40091_STEELE, DOUGLAS_20041029

L�ICAMA / L DREDGE & FILL
GENERAL PERMIT
E,New ❑Modification ❑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
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Previous permit #
Date previous permit issued
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❑ Rules attached.
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Applicant Name'✓�JrGt�i
Project Location: County
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Address /.52
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Street Address/ State Road/ Lot #(s)
City_ e-L,
State zip U
Phone # ('` -') ^ �u- /�'
Fax # ( )
Subdivision k //
Authorized Agent
City 4'�!-rJl--1 �1—
zip-72-5%KJ
Affected 11 CW
❑ EW
PTA ` ES ❑ PTS
Phone # ( )
River Basin
❑ OEA
AEC(s):
❑ HHF
LJ IH ', UBA — N/A
Adj. Wtr. Body '' '
� t y ' � �r %�� � _(_nat /man unkn
-I PWS:
C FC:
Closest Maj. Wtr. Body
0
ORW: a no PNA yes / no Crit. Hao. yes / no
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
w�
Beach Bulldozing =-- -- t
Other
Shoreline Length /40
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 Name
Signature ** Please read compliance statement on back of permit
(Scale:
See note on back regarding River Basin rules.
Permit Officer's Signature
Issuing Date Expiration Date
Ti/ o.s-1 9 43
Local Planningjurisdiction Rover File Name
Application Fee(s) Check #

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, certify that 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:
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 Il
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 Mail
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

DouglasA Steele ��� 66-30/53� - 1036Yµ
XCflddlu Steele
152 RoM�qg wood Dr. �r
,Newport, NC28570 DATE 10 —,12
PAY TO THE
ORDER OF
4 na—.
Look for: MicrPrin o t signature lint gray type and linarark, Firs! CitiDOLLARS o
-ens Bank -logo on back. if not s • . QT� cash,
F,RSI CITIZENS 137
n A FirstCitizans Bank 8 Trust Comparry
�f�l wit Morohaad City, N.C. 28557
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FOR.
':0531003001:0013 L7496037n' O L 36

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/MOORING PILINGSIBOATLIFT/BOATHOUSE)
I hereby certify that I own property adjacent to %�,r �,z % _� /i % e'r 's
(Name (0 Property Owner)
property located at Agl 120A.1)y
(Lot, Block, lVoad, etc.)
on 1�� d l_A A1A%, in Al'-- a) go!-k , N.C.
(Waterbody) (Town and/or County)
He has described to me, as shown below, the development he is proposing at that location,
and, I have no objections to his proposal. I understand that a pier/mooring
pilings/boatlift/boathouse must be set back a minimum distance of fiftee feet--(14) from my area
of riparian access unless waived by me.
` A
I do not wish to waive the setback requirement. J O C T 2 9 2004
I d4 wish to waive that setback requirement. MOCO
head City OCM
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DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
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Telephone Number
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ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/MOORING PILINGSIBOATLIFT/BOATHOUSE)
I hereby certify that I own property adjacent to 1:c c� /rl S / Si'�j� 's
(Name d roperty Owner) =-
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rt located at %'D CN
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ProPe Y - -
(Lot, Block, ad, etc.)
on/G/j cl C /�G�C �r'Iti.� , in Gam' c tJ� /`� , N.C.
(Waterbody) (Town and/or County)
He has described to me, as shown below, the development he is proposing at that location,
and, I have no objections to his proposal. I understand that a pier/mooring
pilings/boatlifUboathouse must be set back a minimum distance of fifteen feet (15') from my area
of riparian access unless waived by me.
A)A I do not wish to waive the setback requirement.
x A- I dQ wish to waive that setback requirement.
DESCRIPTION AND/OR DRANVING OF PROPOSED DEVELOPMENT:
(To be filled in by indi►-idual proposin; development)
ICJ A T'4 G lei ter^ �' A'S
0 C i 2 9 2004
Morehead City DCM
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