38860_FOLEY, DAVID_20040608

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`. II CAMA / - DREDGE & FILL
GENERAL PERMIT Previous permit#
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
❑ Rules attached.
Applicant Name r Y_
Address C.2. h G.i 1.4 Cc It i'rE'
City- „I h Jig State _ zip 17 fir'
Phone # ( ) `.: - t,t'63 Fax # ( )
Authorized Agent fii r4, Id
Affected CW © EW 0 PTA ❑ ES ❑ PTS
AEC(s): OEA -: HHF ElIH ElUBA C N/A
❑ PWS: ❑FC:
ORW: yes / no PNA yes / no Crit. Hab, yes / no
Type of Project/ Activity
Pier (dock
Platforms
Finger pie
Groin len
num
Bulkhead/
avg d
max
Basin, cha
cubs,
Boat ramr
Boathousc
Beach Bul
Other_
Shoreline
SAV:
Sandbags:
Moratoriu
Photos:
Waiver At
Project Location: County
Street Address/ State Road/ Lot #(s)
Subdivision ; L}F rvr�o. y
City 1-.100 v•f'( I ' rf1i zip % 74
Phone # ( ) River Basin V,1 V f f`
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A building permit maybe required by: f, r 4q f ll (,y. V
Notes/ Special Conditions ;* p4wy4e j d 1 �v,a p r
Agent or Applicant Printed Name
El See note on back regarding River Basin rules.
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Permit Officer's Signature
Signature "Please read compliance statement on back of permit"
Application Fee(s) Check #
Issuing Date Expiration Date
u. ) CE
Local Planning Jurisdiction Rover File Name

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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:
A, 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 / 1-888ARCOAST
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

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SERIAL 1 YEAR, MONTH DAY A r.,,...,..
0 6 ^ 2 ^ 01.1
\� POST OFFICE U 9.�DO'jLLARS AND CENTS
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a ' lJNE HUiV.DREU, DOLLARS cm OOd: WNOUNT:
PAY To NEGOTIABLE�ONLY IN THE U.S. 'AND POSSESSIONS
v�. :SEE RE —RSE WAR ING
'ADDRESS -�'
.FROM ' CLERK
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C.O.D. NO. OR
USED FOR
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moa-1.1-cuu4 UJ;I( PrOM-CCANUI
2522403243 T-H2 P-002/002 F-372
ADJACENT RIPAPJAN PROPERTY.' OWNER STATEMENT
(FOR A PIE I'",10OR1iYG PILr'YGSiBOAT.Cl,FTIBOATHDi15g) 6d,,.3P-9,rP--reeY
I hereby certify that I own property adjacent to I s
(Name of Property Owner)
property located at
( ol; Block, etc.) Sh&�],r
an - !�a ou,IL-, in .C.
(�ti'uterbod�) �bsnand/or County)
He has described to r,ge, as shown below, the development he is proposing at that location,
and, Ihave no objeetiorls to h.is proposal. I undcrstand that a piar/moorin,piling- boaclifiboatho«se
must be set back a minirnani distance of fifteen feet (15') front my area of riparian access unless
'waive by me.
I do not wish Co Nvaive the setback requirement,
1 do wish to waive that setback requirement.
4-aw - .....----- _----------------.._-------•.-_-------
DESCRIPTION Al"M/OR DRANK ING Oc PR SED DEVELOPMENT:
(Ti o beJ711eedin by ideal propv ; development)
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