39680_GUSLER, GEORGE_20040824

.
❑CAMA / ❑DREDGE &FILL
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GENERAL PERMIT
Previous permit #
L]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 Resou e�issipiln an area of environmental
concern pursuant to 15A NCAC
.n�
V'XC
[idRules attached.
Applicant Name �<<� t i i';v t +`�.
J i, ,k
Project Location: County (,�, +r
Address � t6, ! jc (I / ! Fyi'
Street Address/ State Road/ Lot #(s)
City f� • ar r.`t i?f; State ZIP
Phone # ( 4) ( 7 - - 7 `j Z Fax # ( }
ft )i
Subdivision
Authorized Agent
City_ °/ P /a• ZIP_
t V
❑ CW EW p PTA ❑ ES ElPTS
Phone # ( ) River Basin
Affected
❑ OEA ElHHF ElIH ❑ UBA ❑ N/A
AEC(s):
G /f(,
Adj. Wtr. Body !'� _ :' '' kE
(nat /man /unkn)
❑ PWS: ❑FC:
Closest Maj. Wtr. Body
ORW: yes / no PNA yes / no Crit. Hab.
yes / no
Type of Project/ Activity
Pier (dock) length 'r
Platform(s) ir i'L
Finger pier(s)
Groin length
number
Bulkhead/ Riprap length
avg distance offshore
max distance offshore
Basin, channel
I i ; c I pf', I -', "
-- I
(Scale: A ,.IC
cubic yards . y IT �_r t]
�. .
Boat ramp t
4
Boathouse/ Boatlift
Beach Bulldozing ' ki
Other
Shoreline Length r,
SAM not sure yes no -- -- -.._ - -- - — -
Sandbags: not sure yes no j
Moratorium: n/a yes no
Photos: yes n- s:
f r�
Waiver Attached: yes --
A building permit may be required by: b . ` ' E: See note on back regarding River Basin rules.
Notes/ Special Conditions ";Jr /rv�
tae� ,
Agent
�oorr Applicant Printed Name;
4.--S+tYt'�f+
S+gna ut re * Please read compliance statement on back of permit
Application Fee(s) Check #
Permit Officer's Signature
Issuing Date Expiration Date
iC1�1`f ESA
Local Planning Jurisdiction Rover File Name
M

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 consistentwith the North Carolina Coastal Management Program.
River Basin Rules Applicable To Your Project:
❑ Tar - Pamlico River Basin Buffer Rules ❑ Other:
l'� 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-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

THIS MULTI -TONE AREA OF THE DOCUMENT CHANGES COLOR GRADUALLY AND EVENLY FROM
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ISSUING BRANCH LL
DATE
F�I,II'jl•J::;T '_r'', ,1 ;'I_il_)c�. 93-541/920
PAY TO THE 7�
ORDER OF ry „�
I I DOLLARS SY SIGNING YOU AGREE TO THE SERVICE CHARGE
AND OTHER TERMS ON THE REVERSE SIDE.
IL RAWER
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DRAWER: TRAVELERS EXPRESS COMPANY. INC i t " `,F S I 'M` D AWER
P.0 BOX 9476. MINNEAPOLIS, MN 55480 (1 �"
DRAW E: FIRST INTERSTATE BANK. HELENA, 11 f
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■ 'IHIS DOCUMENT HAS AN ARTIFICIAL, WA 111(1111 l I'wl'. I I I'
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AUG-15.200Q FRI 11:17 AM NO DIV OF COASTAL MGMNT FAX K 4
P. 07
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C:
ADJACENT RIPARL-�N PROPERTY OWNER STA.TENIEN T'
(1-0R ,A PIER/MOORING PIIINGSIBOAT7-I TIROATNOUSE)
I hc'reb ce;d that I own ro art ad'at:ent t-7 L-1 ��Jlel� - I
(Name of opert} Owner-)
prore--y lrxattxd at R14, CSI0"e �icSTf�••��ilL
(Lot. Block, Road, etc.)
on 0�1v ��., in `e %— N. C
A�ter6odp) _
( own and/or County)
;'Ie ha; desc-Ibea to me, as Shown below, the devejopme:,E he is propos �: t ;mot location
and, I have no obiccdons to his pr0005a , Lr d I I udC.S:2-n t�:�: pir:r/mooting
pilir�s;ooa,1ict/boerhouse must be &;, back a minimum distance oI .freea fee; (j) from my area
of rio`i2m access Unless waived by -me.
I d-O-PA( wish to Wa vz the setback reouirement-
- - I dn wish to wive G:at A r�cuir�-7 -It.
DE:SCRU"TION AND/OR DRAWLtiG OF PROPOSED DEtiELOF� E\`T:
(To be filled ir- by individarl proposin; ceye!opment)
47
of -)I
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Pint or Type I\ame
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RUG- I b-2UW h K I 11 : I( HrI NU U IV Uh UUHJ I HL I IUI IN I r HA NU. 4 1, u l
A-DJAC�:�t RIPARL-.N PROPERTY OWi`r-ER STATE; NT
(FOR A PIER/MOORING Pfl IiVGSB0,-1 TZ.IFT/ROATNOCSE)
f
I Hereby ce:jty that I own property adjacent
(Name of Fropertti Owner)
propc—,y located at .0 %� c.STf}/� �i LC - 0��,5_ cSTt�/� �iCI
/ (Lot, Block, Road, etc.)
Oil in Z
"(Waterbodp) +�own and/or County}
He has desc;Ibe—d to me, as s1hown below, the dove?opme:,E he's propos:-_ a: t I�t Iocadon,
and, I have no obiecdons to his proposr:.I. I ur�ce:s :d tr:E_ ple��mUo(inQ
pilings;boa diftfboaftusc must be se, back a minimum distance of f rtzen fee: (�) from my a ca
of roa^ian access unless waived by -me.
I dn,flnt wish to w2 ve the setback reouiremenr_
I r n �-ish to wLV.- t'at S,.tbaci rc�Ulr�:il� lf.
--------------------...- --
DE.SCRII'TIOV AtiD/OR DRAIN-LtiG OF PROPOSED DEVELOP�IEYT:
• (To be filled il- by individucl proposin; des•e!opment) I
�1 may' i
i
��Yjd/tJi� /�io�or..� lJ.i.itres� S�iurt�l.uc. �
v r1% . 7%' e,;,1(s
sib
Print or Type Name^
-�-�o --1 q�.'A-11\ -�lI