Best, Johnny 77361C

E & FILL
PERMIT
IModification lCompleteReissue trpartialReissue
Previous permit #oB
Date previous permit issued
'/ o0
A D
fu authorized by the State
and the Coastal Resources
of North Carolina, Department of Environmental Quality
tn an ofenvironmental concern pursuant to I 5A NCAC
Jo nApplicant Name
Address I
Phone #
Project Location: County
t v-f i./StreetAddre",iry"rt;;
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Authorized Agent _
Mail
PNA yes no
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trtH
?4 Phone # (_)
Adj. Wtr
Closest Maj. Wtr. Body
ZIP
River Basin
ltty
Affected
AEC(s):
trcw
trOEA tr UBA
X PTS
trN/A
7t1'
b xxr
tr
ORW: yes no
Type of Projec{ Activity ?
>C
)Pier (dock) length
Fixed Platform(s)
Floating Platform(s)
Finger
Groin lengh
length
offshore
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max distance offshore
Basin, channel
cubic yards
Boat ramp
Boathouse/ Boatlift
Beach
Other
Shoreline Length
SAV: not sure
Moratorium: nla
Photos:
Waiver Attached:
Notes/ Special
yes
yes
yes
yes
ino)
tlg
A building permit may be required by:
( Note Local Planning Jurisdiction)
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Please read compliance statement on back of permit *
E S". note on back regarding River Basin rules.
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Permit
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or
Fee(s)Check #
C
Date
iI.L
I
Applicant
Address
Name
trCAMA/ trDREDGE & FILL
ENER/AL PERMIT
flNew EModification [lComplete Reissue EPartial Reissue
fu 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
N977361 A B c D
Previous permit #_
Date previous permit issued_
Street Address/ State Road/ Lot #(s)
Subdivision
ztP
Phone # ( )River Basin
Adl. Wtr /man /unkn)
Closest Mal. Wtr. Body
Project Location
Phone # (_)
Authorized Agent
E-Mail
Affected
AEC(s):
tr clv
trOEA
tr PWS:
trEW
tr HHF
trPTA
trIH
trES
N UBA
N PTS
NN/A
ORW: yes / no PNA yes / no
Type of Proiec{ Activity
(Scale:)
Pier (dock) lengh
Fixed Platform(s)
Floating Platform(s)
Finger pier(s)_
Groin len4h
number
Bulkhead/ Riprap len4h
avg distance offshore
max distance offshore_
Basin, channel
cubic yards
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing
Other
I
Shoreline Length
-
SAV: not sure
Moratorium: nla
Photos:
Waiver Attached:
yes no
yes no
yes no
yes no
E S"" note on back regarding River Basin rules.
Notes/ Special Conditions
H-i*"f-
-+
-t
I
I
Agent or Applicant Printed Name
Signature ** Please read compliance statement on back of permit **
\?p\
Permit Oflicer's Printed Name
Signature
Application Fee(s)
.7
Check#lssuing Date Expiration Date
city- State zlP_
E Rules attached.
-t
A building permit may be required by, .
( Note Local Planning Jurisdiction)
I
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ft&-ryt of Compliance and Consistency
This permit [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
nulland void.
This permit must be on the proiect site and accessible tothe permit officer when the project is inspected forcompliance. The
applicant cirtifies by signing this permit that l) prior to undenaking any activities authorized by this permit, the applicant will
confer with appropriate local authoritiei tg confirm that this prgiect is consistent with the local land use plan and all local
ordinances, and 2) a written staterFent or certified mail return receipt has been obtalned 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
informattpn and belief, certiry thar this proiect is consistent with the North Carolina Coasal Management Prograrn.
River Basin Rules Applicable To Your Proiect:
! Tar - Pamlico River Basin Buffer Rules
f] Neuse River Basin BufferRules
E ott'e.
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 WashinSton ReSional Olfice (252-946-6481) or the
Wilmington RegionalOffice (910-796-7215) for more information on howto complywith these buffer rules.
