37551_TOLTEA, LUCILE_20040302

�]CAMA / J DREDGE & FILL
GENERAL PERMIT
IINew ❑Modification -'Complete Reissue C'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
City - I, "' l State V ZIP
Phone # ( � ') ' 1 t 3--L. 71 s Fax # (
Authorized Agent
!) . ! (a r
❑ CW
❑ EW © PTA
Affected
AEC(s):
❑ OEA
❑ HHF ❑ IH
❑ PWS:
❑ FC:
ORW:
yes / no
PNA yes / no
❑ ES ❑ PTS
❑ USA ❑ N/A
Crit. Hab. yes / no
Previous permit # AVfI
Date previous permit issued
El Rules attached.
Project Location: County
Street Address/ State Road/ Lot #(s)
Subdivision
City /' `'F rr vZIP
Phone # ( ) River Basin
Adj. Wtr. Body r., e.t art^i (nat /man /unkn)
Closest Maj. Wtr. Body v = v
Type of Project/ Activity
(Scale: 4 r t. )
Pier (dock) length -
1 r a
i —1--
Platform(s) - - - I -- - - ---
Finger pier(s)
Groin length
number
Bulkhead/ Riprap length y K
avg distance offshore
max distance offshore
Basin, channel
cubic yards
Boat ramp
Boathouse/ Boatlift
Beach BulldozingIP
_lint
Other
Shoreline Length
SAM not sure yes no
Sandbags: not sure yes no f
Moratorium: n/a yes no
Photos: yes (no
Waiver Attached: yes (Fo
A building permit may be required by: ° / 6 J . k�c, l
Notes/ Special Conditions a iIV,
•d
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1
f
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--
- --
I
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--
❑ See note
--
on back regarding River Basin rules.
Agent or Applicant Printed Name
Signature ** Please read compliance statement on back of permit **
Permit Officer's Signature
Issuing Date Expiration Date
ApplicationFee(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, certify that this project is consistent with the North Carolina Coastal Management Program.
River Basin Rules Applicable To Your Project:
D Tar- Pamlico River Basin Buffer Rules ❑ Other:
L] 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
Mailing Address:
1638 Mail Service Center
Raleigh, NC 27699-1638
Location:
Parker -Lincoln Building
2728 Capital Blvd.
Raleigh, NC 27604
919-733-2293 / 1-888-4RCOAST
Fax:[phone]
Elizabeth City District
1367 U.S. 17 South
Elizabeth City, NC 27909
252-264-3901
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.nccoastaimanagement.net
Revised 10/05/01

MUD BUCKET D
ATLANTIC gEACH KEDGING, INC.
AT BOX CAUSEWAY NCDL 8039839
5 PH(252)726-2191
ATLANTIC BE
ACH, NC 28512
Pay to the
Ordpr of L //I 'n
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RS`T CITIZENS,,, fkw
BANKA%"-Cifigon, Bank g Trust Company
A�iaftc Bead, N.C. 28512
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www. firstcitizens.corn
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Date 66-30/31
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GUARDIAN&SgFETy LU�`E"

Feb 06 04 09:12a Sandy 252-?26-6112 p.1
4
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ADJACENT RIPARIAN PROMMY OWNER STATMUNT
I hereby Certify that I own property adjacent to
1__UCI�=E • TAL.'F-Dl! °s property
located at 2 r tl A-rL,AA-r i e- 14iAC-6* C%4V36w on
r
130qu E
(lot, Bock, Road, etc.)
SJOdPtf�
AdeBSS in A'r*,4Mr C- '�A" ZSSIZ , N-C-
(water Body) T ('town and/oar County)
He has described to me as indicated below the development
he is proposing at that ioaation and i have no Objections
to his proposal. I understand that a pier, pilings and
dredging must be set back a minumum distance of fifteen Peet
(15,) from my area of riparian access unless waived by me.
I do not wish to waive that setback requirement.
I do wish to waive that setback requirement.
Description and/or drawing of proposed development:
(To be filled in by individual proposing development.)
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PiInt Name
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ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to
's property
located at _ 2 (N A-VLAtA'r t C �[.iAe�•k L'403' WAY on
(Lot, Block, Road, etc.)
l,,goC S'ovNn
C c ES$ �-►-t /a N/1 E L _ in ATLA N TI C- 3C'/A" Z BS I Z , N.C.
(Water Body) (Town and/or County)
He has described to me as indicated below the development
he is proposing at that location and I have no objections
to his proposal. I understand that a pier, pilings and
dredging must be set back a minumum distance of fifteen feet
(15') from my area of riparian access unless waived by me.
0
I do not wish to waive that setback requirement.
I do wish to waive that setback requirement.
Description and/or drawing of proposed development:
(To be filled in by individual proposing development.)
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Signature
Print Name
1001
na+-o
Phone Number

Feb 14 04 09:57a Sandy 252-726-6112 p.2
MAR-01-2004 10:48 PM P.02
Feb 09 04 04:23p Sandy 252-726-0112 p.a
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ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to
UC1L� Iyf LTOh( ' e property
located at 2fc4 AT-i AMTlG *S&,Ad-b* CAy1&W4Y on
(Lot, 8 vc , Road, etc.)
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me has described to me as indicated below the devQlopraent
he is proposing at that location and I have no objections
to his proposal. I understand that a pier, pilings and
dredging must be set back a minumum distance of fifteen feet
(15') from my area of riparian access unless waived by me.
I do not wish to waive that setback requirement.
i do wish to waive that setback requirement.
Description and/or drawing of proposed development:
(To be filled in by .individual proposing development.)
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