36758_FOWLER, DON_20031216

CAMA DREDGE & FILL Ply",
GENERAL PERMIT Previous permit #
EINew EModification -]Complete Reissue ElPartial 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
L-1 Rules attached.
Applicant Name -1-)e- '/o;" /'
Address
City 4" s
State A46 ZIP
Phone #(_Iy ) 'W/- Fax #
Authorized Agent
Affected -i Cw
OMW
[�'PTA (DES El PTS
AEC(s): -1 01EA
L1 HHF
Ll lH D UBA El N/A
F--. P W S:
El FC:
ORW: yes / no
PNA
yes / no Crit. Hab. yes no
Project Location: County
Street Address/ State Road/ Lot #(s)
Subdivision
City Zip
Phone# River Basin
Adj. Wtr. Body feat /unkn)
Closest Maj. Wtr. Body
Type of Project/ Activity
(Scale:
Pier (dock) length
Platform(s)
Finger pier(s)
Groin length
number
Bulkhead/ Riprap length
avg distance offshore
max distance offshore
Basin, channel
A
cubic yards
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing
Other
4-
SO
Shoreline Length
SAM not sure yes no
Sandbags: not sure yes ho
Moratorium: n/a yes no
Photos: yes no
Waiver Attached: yes no,
A building permit may be required by:
See note on back regarding River Basin rules.
Notes/ Special Conditions
ell 27
Agent or Applicant Printed Name
Permit Officer's Signature
Y
Signature ** Please read compliance
statement on back of permit
IssuingDate
Expiration Date
4
z 2,16 le-) e
Application Fee(s)
Check#
Local Plan ningJurisdiction
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, certifythat 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 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.nccoastalmanagement.net
Revised 10/05/01

c S e. ba
2283 Iry
PRESCOTT BROTHERS INC
66-30/531
41 -TARA TRL
471
ARAPAHOE, NC 28510 DATE
PAY 9A!-
To THE _p
ORDER OF-
FIRST CITIZENS -
BANKF—t-c;ittzons 15.Ik 9511-1 Company
Ba,b,,1-,NC 2S51 1
7_1 j �C-
FOR 3C)C31:C30L, 10 2 SL. 2911*
11"C1022831" 1:0S3100
:1) / C) (-)
-DOLLARS

ADJACENT RIPARIAN PROPERTY 0117\TER STATEMENT
I hereby certif}' that T o%u property adjacent to -,,j F6CAJ
(Name
of Property Owner)
property located at 1 � 29 � � �� Zk ws — ,
(Lot, Block, Road, etc.)
in t N.C.
(Waterbod,y) (Toiyn 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.
DESCRI q ION ANTD/OR DRANIJNG OF PROPOSED DENTLOVIMENT
(To be filled in by indii,idual proposing development)
Cn
Signature
Print or Type Name
hI LJ)'Ry 7- q,5g
Telepho,-it Number
Date: h 8��73
—29—

ADJACENT RIPARIAN PROPERTY OWNTR STA.TENIENT - -
2-'1 � t - -7 — ?' yy7'
I herebycertif � that I own property adjacent to �wj F: �`� ez- is
5 P P
Game of Property O wrier)
roper""' located at Z-CJ -� 2-9
Z.e--
P
(Lot, Block, Road, tc.
on ��� , in C� , N.C.
(Waterbody) (Town and/or County)
He has described to me zs shown below, the development he is proposing at that location,
and, I have Tibr objections to his proposal. Nu^-6�A q7, 33" 5 d4 0'U (i rA
DESCRIPTi N ANTIOR DRAWING OF PROPOSED DEULOPMENT
(To be filled in by individual proposing developmelt)
'e ur nc�'7e,
Print or Type Name
g1q-�51-53g(---,
Telephone Number
Date: 1; /NO3
—29-