39393_TESSIER, JARK_20040722

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GENERAL PERMIT Previous permit #
C1New —]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 15A NCAC
❑ Rules attached.
Applicant Name J e' ' _. Project Location: County F
Address ' r i r`. Street Address/ State Road/ Lot #(s)
City `� �� �r State ZIP
Phone # ( ) cu `f , Fax # ( ) Subdivision f : I..,
lc
Authorized Agent A<F r City fcn -t ZIP 7C4
Affected ❑ CW ❑ EW D PTA ❑ ES ❑ PTS Phone # ( ) River Basin
ElOEA HHF ❑ IH [IUBA El N/A '
AEC(s): Adj. Wtr. Body (riat: /man /unkn)
❑ PWS: ❑ FC:
ORW: yes / no PNA yes / no Crit. Hab. yes / no Closest Maj. Wtr. Body
Type of Project/ Activity
(Scale: ti4 rf )
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/ �tlift " n'c
Beach Bulldozing
Other
Shoreline Length
SAM not sure yes no
Sandbags: not sure yes no
Moratorium: n/a yes no L._r iII
Photos: yes no - - - — - -
4- Waiver Attached: yes no I -
i
A building permit may be required by: !C. El See note on back regarding River Basin rules.
Notes/ Special Conditions s>' 4k• rRla.l tt c 4L %c't F
4 �y, Y►R Q. y, 3 F l A St r p N C% t I ✓% a n o rld, A t. r. i t W
7 i
j 4, l 1 ( ly't'+A rV G (r
Agent or Applicant Printed Name
Signature Please read compliance statement on back of permit
ed
Application Fee(s) i Check #
K,i r ,
Permit Officer's Signature
2 7 r tl
Issuing Date Expiration Date
_ tjl'�j+ i
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:
❑ 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
Mailing Address:
1638 Mail Service Center
Raleigh, NC 27699-1638
Location:
Parker -Lincoln Building
2728 Capital Blvd.
Raleigh, NC 27604
919-733-2293 / 1-888ARCOAST
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
151-13 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
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

1.
J TESSIER CONSTRUCTION INC.
P.O. BOX 4386
EMERALD ISLE, NC 28594
5 c e 6 a
4755
✓ / 66-30/31
31
DATE
THE OPAY 41-
6� ' do
ORDER OF `-r //
O L L A R S
FIRST CITIZENS -
1 A1�T,I First-Citizons Bank&Trust Company
Jill �r �n Morahoad City. N C. 28557
www.firstcitizens.com
FOR
li'00475Sill 1:0531003001:001312L5 L9Gil'

ADJACENT RIPARLAN PROPERTY OWNER STATENIT-L
(FUR A PIERIMOORING PII_IrVGSIBOA7LIFT/BOATHOC'SF)
I hereby ce:-'dfy that i owr, p; operty adjacent to (fyaj51-/l-"'
(Name of Property Omer)
y3 girllf Foe- �qy3
pmre-.y locnted at �. � '_ '� �• R 5/�5 I IA, IV �3 yid y, 5_4 5" ,
(Lot. Block, Road, etc.) wl y -5 4 A 130 Lf /2
on in f' N.C.
(Waterbody) (Town and/or County)
He has desc—&Lbed to me, 2z drown below, the deve'.opmenc he is propos:-Z a: that location,
and, I have no objections to his proposal. I unde-sand tra: a pie.- moorna
pll1;i 5%Goa:itrt/boaihouse m:is: be sz: back a minimum d:siance of fliietn fet: (:_`) fiorn my are:
of rD'- in access unless waived bv•me.
I in_nnj wish to waive the setback requirZmea:.
I o wis�i to ttl�vt s':baCk
---- _ DESCRiPTION A:�D/OR DE:AWD G OF PROPOSED DEVELOPMEN-T: _
(To be filled ir: by individu-al proposing development)
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JUL-15-2004 11;58 EDWARDS INC. 252 478 5017 F.02
A-DJACENYr R.IPARL. PROPERTY OWNER STATEMENT
(FUR A PIERIVOORING PlUrNGSISOATI.IFTI90ATNOUSE)
I hereby ceriFy that I own, property adiacent to g'k ao�ST��'�'
(Name aF Property- Owner)
—fj 5? e y..
(Lot. P iook, Road, etc.) vr.y -s 46 6� 41 A 0a J I�
(Waterbodv) (Town acid/or Cnuncy)
F,- has des.;ibtd to, me, a- sown below, the ae-'e!opmenr: he is propcs`~r ar L''ac lcc;-6011,
-a°)d, I have ro objecrion_< to his propoud. I unde-;.: ^d crG- s pie -,"mooring
Fa �`-"'cro��i�vbot-hc;use ur.ls': be s°. black 2 minimum distance or f;r-een Fee. { d i t`orn my 2rc-a
of m),ri .n a=ss unless Waived bvgre,
I r� wise to u':.�'e the sc:back rcquirene:�:.
v
I tl u'15;� to wr v% L:2: wbac'.< r��U1r�T•C'Y[.
.. _..wY DESR-17110\ A.NVOR DRAWrti G ()F PR0POaED DEVEIC'PNfE�17:
(To be Filejd ir by inditi�ducl proposing dave:'opment)
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Print or T}re N��e
�r,• NUM bc-
JT1L-13-2001 14.00 252393790E 90; P.02
TOTAL P.02