Division of Coastal Management Ofiices
Morehe:d City Headquarters
400 Commerce Ave
Morehead City, NC 28557
252-808-2808/ | -888-{RCOAST
Fax: [phone]
(Sewes: Caneret, Craven, Onslow -
North of New River lnlet- and Pamlico
Counties)
Elizabeth City District
401 S. Griflin St.
Ste. 300
Elizabeth City, NC 27909
252-2U-3901
Fax: [phone]
(Serves: Camden, Chowan, Currituck,
Dare, Gates, Pasquotank and Perquimans
Counties)
Washington District
943 Washington Square Mall
Washington, NC 27889
252-946-6481
Facl.:252-948-0478
(Serves: Beaufort, Beftie, Hertford, Hyde,
Tyrrell and Washington Counties)
Wilmington District
|,27 Cardinal Drive Ext.
Wilmington, NC 28405-3845
910-796-72t5
Fax: 9 l0-395-3964
(Serves: Brunswick, New Hanover,
Onslow - South of New fuver lnlet-
and Pender Counties)
Revised 7/06/ I 7
http://portal.ncdenr.org/web/cm/dcm-home
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i hereby certify that I own property adiac€nt to
property located at (Address,Loq Block,
tn
of Pro Perty Owner)
.)
I (t
orfln an d/or CountY)0n
tlsti
Ihe app)a\y
s+Si*
^){s
F\J*'s
(WaterbodY)
nt has described to me, as shown below, the dewlopment proposed at the above
I have no obiedion to this proposal'
DESCRIPTION AN D/OR DRAWING OF PROPOSED DEVELOPUENT
ow or altach a site drawfig)
(l ndivi dual P roPosing dev eloq ment must fill in descriPtion bel
'lkhe,,t'U o"t*t*t
,Jd ue,{t28(
Pl1 vttt\
t\rs
-ty
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W RS
erstand that a pier, dock, moonng pilings, brea kwater, h house, lift, or gro in must be set
rea of riP arian acess unless waived by me. (li You
wish to walve
k a minimum dist
back, You must initial ihe approance of '1 5' from mY a
priate bhrk below )
I do not wsh to waive the 15' setback requiremert
ntP rty Owne r lnformation)
(Prope lnformation)
(4
\ghn,.5h*N dcsr ct
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[\ 7,.L)Pdnt or
/ st)
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me
ef lvressL,ta iling
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Telephone Number
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mber
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ADJACENT RIPARIAN PROPERW OW ER STATEI'ENT
I do wish to waive the 1 5' setback requirement'
L )
P
I ierebY certtg that
property located at
I own Property adjacent to
on
Wate rbodY)
The aPPlicant has described to me'
(city,T an d/or CountY)
as shown below, the development proposed at the above
LOPilIENT
allach a srte drawing)
f*dpsl ,l;n7/ ,l,ftle/
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S
(of perty Owner)
t4 4,r/khGi/
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(Address,Lot
ln
uilr*
)
oaD
NC-
qqG
2.ch**/ rrt ocue
lnformation)
J
Road '
n
locatiorvr I have no objection to this proposal
D/OR DRAWING OF PROPOSED DEVE
DESCRIPTION AN
(l ndl i dual P ro P os i n g dev el o P m ent musl fill in descriPton below or
rrDni 12 'u{a
qsD
c,.c.j\, tl ,t,t'
t understanO tir-at a pier, dock' moorin
o]"f , rnin'.un distance of 15' from
;;h ;;;tt" the setback, You must i
ffi Hffi f,*',:*ffi J;:',"::if ,H:'ffi ;1"-u
"o, of nparian aq€ss un
;ir'i"iil; approPnate blarK belorv )
J- I do wsh to waive the 1 5' setback requirement
I do not wish to waive the 15' setback requiremerd'
9t0
(PropertY r lnlormation)
51"'"vl iJ/\
Pint or TYPa Name
J
Pnnt or ame
iling Addrsss
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5?> ll:iT (-Mailing A
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Telep hone Nun
Ddte
o
ber
83b
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Tel Number
Bevlsed 5r'1*01 2)
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NC Division of Coastal Management
Cashier's Official ReceiPt 14859 n't@o
zlt ,dLDate
Received From:,Slna,ao 1b.s*$4bo-
Permit No.:T7Z t( Br1 Check No.. t0D?
Cou nty Ck {Applicant's Name
Proiect Address;
Signature of Field Representative
Please relain receipt tor your records as proof of payment for permit issued.
-,/Date:
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4<n t' .-^:h\ ll
Signalure of Agent or Applicant:
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