39670_DALY, TOM_20040916

ITCAMA / 'I DREDGE & FILL 4 a
GENERAL PERMIT
Previous permit # ,kV r
New Modification ]Complete Reissue ❑Partial Reissue Date previous permit issued !✓
As authorized by the State of North Carolina, Department of Environment and Natural Resources
and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC
�Rc'�le attached.
Applicant Name i ; ' `(% j `" Lr c 1 -�''�e j County
r`� y,,_ sJ 1 <u
Project Location: Coun
Address' 7 ` '� �- " `1e Street Address/ State Road/ Lot #(s)
City Or ic.-. ►:;! State ZIP
�? +
Phone # (�'f -� 4 _ g u Fax # ( ) Subdivision 01
Authorized Agent (1 City_ f 1. ZIP J
❑ CW ❑.EW C A ❑ ES ❑ PTS Phone # ( ) River Basin f v eM e"k
Affected ❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A r
❑ PWS:
ORW: yes / no. PNA
Type of Project/ Activity _
Pier (dock) length `t
Platform(s) —
Finger pier(s)
Groin length
number
Bulkhead/ Riprap length
avg distance offshore
max distance offshore
Basin, channel
cubic yards_
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing
Other
El FC: Adj. vvtr. Body R (nat ,Cmani /unkn)
yes
f/ no Crit. Hab. ye�1s(/ no
Closest Maj. Wtr. Body
(Scale: IV u , %
Shoreline Length
SAV: not sure
yes
—
Sandbags: not sure
yes
'
Moratorium:
Moratorium: n/a
yes
o
�l
3
Photos:
yes
Waiver Attached:
yes
�"" O
A building permit may
be required by: /'
Notes/ Special Conditions
aS/e /C 4-1
ent or plicapt Pr' ed Name y
Signature "Please read compliance statement on back of permit"
Application Fee(s) Check #
E See note on back regarding River Basin rules.
Permit Officer's Signature
-u y
40
-- 4- 04
�1- 1 U
j;� rr
Issuing Date
Expiration Date
/
jJ
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 1) 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 consistentwith the North Carolina Coastal Management Program.
River Basin Rules Applicable To Your Project:
❑ 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 (252-946-6481) or the Wilmington
Regional Office (910-395-3900) for more information on how to complywith thesebuffer rules.
Division of Coastal Management Offices
Central Office Elizabeth City District
Mailing Address: 1367 U.S. 17 South
1638 Mail Service Center Elizabeth City, NC 27909
Raleigh, NC 27699-1638 252-264-3901
Location:
Parker -Lincoln Building
2728 Capital Blvd.
Raleigh, NC 27604
919-733-2293 / 1-888-4RCOAST
Fax: [phone]
Fax: [phone]
(Serves: Camden, Chowan, Currituck,
Dare, Gates, Pasquotank and Perquimans
Counties)
Morehead City District
151-B Hwy. 24
Hestron Plaza II
Morehead City, NC 28557
202-808-2808
Fax: [phone]
(Serves: Carteret, Craven, Onslow -above
New River Inlet- and Pamlico 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
127 Cardinal Drive Ext.
Wilmington, NC 28405-3845
910-395-3900
Fax: [phone]
(Serves: Brunswick, New Hanover,
Onslow -below New River Inlet- and
Pender Counties)
www.nccoastaimanagement.net
Revised 10/05/01

L 1036
EBbLLC
384 BEARDS CREEK RD 66 112/531
FI
ARAPAHOE, NO 28510-9554 Date 01901
Pay to the
D
Order Of
BB&T —Classic—
BRANCH BANKING AND TRUST COMPANY BANKING
NEW BERN, NORTH CAROLIVA
For
40S3 LO 1 12 ll:S 290 P-9 1 1911- 10 3 C�
— - GUARMANC-SAFETY BLUE DEBL

ADJACENT RIPARIAN PROPERTY ONVVNLR STATE NM,
(FOR A PIER/hfOORING PILINGSIBOATZIFT/BOATHOUSE)
I hereby certify that I own property adjacent to
s
(Name of Prope Owner)
property located at
�1/� (Lot, Block, R d, etc.)
on SM 19 6?ee'� m
. N. C.
(Waterbody) (Town and/or County)
• He has described to me, as shown below, the development he is proposing at that
location, and, I have no objections to his proposal. I understand that a pier/mooring
pilings/boatlift/boathouse must be set back a minimum distance of fifteen feet (IS') from my area
of riparian access unless waived by me.
I do not wish to waive the setback requirement.
I do wish to waive that setback requirement.
DESCRIPTION A.NL 7D/OR DRAM' rr G OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development) RA
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ley
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Sides dices
------------------------------------------------------ -------------------------------------------------------------
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Sigry' ture
Print or Type Name
'2 V/6-- .
t, Telephone Number
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ADJACENT RIPARIAN PROPERTY OWNER STATE AMNT
(FOR A PIER/MOORING PILINGS/BOATZIIT/BOATHOUSE)
Vt4
I hereby certify that I own property adjacent to /nr 4110%N'rope
; p 's
(Name Owner)
property located at YK)%
(Lot, Block, R d, etc.)
on S/rn 1 � ee, k in
N.C.
(Waterbody) (Town and/or County) ,.
He has described to me, as shown below, the development he is proposing at that
location, and, I have no objections to his proposal. I understand that a pier/mooring
pilings/boatliftlboathouse must beset back a minimum distance of fifteen feet (15') from my area
of riparian access unless waived by me.
I do not wish to waive the setback requirement.
I do wish to waive that setback requirement.
- ------------------------------------------------------------------------------------------------------
DESCRIPTION A,INTIOR DRA'4VLtiG OF PROPOSED DEVELOPMENT:
(To he filled in by individual proposing development) RAx
C Y° h,r
P44
i
ke-McN6"dC4- n2a �o
gnature
n���y��
Print or Type Name
Telephone Number
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