36774_LEE, DANIEL_20031109

C J CAMA / '`1 DREDGE & FILL
GENERAL PERMIT
C1New hModification ]Complete Reissue ❑Partial Reissue
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
Applicant Name_
Address j
City C /
Phone # ( _' )_
Authorized Agent
Affected -1 CW
AEC(s): O OEA
PWS:
ORW: yes / no
State ZIP
'i ',,(Z Fax #( )
O EW Da PTA
❑ HHF ❑ IH
❑ FC:
PNA yes / no
C7 ES ❑ PTS
❑ UBA I N/A
Crit. Hab. yes / no
Previous permit # 0
Date previous permit issued
�l 1'lCO
Rules attached.
Project Location: County i/ • : j
Street Address/ State Road/ Lot #(s)
r�
Subdivision
City - - ZIP C iff
Phone # ( ) River Basin d' A h lC!�
Adj. Wtr. Body Klri r� UA, (at %mom an /unkn)
Closest Maj. Wtr. Body `"L-fN' err, ed
Type of Project/ Activity : Ur a
t , (Scale: .Q 6,- F )
Pier (dock) length
Platform(s)
Finger pier(s)
Groin length
number -
Bulkhead/ Riprap length �Q' 1
avg distance offshore
max distance offshore S _
Basin, channel
cubic yards
Boat ramp
Boathouse/Boatlift
Beach Bulldozing_ V�/ Other
Shoreline Length r
{L,C Vr
SAM not sure yes no
Sandbags: not sure yes no i
Moratorium: n/a yes no
Photos: yes no
Waiver Attached: yes 'no
A building permit may be required by: It See note on back regarding River Basin rules.
Notes/ Special Conditions vvo' t-P -i j a r
71' �lr"f !1%6fllItr I t �f11AJ"=itAJ1.0, t4 rV101; r:1,.� I �- I'; 1 'f ri✓J � o �GUNd d/II I- loP,!/
Agent or Applicant Printed Name
Signature ** Please read compliance statement on back of permit
Application Fee(s) Check #
id 'f, -
Permit Officer's Signature
;5a3 s'
Issuing Date Expiration Date
Local Planningf urisdiction 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, 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 (252-946-648 [)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
151-13 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
2S2-946-6481
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

TINA L. LEE —"
DANIEL LEE
NC LIC. 8922734 NC 3993940
3029 WHITE HART LN. PH. 919-661-7118
RALEIGH, NC 27606
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ADJACEivT RIPA U-- PROPERTY OWNER STATEMENT
(FOR A PIER/MOORING PILINGSIBOATLIFTIBOATHOUSE)
I hereby certify that I own property adjacent to J�d
(Name. of Property Owner)
prope.-y located at o T /'7 �/ C�GZ�9d( 7 2,57 yQo�
(Lot; Block, Road, etc.)
on JZ ��C� �� I , N. C.
(Waterbody) (Town and/or County)
He has described to me, as stlown below, the deve'.opme.,t he is propos:- a.- that location,
and, I have no objections to his proposal. I understLnd tha: a pier; moonng
pilings/boa liiTlboathouse must be s : back a minimum distance of fiietn fee: (5•) from my area
of ripa ian access unless waived by -me.
_— I do not wish to wa v-z the setbac'.< requirement.
I do wish to waive r`at setbac!< recuirement.
--------------------
DESCR=10. ' A.',,,-D/OR DRAWD G OF PROPOSED DEVELOP`fE\T:
--- ---- a (To b t lleb_v individual proposing aeyelopmenr)
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ADJACENT RIPARIAN PROPERTY OWNER STATENIEN'T
(FOR A PIER/MOORING PILINGSIBOATZIFTIBOATHOC'SE)
I hereby cerdfy that I own property adjacent to ✓ � ` �� 'S
(Name of Property Owner)
prope y located at ,� 0 �� e (v,�L #��' y p G,? 77.S? c/C10, 0
(Lot. Block, Road, etc.)
C C� / , N.C.
(Waterbody) (Town and/or County)
He has described to me, as shown below, the deve'.opme:ic he is propos:-- a_ that location,
and, I have no objections to his proposal. I u ,ce-s �::d t :a: a pier; mooing
PL-i s,'boadlififboachouse must be sz, back a minimum distance of FI�e-2n fet: (5') Fom my area
of ripzian access unless waived by -me.
— K I n nn wish to wave the setback requiremenc.
I do wish to waive t.`ac setback recuiremenc.
--------------------------
DESCRIPTION A.YD/OR D.RAWE\�G Of PROPOSED DEVELOF�fE`T:
-- - /To Lc FClled in by individual proposing deve!opmenr)
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