38647_FRIEDMAN, SYLVAN_20040712

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GENERAL PERMIT Previous permit #
❑New rjModification ':]Complete Reissue L-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 I SA NCAC
Rules attached.
Applicant Name > "j �� �/ Project Location: County_
Address _ r� ' ' s- _ Street Address/ State Road/ Lot #(s)
City State a_ ZIP
Phone # () Fax # ( ) Subdivision
Authorized Agent City
Affected El CW F71 EW @ PTA C ES PTS Phone # ( )
AEC(s): El OEA ❑ HHF ❑ IH C UBA 7 N/A Adj. Win Body
❑ PWS: ❑ FC:
ORW: yes / no PNA yes / no Crit. Hab. yes / no Closest Maj. Wtr. Body
ZIP
River Basin
nat!/man /unkn)
Type of Project/ Activity
(Scale:
Pier (dock) length
Platfo
Finge
r pier(s)
Agent or Applicant Printed Name )
c
Signature ** Please read compliance statement on back of permit
rw
Application Fee(s) Check #
Permit Officer's Signature
Issuing Date Expiration Date
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 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 / 1-888-4RCOAST
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

PRESCOTT BROTHERS INC
141 TARA TRL
GRANTSBORO, NC 28529
PAY
TO THE
ORDER OF
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�[-fl \ 1� Oriental, N C. 28571 � � j�//'��
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FOR -
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07/A2/2004 08:15 91 9380h58 ROCKWELL AUTOMATION PAGE 02
13un 20 04 09:5Ea Chris Machle 2E2-249-9800
AD.TACE, IN7RIPARIAN P110PERTY 01�'-\-L-P' S J. A-,
'Y 2ci .0per, arent to
I h�-,rc.by certify that I CY�',-L P�' '.. N.'aule V Pcope-,ty
2t
(Lot, Blot-., Road, etc
(Town andlo" CourAY)
PPOSM7 Z
-n below, Vic development be,", P'
14 cIrscribeJ to 1-ne as _chov,.
no cbJections to his proposal.
06-29-04 06:26
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- TWOR DR, WING OF pp01)OSE
(To bcf1-!1ee1 in by indfv!dm31proposing
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Date:
-29-
RECEIVED FROY:252 249 9988

ADJACENT RIPARIAN PROPERTY OWNTER STATEMENT
I hereby certify that I own property adjacent to 4-17
(,.'Name of Property Owner)
property located at > _7 % /
(Lot, Block, Road, etc.) n �Lf f- /" y/ C
on /� F i C 1 < E�� , in
(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� 'rD/OR DRAWING OF PROPOSED DEVELOPMENT
DESCRIPTION A
(To be filled in by individual proposing development)
e 1 r o
4-13'
• 6`�IS•fn�G. �r�„Jr
Sicc,naturc
Print or Type Name
Telephone Number
Date:
-29-

Jun 29 04 10:18a Jim Barton
Jun 29 04 09%52a Chris Machle
904-221-0637 p.2
252-249-SS88 p.2
ADJACENT RIPARIAN PROPERTY OWNER STATEAMN'T
I hereby certify that I own property adjacent to s
(\'ame or Property Owner).
property located at
(Lot, Block, Road, etc.)
on in
(Waterbody) (Town and/or County)
He has described to me as shown below, the development he is proposing 2t that location,
and, I have no objections to his proposal.
DESCRIPTION' Ai�'D/OR DRA�4'�'In'G OF PROPOSED DENSLOP�'iENTT
(ro be filled in by individual proposing development)
-A
Signature
Print or Type hpne
Telephone Number
Date: �/ �a0o _-- r
-29-