36781_HUBBARD, WILLIAM_20031216

❑CAMA DREDGE & FILL
GENERAL PERMIT
P
Previous
ermit #
CNew ❑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 15A NCAC
L�J Rules attached.
Applicant Name Project Location: County
a
Address �, / �' �C%, I,�;.<.;./ Street Address/ State Road/ Lot #(s)
City_ State /(1C ZIP -?7'�l`I-87r/
Phone # (! �) �. - % i{ 9U Fax # O Subdivision
Authorized Agent City ZIP_
Affected ❑ CW ❑ EW ❑ PTA 'YES ❑ PTS Phone # ( ) River Basin
AEC(s): ❑ OEA ❑ HHF ❑ IH ❑ USA ❑ N/A Adj. Wtr. Body
❑ PWS: ❑ FC:
ORW: yes /, no} PNA yes /(no) Crit. Hab. yes / no
Closest Maj. Wtr. Body i =
Type of Project/ Activity
Pier (dock) length__
Platform(s)
Finger pier(s)
Groin length
number
Bulkhead/ Riprap length
avg distance offshore
max distance offshore
Basin, channel
cubic yards
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing_
Other
Shoreline Length
SAM not sure yes
no
Sandbags: not sure yes
no
Moratorium: n/a yes
no
Photos: yes
no
Waiver Attached: yes
no
A building permit may be required by:
Notes/ Special Conditions
Agent or Applicant Printed Nam
i
Signature Please read compliance statement on back of permit
Application Fee(s) Check #
T
See note on back regarding River Basin rules.
Permit Officer's Signature
Issuing Date Expiration Date
Local Planning) urisdiction Rover File Name
nkn

o�
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:
❑ 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.nccoastaimanagement.net
Revised 10/05/01

TO: Ted Tyndall (Cama)
Fax#: [phone]
Date: December 10, 2003
Page#:
From: Foley & Foley (Sandy)
Phone#: [phone]
Customer Work Sheet
Customer Name: Dr. William Hubbard Date:
Mailing Address: 10413 Manly Rd. Chapel Hill, NC 27517-8391
Job Address: Phone: [phone]
Adjacent Property Owners
Left Side: Rusher Right Side: Brady
Job Type Description
Bulkhead
Dock/Walkway
Platform end of dock
Boathouse
Boatlift/jet ski
Piling Install
Ramp/Jetty
Dredge
Rip Rap Add

12/03/03 16:48 FAX [phone] RALEIGH PEDIATRIC
1/ vV iU. VJ f'�b
i
IM002/003
14n02
ADJACENT R1-PA IUAN PROPERTY OWr I R STA
�`— (BulkhcaWrip rap)
I hereby certify that I ov;-n
P+'oPcrtY adjacent toj ,, L b2w;�
0 qi Lme of I
Prosy located at 'jatilid
(Lot, Black., Rom a ce c
on AJF,'g rpi f�'� n in
(Water body) (To a.nd/or . a in
fie has described to meas s shown below, the develo )i nent he it prolm acing at the
loeatiott, and, I have no objectisliis to his proposal.
DE3C-'RIPTION ANDMP: DRAWING OF I'ROPC IjFD
(to bojWed bi! by btdividual propwsing d �1,elo'
AWLV
___101 1"a
Foley & Foley Contractors, Inc.
Phone#: [phone] S
ki [phone]*-
�Lf
5 &C-4-
gnature
Print A r Type T
5- a
Tel h shone M
Ij
3
] "MENT
u ,,QW126--r.
ON ) C; 10k

DEC-11-03 02:13 AM
P. 01
P1
ADJACENT RIPAR[AV PROPERTY OWNER STATEMENT
(Bulkhead/rip rap)
reby certify that I own property adjacent t��;� rt,/��� .s
(Name of Property Owner)
:ate@ at V,.eLQ--L ZJ
(Lot, Block, Road,
on c�,_� h . in - ti �'
(Wetter body) �C19.
(To n nndror otmty)
He has deser.bed to me as shown below, the development he is proposing at the
location, and, I have no objections to his proposai,
IDF.SCRIPTTON AND/OR DRAWING OF PROPOSED D>E`'ELOPWNT
(to befiAed In by Individual proposing devsiopawnr)
-gel
gA4 J, ) )RBI,-
0 0��A 0
6 co �o ��
Foley do Foley Contractors, Inc.
Phoned'052)636-2515
VFUN [phone]
�k
�a
­ C f '4' "��
z)r
Print or Type Name
5-T-(C1 :? -r ? - S—/ Z (1
Telephone Number
r -/ ! d c-3
Date