38372_JORDAN, JACK_20040514

❑CAMA / ❑ DREDGE & FILL l
V
GENERAL PERMIT Previous permit#
'El 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 Resources Commission in an area of environmental concern pursuant to I SA NCAC
_ L Rules attached.
Applicant Name --�C"Zckat Project Location: County
Address j j,,`t(,�:� Street Address/ State Road/ Lot #(s) f.,
Ci
,c) t ,•� '� State'...,, �C, ZIP
Phone # (` '��t—` Fax # Subdivision-T^-----
Authorized Agent City 1c. ,� `J _ ZIP
Affected ❑ CW CI EW [' ,PTA El ES ❑ PTS Phone # (�) `"� River Basin
AEC(s): 'IOEA ElHHF ❑ IH UBA El N/A Adj. Wtr. Body (nat. man unkn
ORW: yes / no PNA yes / no Crit. Hab. yes / no Closest Maj. Wtr. Body
Type of Project/ Activity
Pier (dock) length—_-
j
Platform(s) U S4 i
Finger pier(s)
Groin length [(:.
number' --�-- -�-�
Bulkhead/ Riprap length
avg distance offshore 4
max distance offshore
Basin, channel
cubic yards j
Boat ramp
e-� 1 f ---- ---
Boathouse-/ Boatlift
Beach Bulldozing
Other=� :_i
Shoreline Len h
� ! I
gt
SAM not sure Zes
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 ame
j
t ' nature Please read compliance statement on back of permit
Application Fee(s) Check #
(Scale: )
See note on back regarding River Basin rules.
Permit Officer's Signature
Issuing Da a ExF iration bate
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 U 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 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 / 1-888-4RCOAST
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

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PURCHASER. SIGNER FOR DRAWER
PURC(7 By SIGNING YOU AGREE TO TI,F TEPUS ON THE REVERSE SIDE
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MONEY ORDER ADDRESS GIFT CERTIFICATE RECIPIENT
ISSUER/DRAWER:-•------------------------------------�
TRAVELERS EXPRESS COMPANY, INC.
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05/13/04 THU 11:55 FAX [phone] HP&W-HILLSBOROGH la0
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MON 10:07 FAX [phone] HP&W-HILLSBOROGH Z 002
ADJACENT' 1JPA,�. N �P �3PEr Y. (OWNER STATE.c +fEN7
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(FOR A IER/MOQRMG`B J.;NigS1#DATLIFIYBOATHOUSE)
I hereby certify that I own pmperty, ad9acenc to
(Name of Property Owner)
property located at 1S - acK Joust
(Lat, Block; koad, etc_)
on ggck .,Scum , in s%4rt �4/'/' , N.C-
(Waterbady) (Town and/or Cou ty)
He has described Ito me, as shown below, the development he is proposing at that location,
and, I have no of ections to his proposal.: I understand that a pierlmooring
1 ilingsiboadiftlboathouse must be.sm back a minimum distance of fifreen- feet (15) from m area
of riparian access unless waived by me. Y
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I donot wish to waive the setback requirement.
I d2 wish!! to, wive ti:at setback' requirement.
DESCRUK AND/OR DRAG OF PROPOSED DEVELOPtiiENT:
IP1i
I (To'be filled in by individual proposing development)
Signature
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Print or Type Naive
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Telephone Number
Date:

04/26/04 MON 10:07 FAX [phone] HP&W-HILLSBOROGH Z 004

04/26/04 MON 10:07 FAX [phone]
�09/12/2004 11:11 252729�221
0311004 WED 12:53 PAZ 919 732 H990
HP&W-HILLSBOROGH
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Jack Jordan, Buyer, has Alton Best & Glenda Bes4 Sellers, pmmi$40n to a"ly for'
permit to buuld a boat dock on the property Jocated at 139 Back Sound Lane, H.aracer's
1,land, NC (PIN# 733519427091),
Seller bate Sewer Date

04/26/04 MON 10:07 FAX [phone]
HP&W-HILLSBOROGH 0003
IS Complete'items 1, 2, and 3. Also aomOJ6 e
item 4 if Restricted Delivery is desired-
■ Print your name and address on the reverse
so that we can return the card to you_
R Attach this Card to the back of the mallpiece,
or on the front if space permits.
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❑ Insumd Mail 0 C.O.Q,
4. Rertrictod Delivery? (Extra Fee) G7 v
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(Hans/ar rrom service 6 003 1680 0004 9068 4981
PS form 3811, August 2001 Domoste Retvm Roceipt 2ACPR)-0}P4oB