(s)
read compliance statement on back of
Check #
Name
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Date
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Notes/ Special Conditions S' //
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Statement of Compliance and Consistency
This permit is subiect to compliance with this application, site drawing and attached general and sPecilic conditions. Any
violation of these terms may subiect 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 officer when the proiect 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 adiacent riparian
landowner(s) .
The State of North Carolina and the Division of Coastal Management, in issuing this Permit under the best available
information and beliel certifythatthis proiect is consistentwith the North CarolinaCoastal Management Program.
River Basin Rules ApplicableTo Your Proiect:
[l Tar - PamlicoRiver Basin Buffer Rules
E Neuse River Basin BufferRules
E other:
lf indicated on front of permit, your proiect is sublect 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 bythe NC Division of
Water Resources. Contact the Division of Water Resources at the Washington Regional Office (252-946-5481) or the
Wilmington Regional Office (910-796-7215) for more information on howto complywith these buffer rules.
Division of Coastal Management Of,ices
Morehead City Headquarters
400 Commerce Ave
Morehead Ciq/, NC 28557
2s2-808-2808/ r -888-4RCOAST
Fax: [phone]
(Sewes: Carteret, Craven, Onslow -
North of New River lnlet- and Pamlico
Counties)
Elizabeth CitY District
401 S. Griffin St.
Ste.300
Elizabeth City, NC 27909
2s2-264-3901
Fax:[phone]
(Serves: Camden, Chowan, Currituck,
Dare, Gates, Pasquotank and Perquimans
Counties)
Washington Oistrict
943 Washington Square Mall
Washington, NC 27889
152-946-6481
Fax:252-948-M78
(Serves: Beaufort, Benie, Hertford, Hyde,
Tyrrell and Washington Counties)
Wilmington District
127 Cardinal Drive Ext.
Wilmington, NC 28405-3845
9t0-796-7715
Fax: 9 I 0-395-3964
(Serves: Brunswick. New Hanover,
Onslow - South of New River lnlet-
and Pender Counties)
Revised 7/06/ I 7
httpr//porul.ncdenr.org/web/cm/dcm-home
trCAMA/f]DREDGE&FILL
ENER/AL PERMIT
IModification ICompleteReissue IPartial Reissue
fu authorized by the State of North Carolina, Department of Environmental Quality
and the Coastal Resources Commission in an area of environmental concern pu rsuant to l5A NCAC
N9 7954s A BCD
Previous permit #_
Date previous permit issued_
E Rules attached.
Project Location: County
Street Address/ State Road/ Lot #(s)
Subdivision
City ztP
Phone # ( )
Adj. Wtr (nat /man /unkn)
Closest Mai. Wtr. Body
Applicant Name
Address
State_ Z'IP-
Phone # ( )-e-rvait
Authorized Agent
Affected tr cw
AEC(s): troEA
tr PWS:
ORW: yes / no
trEW
tr HHF
! PTA
trrH
Ers'
! UBA
tr PTS
NN/A
PNA yes / no
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Type of ProjecU Activity I
(Scale:)
Pier (dock) l.ngth_
Fixed Platform(s)---J--lfi-
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1-
I
T'IFloating Platform(s)
Finger pier(s)
{,1r-r
Groin length
number
Bulkhead/ fuprap length
avg distance offshore
max distance offshore
Basin, channel
-fr
cubic yards_
Boat ramp
Boathouse/ Boatlift _L_+,
Beach
Other
#lr
Shoreline Length
SAV: not sure
Moratorium: nla
Photos:
Waiver Attached:
yes no
yes no
yes no
yes no
A building permit may be required by:
( Note Local Planning Jurisdiction)
E S"" note on back regarding River Basin rules
Notes/ Special Conditions
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Agent or Applicant Printed Name
Signature ** Please read compliance statement on back of permit x*
Permit Offi cer's Printed Name
Signature
Application Fee(s)Check#lssuing Date Expiration Date
River Basin
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Statement of Compliance and Consistency
This permit is subject to compliance with this application, site drawing and attached teneral and specific conditions. Any
violation of these terms may subiect the permittee to a fine or criminal or civil action: and may cause the permit to become
nulland void.
This permit must be on the projectsite and accessibletothe permit officerwhen the proiect is inspected forcompliance. The
applicant certifies by signingthis permitthat l) priorto undenaking any activities authorized bythis permit, the applicant will
confer with appropriate local authorities to confirm that this proiect 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 adiacent riparian
landowner(s) .
The State of North Carolina and the Division of Coastal Mdnagement, in issuing this permit under the best available
information and belief, certirythatthis proiect is consistent with the North CarolinaCoastal Management Program.
River Basin RulesApplicable To Your Proiect:
E oth..'Tar- PamlicoRiver Basin Buffer Rules
Neuse River Basin Buffer Rules
lf indicated on front of permit, your proiect is sublect 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 ReSional Qlfice (252-946-6481) or the
Wilmin6on RegionalOffice (910-796-721 5)for more information on howto complywith these buffer rules.
Division of Coastal Management Ofiices
Morehead City Headquarters
400 Commerce Ave
Morehead Ciq/, NC 28557
2s2-808-2808/ | -888-4RCOAST
Fax: [phone]
(Serves: Carteret, Craven, Onslow -
Nonh of New River lnlet- and Pamlico
Counties)
Elizabeth Citv District
401 S. Grifiin St.
Ste.300
Elizabeth Ciq/, NC 27909
252-2U-190t
Fax:[phone]
(Serves: Camden, Chowan, Currituck
Dare, Gates, Pasquotank and Perquimans
Counties)
Washington District
943 Washington Square Mall
Washington, NC 27889
257-946-6481
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 0-395-3964
(Serves: Brunswick, New Hanover,
Onslow - South of New River lnlet-
and Pender Counties)
http://portal.ncdenr.org/web/cm/dcm-home
Revised 7/06/ I 7
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NC Division of Coastal Management
Cashier,s Official Receipt 13048 I n@u
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Received From:
Project Address:
Signature of Agent or Applicant:
Signature of Field Representative:
$b
County:?
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Please retain receipt for your records as proof of payment for permit issued.
Date:
o^t,M,_
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Permit *o.,
Applicant's Name:
check *r.,/LDA