39616_JONES, JOHN_20040804

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GENERAL PERMIT
Previous permit #
New `-Modification _Complete Reissue 0-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
r _ _
Applicant Name ��' �'�1
❑ Rules attached.
Project Location: County
u,'
Address J l l %
Street Address/ State Road/ Lot #(s)
City_ J.. o State N ZIPS
_
Phone # ( )-7 7 V 67 Fax # (^)
Subdivision '•'�"
Authorized Agent ""
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City ZIP
-i CW I E1N E3 TA � ❑ PTS
Phone # ( ) -` River Basin N"?�-
Affected
❑ OEA ❑ HHF ❑ IH ElUBA ❑ N/A
AEC(s):
< o �f �-h
Adj. Wtr. Body_ /man /unkn)
nat
I- PWS: ❑FC:
` �'
0�
ORW: yes / no PNA yes / no Crit. Hab. yes / no
Closest Maj. Wtr. Body
Type of Project/ Activity
Pier
Platf
Finge
Groff
Bulkl
Basir
Boat
Boat
Beac
OthE
Shor
SAM
Sand
Mor;
Phot
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(Scale: )
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length
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max
cubic yards
ramp
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Bulldozing
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Length 7
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not sure yes Q
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■■■■■slags:
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A building permit may be required by:
Notes/ Special Conditions
Agent or Applicant Printed Name
Signature Please read compliance statement on back of permit
Application Fee(s) Check #
E See note on back regarding River Basin rules.
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, 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:
Buse 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

JOHN "ONES
DONNA P JONES
8985
NCDL 3492096 /Ncdl 5202535
12040 Nc Hwy 304 252-745-4667
66-21/530
Bayboro, NC 28515
BRANCH 77512
/
Pay to the
Order of
Date
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Dollars
+ WACHOVIA
Wachovia Bank, N.A.
wachovia.com
1:0 5 3000 2 1 91: L00 78 6 20 2 L 7 5 311'
8 98 5 ``

+ 0'5/05i2004 09:28 NEW BERN DISTRICT OFFICE 4 92522473330 NO.962 D01
IFAX [Date
INumber of pages including cover sheet
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FROM: eAesft;— roL"t
N. C, Dept. of
Transportation
209 S. GLENBURNIE RD
NEW BERN, NC 26560
Phone [phone]
Fax Phone [phone]
REMARKS: ❑ Urgent ❑ For your review ❑ Reply ASAP ❑ Please Comment
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'Ct/05/2004 09:28 NEW BERN DISTRICT OFFICE 4 82522473330
'APR-30-2004 FRI 04;08 PM NC DIV OF COASTAL MGMNT FAX NO, 4
NO. 962 J2
P. 02
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DIVISION OF COASTAL MANAGEMENT
TO:
OFFICE:
NCDENR
NORTH CAROUNA DEPARTMENT OF
ENVIRONNE.NT AND NATURAL RESOURCES
151-B HWY. 24, HESTRON BUILDING
MOREHEAD CITY, NC 28557
TELEPHONE: [phone]
FAX: [phone]
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TELEPHONE #: jaf-�I'] fly — u-7 / � FAX #: j2:�t3 sS/y `i 8- % y
FROM:
OFFICE: DIVISION OF COAS T Ai. NiANAGENIENT
RE: P� �,, a�' #'y 3o
DATE SENT:
TOTAL NUtvlBER OF PAGES INCLUDING COVER SHEET: