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XCAMA / ❑ DREDGE & FILL /
GENERAL PERMIT Previous permit#
ONew ❑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 I SA NCAC
FD Rules attached.
Applicant Name i4014, �-I, r,/ r-
Address
City_ r4 ? j0 to � c �_d , L State tJ" ZIP
Phone # (1 `i�) � 91 3';�� Fax # ( )
Authorized Agent vet
Affected ❑ CW K EW p PTA ❑ ES ❑ PTS
AEC(s): ❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A
❑ PWS: ❑ FC:
ORW: yes / no PNA yes / Imo Crit. Hab. yes / no
Type of Project/ Activity r
hOd
Pier (dock) length
Platt
Finge
Groin length
Bulk
Basil
Boat
Boat
Beac
Othi
Shor
SAM
Sanc
Mor
Phoi
Wain
Project Location: County
Street Address/ State Road/ Lot #(s)
`I /4r'! 47"e
Subdivision
City /'`ao x' u'•�.r l ZIP
Phone # ( ) RiverBasin �rf
Adj. Wtr. Body :' �~�. (nat % am n /unkn)
Closest Maj. Wtr. Body
(Scale: /v o NE )
r pier(s)
i
-
number
Ir�. o~
lead/ Riprap length }
avg distance offshore _.� _ t 1X L r (.0 S� ' V )
max distance offshore
channel
cubic yards
?
ramp
louse/ Boatlifi 'Cyr M
i Bulldozing --- -
�I I
r
W
i
I
dine Length _T
not sure yes no
Sags: not sure yes no
torium: n/a yes no L
Ds: yes no
er Attached- .vec nn - - --
A building permit may be required by: ! 10 a �r•A, c L
Notes/ Special Conditions
t 6-
tignafur * Please read c6r6 lWhEe'staterient on back of permit"
Application Fee(s) Check #
❑ See note on back regarding River Basin rules.
_&J [A
Permit Officer's Signature -7 _ / c-
? � 1 61 - __
Issuing Date Expiration Date
''J1/r.1JT( 1,V3�//ed
Local Planningjurisdiction Rover File Name
A building permit may be required by: ! 10 a �r•A, c L
Notes/ Special Conditions
t 6-
tignafur * Please read c6r6 lWhEe'staterient on back of permit"
Application Fee(s) Check #
❑ See note on back regarding River Basin rules.
_&J [A
Permit Officer's Signature -7 _ / c-
? � 1 61 - __
Issuing Date Expiration Date
''J1/r.1JT( 1,V3�//ed
Local Planningjurisdiction 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 howto complywith 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:919-733-1495
Elizabeth City District
1367 U.S. 17 South
Elizabeth City, NC 27909
252-264-3901
Fax: 252-264-3723
(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: 252-247-3330
(Serves: Carteret, Craven, Onslow -above
New River Inlet- and Pamlico Counties)
Washington District
943 Washington Square Mall
Washington, NC 27889
252-946-6481
Fax: 252-948-0478
(Serves: Beaufort, Bertie, Hertford, Hyde,
Tyrrell and Washington Counties)
Wilmington District
127 Cardinal Drive Ext.
Wilmington, NC 28405-3845
910-395-3900
Fax:910-350-2004
(Serves: Brunswick, New Hanover,
Onslow -below New River Inlet- and
Pender Counties)
www.nccoastalmanagement.net
Revised 10/05/01
HILL'S MOBILE HOME & APTS. 2729
PH 919-447-1948
15M NC HWY 101 HAVELOCK, NC 28532 p 66-152/531 CC
ATLANTIC BEACH, NC 28512
Date
Pay To The �^ 0 Order
rs
Wachovfa Bank, N.A.
L1
NC2&it6
Mem t r�� 3-601, 3
':053 10 l5 291: 5468 l 15
OH RVND 2000
er
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/MOORING PILINGSIBOATLIFT/BOATHOUSE)
�� I hereby certify that I own property adjacent to S &Z 's
( ame of Property Owner)
property located at / / /
on
(Waterbody)
(Lot, Block, Road, etc.)
in Il9 i--8%tL , N.C.
(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/mooring
pilings/boatlift/boathouse must be set 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.
I & wish to waive that setback requirement.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
11��
ature
1'�Me-s /I 000 4, L
Print or Type Name
Telephone Number (�
Date: "'�l'
�' ��.-�s 1 ()1 YN.d'; fa c.;,r, ,: i �' ;,
(FOR A PIERAWt::0VERED B0AT
I hereby certify that I own property adjacent to 1 _ L
i`r; ntc of Property O.,4)
property loc-aced at—��C----_.-
(Lot, Block, Road, etc.) % -
on ut /r /� �. �__C /—.—) ri.C.
(Waterbody) (Tow'n anc!ior! ounty)
He has described to .me, as shown below, the deve!op!,rr°nt he is propcsu1v at r ,,at
location, and, I have no objections to his proposal. I undersuind !,hit a pier/uncoverce. boat lift
must be set back a minimum distance or rirteen rat (I5') from my,ar"a of riparian access urijess
waived by me.
I do not wish to waiva the seiback requirement. I
xI do wish to waive that setback requirement.
- - - ------------- -------------------
DESCRiPTIOIV A-'N-D/OR DRAWING OF PROPOSED DE ELOPNIE.'IT:
(To be faded in by individ-l-a-I -s-i-tr,^
Print or -I-yp- ti..rtie
a 7 r 7�f-
Tzdephone Ivy. rib":r
Date:
.O
piw OF OLD
CAUSEWNY
POND DRIVE (AD' R/w)
SURVEY FOR
J. B. HILL
LOTS 1 I� 12, 13, E 14, C3L0CK 20
,L,TL,LNTI C 6E,4,,C" ISLES
M0RF_' H EkD 7T0WNSH I P
CA RTERET COUNTY
SEPT. 2 81 1987 ScoL E : 1 " = 30 / +f
FiMENt]Gn 17.(GI b(c To SN.,,, cae�p.iEo L1�1�g pt>J
1-\WlE.1CX-- D - SEPT I / "2b8,Z- (To 5How Pi l2fj�
SURVfYEO BY
POWELL SURVEYING COMPAt1Y
P. o. 8 O X 616
8EAO1 09T NC 285IG