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N9 8001 I
Previous permit #
Date previous
@ D
As
and the Coastal Resources Commisslon in an area of environmental concern pursuant to I5ANCAC
Applicant g Proiect Location: County
Street Address/ State Road/ Lot #(s)
sa,.*NL ztP
ehone# (ffi6)fo
Authorized Agent
Affected
AEC(s):
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tr UBA
trPTS
ON/A
Phone # (_)
Adi. Wtr
Closest Mai. Wtr, Body
ZIP
River Basin
So
/ rrc PNA /no
Type of Project/ Activiry
Pler (dock) length
(Scale:)
Flxed Platform(s)I
j i l
_T
TIFloatlng Phtform(r) _ '- _
Flnger
Groin length
len4h
avg offshore
max distance offshore
Basln, ctrannel
cubk
Boat ramp
Boathousd Boatli{t .r
Beach
Other
Shoreline Length
SAV: notsure
Moratorium: nla
Photos:
WaiverAtached:
yes
yes
yes
yes
A bullding permit may be required by:t] S". not" on back regarding River Basin rules.( Note Local Planning Jurlsdictlon)
Notes/ Special Conditlons
no
no
no
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Fee(s)
read backof
Check #
PermltOflicer's
Date
& FILL
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ENew Reissue _PartialReissue
As authorized by the State of North Carolina, Department of Environmental Quality
and the Coastal Resources Commission in an area of environmental concern PUrSUant to l5A NCAC
Applicant Name g Project Location:
Address
Previous permit #
Date previous
Street Address/ State Road/ Lot #(s)
. cclsubdivision
City ztP
Phone # (-)_- River Basin
Adj. Wtr
sat" NC ztP
Phone #
Authorized Agent
Affected
AEC(s):
{w Art'.#trES trPTS
! UBA tr N/AtrOEA tr HHF
tr PWS,-
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ORW:lno PNA lno Closest Maj. Wtr. Body
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no
no
no
Type of ProjecU Activity
(Scale:)
Pier (dock) lengh
Fixed Platform(s)
Floating Platform(s)
Fingerpier(s) /
Groin length
length
av8
m,x
Basin, channel --
cubicrards /
Boat ramp
Boathousd Boatlift //'
Beach Bulldozing -
Other 7
Shoreline Length
SAV: not sure
Moratorium: nla
Photos:
Waiver Atached:
yes
yes
yes
yes
A building permit may be required by:E S"" note on back regarding River Basin rules.
( Note Local Planning jurisdiction)
Notes/ Specia! Conditions
:f,l,nnv s; aes
PermitOfficer's
** Please read compliance statement on back of la sltr,lzt
**SignatprpLtfii,
Fee(s)
w
Check #lssuiny'Date/Fpffi;Date
& FILL
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offshore
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 subiect the permittee to a fine or criminal or civil action; and may cause the Permit to become
nullandvoid.
This permit must be on the proiect site and accessibletothe permit officerwhen the prolect is inspected for compliance. The
applicant certifies by signingthis permitthat l) priorto 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 Nonh Carolina and the Division of Coastal Management, in issuing this permit under the best available
information and beliei certifythatthis proiect is consistentwith the North CarolinaCoastal Management Program.
River Basin RulesApplicable To Your Proiect:
Tar- Pamlico River Basin Buffer Rules
Neuse River Basin Buffer Rules
E oth..,
lf indicated on front of permit, your proiect is subiect to the Environmental ManaSement 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)lor more information on howto complywith these buffer rules.
Division of Coastal Management Oflices
Elizabeth Ci ty District
401 S. Griffin St.
Ste. 300
Elizabeth City, NC 27909
2s2-264-3901
Fax: [phone]
(Serves: Camden, Chowan, Currituck,
Dare, Gates, Pasquoank and Perquimans
Counties)
Washington District
943 Washington Square Mall
Washington, NC 27889
252-946-6481
Fax: [phone]
(Serves: Beaufort, Bertie, Hertford, Hyde,
Tyrrell and Washington Counties)
Wilmington District
I 27 Cardinal Drive Ext.
Wilmington, NC 28405-3845
9 to-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 7/06/17
Morehead City Headquarters
400 Commerce Ave
Morehead City, NC 28557
252-808-2808/ | -888-4RCOAST
Fax: [phone]
(Sewes: Carteret, Craven, Onslow -
North of New River lnlet- and Pamlico
Counties)
)
-H
NC Division of Coastal Management
Cashier's Official Receipt t252g o*6
,fu
Received From:s
Permit No.:
Date:
$
Check No.:fl8.t4
County:ooclo,l
Date:
Date:h4rrO
Applicant's Name:
Project Address:
Signature of Agent or Applicant:
Signature of Field Bepresentative:v^,ta
Please retain receipt for your records as proof of payment for permit issued.
7
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