39682_FAIRFIELD, LEONARD_20040826

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ZCAMA / R DREDGE & FILL '
GENERAL PERMIT Previous permit #
C,JNew ElModification El 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
Rules attached. a
Applicant Name ( e ; ru , ,I G, Project Location: County n , It,
Address 'I h.. e Street Address/ State Road/ Lot #(s) i
CityIf, l 4 State IJ( ZIP ���'>✓`I G .I � I
Phone # ( } < 9 i - 1 ! b Fax # O Subdivision
Authorized Agent City (,r /G. rucr. 'i< ZIP 72 S 4 y
CW O EW ® PTA 0 ES 0 PTS Phone # ( ) River Basin !n//,. {. '.la k 1
Affected OEA ❑ HHF ❑ IH [IUBA ❑ N/A
� AEC(s): Adj. Wtr. Body nw J e "uNf j (nat /tr�an� /unkn)
❑ PWS: ❑FC:
ORW: yes / no PNA yes / Crit. Hab. yes / no Closest Maj. Wtr. Body
Type of Project/ Activity Ti C I ! c _ < i rr r n-16 ell �: , . n • I rc �, �/
ff ii ( ,
ailfI i, �vt• lV&V•l 1 Lt i,. r� `7il t "f 1, ��F.vF,.(ci (�c,'''� (Scale:�;'L.f
Pier (dock) len h
r
Platform(s) �, ki
Finger pier(s) fV't N MUt f: fit, ��• ; .t., !p i� 1 fr'< ,ti e. '.- 3
- t
Groin length
number
Bulkhead/ Ripraplength
avg distance offshore_
max distance offshore
Basin, channel
cubic yards
Boat ramp
Boathouse/ B(iat ift c ►, , c L F r' r l
i c, n ,
Beach Bulldozing
Other
Shoreline Length
Got
SAM not sure
yes /no;
Sandbags: not sure
yes ho
Moratorium: n/a
yes fiq:
-
tn,�"!/M� ��cf
�i,•t,N�' jl,<
Photos:
yes no
1-
Waiver Attached:
yes rno ---- -
--
—
--
-
A building permit maybe
required by: (e , i ; ; ' ) rr
❑ See note on back regarding River Basin rules.
Notes/ Special Conditions
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��entor Applicant Printed Name
Signature ** Please read compliance statement on back of permit
Fij-- rc
Application Fee(s) Check #
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Permit Officer's Signature
['A
Issuing Date Expiration Date
Local Planningjurisdiction 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 consistent with 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 comply with thesebuffer rules.
Division of Coastal Management Offices
Central Office
Mailing Address:
1638 Mail Service Center
Raleigh, NC 27699-1638
Location:
Parker -Lincoln Building
2728 Capital Blvd.
Raleigh, NC 27604
919-733-2293 / I-888-4RCOAST
Fax:[phone]
Elizabeth City District
1367 U.S. 17 South
Elizabeth City, NC 27909
252-264-3901
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.nccoastalmanagement.net
Revised 10/05/01

MARION M. FAIRFIELD 66-7489/2531 2247
LEONARD P. FAIRFIELD 1090000401931
103 HYACINTH LN. PH. 252-633-5556 DATE
NEW BERN, NC 28562
PAY TO/ / j[ 00
S THE ORDER ,OF
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Federaf Credit Union
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Rug 25 04 03:12p Bluewater Builders, Inc. 252-354-7892 p.1
Rug 25 04 03:15p
Bluewater Cove 252-393-1829 P•1
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/MOORING PILINGS/80ATL1FT1D0ATN0USE)
I hereby certify that I own property adjacent to
(Name of Property Owner)
property located at
(Lat, Block, Road, etc.)
N.C.
0nJ1{Jlg
(Wnterbody) (Town andlor County
lie has described to me, as shown below, the development he is proposing at that lmoonn
and, o 1 atlift/boa house must be set back a minimum distance ofave no objections 10 his proposa). I efifteen feet (15) from my area
pilin41
of riparian access unless waived by me.
t do not wish to waive the setback requirement.
I do wish to waive that setback requirement.
DESCRIMION AND/OR DRAWING OF PROPOSED DEYELOPitMNT:
(To be filled in by irr(lividual proposing developntOtt)
A"L
Print or Type Name
Telephone Number
Bate:
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