36789_LAVALLEY, BERNARD_20040108

I 1 CAMA / ❑ DREDGE & FILL
GENERAL PERMIT
Previous permit#
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 I SA NCAC
❑ Rules attached.
Applicant Name ` r( Plot Cl f o )It,,
Project Location: County
Address
Street Address/ State Road/ Lot #(s)
City >v'�WP�<� State N( ZIP
Phone # ( ) . '"- ' 1 j. 9 5 Fax # ( )
Subdivision t 11 , j ' / cD
inlLtiLC�
Authorized Agent en -
City lJrwnG, ZIP G
Affected I CW ❑ EW PTA ❑ ES C PTS
.
Phone # River Basin I ( ) nf � 14
❑ OEA ElHHF El IH ❑ UBA ❑ N/A
AEC(s):
'
Adj. Wtr. Body r l wea /man /unkn)
❑ PWS: ❑ FC:
ORW: yes / no PNA yes / no Crit. Hab.
yes / no Closest Maj. Wtr. Body
Type of Project/ Activity i �� t,, Ow r J /4 ( fool r C c
i ►H tf • �, <i <. �J (Scale: /vcy, i" )
Pier (dock) length
Platform(s) ;�
Finger pier(s) - Groin length --
number
Bulkhead/ Riprap length
i
avg distance offshore
max distance offshore I lr�� �f�" *'� 4,0s( / (f<
Basin, channel --
cubic yards
Boat ramp
Boathouse/ Boatlift
�•' % (iTll. 4 V''�
Beach Bulldozing
Other
Shoreline Length /
SAM not sure yes no
Sandbags: not sure yes ,no
Moratorium: n/a yes
/`�`�'" _
Photos: es no
o
Y
Waiver Attached: yes, no
A building permit may be required by:
Notes/ Special Conditions /V1
. 41 a ; 410114
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❑ See note on back regarding River Basin rules.
101 f r.6J 1. C A If
Agent or Applicant Printed Name
Signature Please read compliance statement on back of permit"
V ii�(. L 0
Application Fee(s) Check #
'r
Permit Officer's Signature
,•�;�y
�►y c'1
Issuing Date
ipj4f,(•4
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 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.nccoastalmanagement.net
Revised 10/05/01

BERNARD M LAVALLEY
634
NCDL 7626764 PH. 252-240-1695
P O BOX 1828
NEWPORT, NC 28570-3766/1
66-I12/53I
02001
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BRANCH BAN MPANY
11111 G 0 L D
HAVEL CK, NORTH CAROLINA
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Page 1 of 1
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ir,"1'IY'i%I} NMATI.f • IZ ?l 1 '' REt EIPI' IZE . -:S'r ; )
DIVISION OF COASTAL MANAGEMENT
ADJe` CENI RIPARIAN PIZUI'lrRTYOW�NLIt?ai�U'I'IFlC/��T1tJ�^�'i�ti'AIVER FOPUYI
I' nine of Individual applying for Pei mit: 6 E1f UA�,Q Z414Z4-Iff l V-
Address of Property:- 'na(a_—a04LiNCyWOOO roakle ..- _ _C`-�'%. 2t3
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(Lot or Sire-t #, Strect or Road, City & County),
I h.-I-:roby certify that I own p4roperty adjacent to the above referenud property. The individual
nrpiyinr, for this perrlit has dcscri+xd to me as shown on the attached d,-au.;«p the devel-opment
they a:c proposing. A description or drawing, with dimensions, should be provided with this
Letter r.
✓ I have no objections to this proposal.
If you have ohjectlnr:s to -;dual is heing proposed, please write the Division of Coastal
Management, llestrort Plaza 11, 151-il, Hwy. 24, hforcheat: City, NC:, 28557 or call (252) 8OS-
2808 wiihin 10 rtay,� qf receird or this notice. No response is cortsidercd Me same as no Abjection
if you have beer: notifted by C,'ertijied AMR.
WAIVER sr:c•rION
I uiidE!rstancl that a Pier, dock, mooring pilings, breakwater, boat house, lift or sandbags must be
set back a, iWmini uil distance of 15' from my area of riparian. IcceSS r:nless waved by rne, lffyou
wish to waive thzu setback, you Piust initial the appropriate blank below.)
X _ ✓ I do wish to waive tilt 15' setback requirement.
1 do not wish to wa:vc 1!1c 15'set►:ack requirement.
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Print N'•:11110
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(FOR A PIFRIIVICit.')RIPIG PILle;GSIBOA7`LIfTIBOATHOL'Stj
own proD,rty ad;scP ,t to t5'C2AIM6 / ��LG�Y 'S
(Name of Propert► Owner)
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ffatenccdti',l (Town and/or County)
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AtiT%OP. DRAWING OF PRUPOSED DEV'A-rC, .[E\—t:
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■ Complete items 1, 2, and 3. Also complete
item 4 if Restricted Delivery is desired.
■ Print your name and address on the reverse
so that we can return the card to you.
■ Attach this card to the back of the mailpiece,
or on the front if space permits.
1. Article Addressed to:
�G�D6itJ � oi�N�iC
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A. Sign r
X ` ` NLAgent
❑ Addressee
B. c iv y (Printed Name) I ate of Delivery
D. Is delivery addres,9p"different from item 1? ❑ Yes
If YES, enter delivery address below: ❑ No
3. Lervice Type
Certified Mail ❑ Express Mail
❑ Registered ❑ Return Receipt for Merchandise
❑ Insured Mail ❑ C.O.D.
4. Restricted Delivery? (Extra Fee) ❑ Yes
2. Article Number f� r
(Transfer from service label)
PS Form 3811, August 2001 Domestic Return Receipt 102595-02-M-1540
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■ Complete items 1, 2, and 3. Also complete
item 4 if Restricted Delivery is desired.
■ Print your name and address on the reverse
so that we can return the card to you.
■ Attach this card to the back of the mailpiece,
or on the front if space permits.
1. Article Addressed to:
jUSTi l Wil- 5C1
A. Signature
X Agent
Addressee
B. Received by ( Printed Name) Date of Delivery
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D. Is delivery address different from Item 1? ❑ Yes
If YES, enter delivery address below: ❑ No
i'1�U2 i G/ice t✓I�y Aj -4. 3. Service Type
--5— 7 certified Mail ❑ Express Mai!
/ � Registered ❑Return Receipt for Merchandise
❑ Insured Mail ❑ C.O.D.
4. Restricted Delivery? (Extra Fee) ❑ Yes
2. Article Number
(Transfer from service label) 7003 3110 0000 3036 1266
PS Form 3811, August 2001 Domestic Return Receipt 102595-02-M-1540