37545_STROUD, JERRY_20040224

❑CAMA / . DREDGE & FILL
6iGENERAL PERMIT
ElNew ❑Modification -Complete Reissue I _'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
Previous permit #
Date previous permit issued
A licant Name o y County—'--,,, �I = �<< Project Location: Coun "�• .f �
PP 1 -
Add Street Address/ State Road/ Lot #(s)
ress__ -.
City �; .
_ State _ ZIP
Phone # O _`� `�� �-
Fax # ( )
Authorized Agent `)rlt�
1
Affected Ll CW ❑ EW
PTA ❑ ES PTS
AEC(s): —' OEA ❑ HHF
❑ IH ❑ UBA = N/A
D, PWS:
«yOFC:
ORW: yes / no PNA
yes / no Crit. Hab. yes / no
les attached.
Subdivision
City - s. r (n, f .. i ZIP
Phone # () River Basin WE' 4 ' ok
Adj. Wtr. Body N�-r>! At,/man /unkn)
Closest Maj. Wtr. Body. ' ` I
Type of Project/ Activity
(Scale:
Pier (dock) length
Platf
Finge
Groin length
Bulk
Basin
-7
Boat
Boat
Beac
Othe
Shoreline Length
SAV: not
Sand
Mor
Phot
Waiver Attached. yes eno
A building permit may be required by: / El See note on back regarding River Basin rules.
Notes/ Special Conditions c
r pier(s)
' r
Agent or Applicant Printed Name Permit Officer's Signature
Signature ** Please read compliance statement on back of permit" Issuing Date Expiration Date
Application Fee(s) Check # Local PlanningJurisdiction 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:
El 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 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

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3/0Zl)ll� ;P4• 252-393-6121
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Pay to the
Order 4
MARINEC FEDERAL
CREDIT UNION
JACKSONVILLE,
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CHECK GALLERY. 1995 STYLE, P20 1-800 354.3540 www.th90kgaII8ry,C0r

ADJACENT RIPA.RL�N PROPERTY OWNER STATE -PENT
(FOR A PIER/MOORING PILINGSIBOATLIFT/BOATHOUSE)
I hereby certify that I own property adjacent to �h; �? �R ;� . �`�i ��� iJ 's
(Name of Property Owner)
Property located at j - L .j C-- 0 ,4 ` 1-?a ;4 is
(Lot. Block, Road, etc.)
on E�h , in CAFE ('.:^r ' 4-C � �' 1�! , N.C.
(Waterbody) (Town and/or County)
He has described to me, as shown below, the development he is proposir.7 t; at location,
and, I have no objections to his proposal. I understand that a pier/ moorinQ
pdin gs/boatiift/boathouse must be se_ back a minimum distance of fifteen feat (IS) from my area
of riparian access unless waived by me.
I do nnt wish to wai,.,e the setback reouirement.
I J-Q wish to waive t ..at setback rec uirement.
DESCRIPTION AND/OR DRAWD\ G OF PROPOSED DEV-ELMIENT:
(To be filled in by individual proposiiz development)
Siznature
/ ! (�
Print or Type Naine
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Telephone Number
Dater S �G

.. , "JACEN'T RIPARLiN PROPERTY OWNER STATE-�LEN•T
(FOR A PIER/MOORING PILINGS1E0A77IFT EOATHOC'SEj
I hereby c--7ary that I own property adiaceat to i s
(Name of operty Owner) �i3-2-1
prone..-y located at 3i v &-3 CLIN (fl- /?6 ,'4'o
(Lot. Block, Road, etc.)
on N.C.
( aterbody) (Town and/or County)
Fe has desc: bed to me, is s;;own below e developme:,t he is propos -= a_ t``_ location,
and, I have no obiecdons to his propo� 1. I under--='d tr
pI r m00rnZ
D11i`1=Sr'vGallrTibOa iou� must be Sc: baCiC a IiiinliTium dIstanct Or i!��een (! 5•) -:-on
back my arm
or 7a ar, access unless waived by .riles 1
o WILL C'OmlA,G- Ou T Igo
I do not wish to wa::e the se:bac'.c ie-ulremeat. �1�CK TN'F�(iv(Z�11t� C� flN(iJE(,
I �Ln ,visi1 to wLve _`zt setback r .ire; ,ent. it k0j (T L )F -S (�,-FGV
-------------
DESCRIPTION AN-DiOR DRAWS G OF PROPOSED DEVELO?'%F�:\ T
(To be filed i:: by individ Z propose, developmer.)
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