37535_GOMBAR, BRUCE_20040220

L,I,CAMA / J DREDGE & .� ..FILL 1� rrl ® �''!�•:�, GENERAL PERMIT Previous permit#
❑New ❑Modification ❑Complete Reissue El 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
Address —X
State ZIP
Phone # O Fax # ( )
j�
Authorized Agent
Affected El
CW ] EW Id'PTA ElES ElPTS
AEC(s): ❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A
❑ PWS: ❑ FC:
ORW: yes / no PNA yes / no Crit. Hab. yes / no
Project Location: County
Street Address/ State Road/ Lot #(s)
Subdivision
City i ZIP ?
Phone # (�) ' River Basin
Adj. Wtr. Body (nat /man /unkn)
Closest Maj. Wtr. Body.
Type of Project/ Activity�-
Pier (dock) length
Platform(s)
Finger pier(s)
(Scale:
Groin length
number
Riprap length
avg distance offshore
max distance offshore
Basin, channel
cubic yards
Boat ramp
Boathouse/ BoatlifE(�
Beach Bulldozing
Other
JBulkhead/
J-
!
I
-
I
I
Shoreline Length ?
SAV: not sure yes In
Sandbags: not sure yes o i
Moratorium: n/a yes
Photos: ;.yes-•` o
Waiver Attached: yes# ' L
A building permit may be requi ed by: j' f `
Notes/ Special Conditions
V,!
-
- -
_ r �
- - ?r--
❑ See note on back regarding River Basin rules.
Agent or Applicant Printed Name
Signature Please read compliance statement on back of permit"
i
Permit Officer's Signature
Issuing Date Expini ion Date
Lod " Ianningjurisdiction -(_ Rover File leNaTme
a
Application Fee(s) Check #

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, certifythatthis 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 / 1-888ARCOAST
Fax: [phone]
Fax: [phone]
(Serves: Camden, Chowan, Currituck,
Dare, Gates, Pasquotank and Perquimans
Counties)
Morehead City District
151-13 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

SHORELINE MARINE CONST. 28011341
ASHLEY BROOKS NCDL 7666496
PH (252)-646-3212 66-21/530
99 CENTURY COURT DATE L-2OZel BRANCH 77614
SWANSBORO, NC 28584
TO THE
PAY AI CwI
ORDER OF , v �LI " $ -
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WACHOvia
Wachovia Bank, N.A.
w�chovia. om _
FOR Watrs
"no 1 IP. 11 1:053000 2 191: 2054E
700 2 5 7911'
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Feb 16 04 09:55a Ashley Brooks 910-326-8523
Shoreline Marine Construction, Inc.
Flo(ltlny Docks - Piers - Sea U'allc - Hi 'Title Boat Lifts DEALER
abrooksl (&ec.rr.com
Fax Cover Sheet
Date ;Z- l l t! l O'¢
From:
Fax # :Z47� 3 3 3 n
Pages (Including Cover Sheet) : 5
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Notes: OaAd of':�--
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Ashley Brooks
99 Century Court Swansboro, NC 28584
(h & Fax) 910-326-8523 (m) 910-326-8523
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Feb 16 04 09:55a Ashley Brooks 910-326-8523 p.2
02/13/2004 02:48 3472842 ECON DEV PAGE 04
ADJACENT R.�PMUA.N PROPERTY OWNER STATENL IL
(FOR A PIERIMOORING PILINGS/BOATZ.I MBOAT'HOUSE)
I hereby certify that I own property adjacent to `,;� �—' 1,��_ 's
1 � (Name of Property Owner
property located at S NL , 4yb/ - r A� C 124-t?-4)
(Lot, Block, Road, etc.)
on C— . /�atiY , in a�I5k? - , N.C.
(Waterbody) 0 (Town and/or County)
He has described to me, as shown below, the development he is proposing ar that location,
and, I have no objections to his proposal. I understand that a pier/mooring
p2ingslboatlift/boathouse must be se: 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.
X I do wish to waive tat setback requirement.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPtifENT:
(To be felled in by individual proposing development)
A&,6�9*
Signature
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Print ar Type N e
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Telephone Numbe;
Date: r( f-06 'Of

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Feb 16 04 09:55a Ashley Brooks 910-326-8523 p.4
02/13/2004 02.48 3472842 ECON DEV PAGE 02
s... .
ADJACENT RIPAKL N PROPERTY OWNER STATEL1�IFN7
(FOR A PIER/MOORING PILING5/80ATUMBOATHOUSE)
I hereby certify that I own property adjacent to &4 U, 'S
(Nwne of Property Owner)
property located at
(Lot, Block, Road, etc.)
K)r_/94-4'-2
on �S-"A- " On 6-XCTw;TI'r
(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/moorin-g
pilings/boatlitUboathouse must be see back a minimum distance of fifteen feet (15') from my area
of riparian access unless waived by me.
I da not wish to waive the setback requirement.
142 wish to waive tat setback requirement.
DESCRIMON AND/OR DRAWPiG OF PROPOSED DEYELOPNIE\"T:
(To be-ftUed in by individual proposing development)
i AO, //
Print or Type Name
Tt o -3cZ - & 7-�
Telephone Number
Date_

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