38076_TRUAX, WYANE_20040330

❑CAMA / ❑ DREDGE & FILL
GENERAL PERMIT
[]New Modification Complete Reissue GPartial 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 kl [
Address
City k' State W ZIP
Phone # (1j1) -4 7 Z t b t C Fax # ( )
Authorized Agent
Affected '_i CW ❑ EW ❑ PTA ❑ ES ❑ PTS
❑ OEA HHF ElIH ElUBA ❑ N/A
AEC(s):
PWS: ❑FC:
ORW: yes / no PNA yes / (io Crit. Hab. yes / no
Previous permit #
Date previous permit issued
i_ Rules attached.
Project Location: County_
Street Address/ State Road/ Lot #(s)
Subdivision
City ( t,n,r 4, Via. r ZIP
Phone # ( ) River Basin
Adj. Wtr. Body ! 10110 *VV , . J t an (nat /man /unkn)
Closest Maj. Wtr. Body ^' V
Type of Project/ Activity
(Scale: Nth- )
Pier (dock) length
Platf
Finge
Groi
Boat
Beac
Othe
SAV:
Sand
Waiver Attached. yes no
A building permit may be required by: See note on back regarding River Basin rules.
r.
Notes/ Special Conditions Me,�
Bulk
Basin
cubic50
14,
ShorLI
Moratorium:
Phot
n
r pier(s)
{
I
'
length
number
Agent or Applicant Printed Name
Signature ** Please read compliance statement on back of permit
Application Fee(s) Check #
Permit Officer`s Signature
Issuing Date Expiration Date
sib, f'
Local Planning Jurisdiction 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:
❑ 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 / 1-888-4RCOAST
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

1044
d� 66-7075/2531
TRUAX CONSULTING AND INVESTIGATIONS 0000058445
PH. 919-772-5585
r 2504 DUNHAVEN DR. !? I,;L7C'l
GARNER, NC 27529-5585DATE.�
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PAY TO THE
�ORDER OF
, L A R S
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KENLY
u' SAVINGS
u Gamer, NC 27529
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1' 2 5 3 L 70 7 Sal: 00000 58 4 4 511■ 10

MAR-17-2004 WED 12:23 PM NC DIV OF COASTAL MGMNT FAX NO, 4
P. 02
AIVACENT RIPARIAN PROPERTY OWNER STATEM1:NT
(I'OR A HERI LIOORING PILIN(,SIBOn T L1ITIBOATIIOVSL')
I hereby certify th.tt I own prc.)perty adjacent to _ `�' C ' � � '
(Name of Properly Owner)
projwrty Iodated at �1 0. _ Ise 3 t- 1. & JL�__ _.
(Lot, [hock, Road, etc.)
's
one=c�t3JNG P C A r £y? "i _.__. , N.C.
(Watcrhody) (Town and/or County)
Ile has described to me, as shown below, file development he is proposing at that location,
and, I have no objections to his proposal. I understand that a pier/mooring
hilin�rsibc)ttlift/bnaflwuse must be scl hack a minimum distance of fifteen feet (IS') from my area
of riparian access unless waived by me.
I iltl,pnt wish to waive the setback requirement. MAR 2 9 2004
I ,ft wish to waive, 11)a1 setback requirement.
_ - DI?SC RII'TION AND/Olt DRAWING OI' PROPOSED DEVELOPMENT:
('%o be filled in by individual pi-oposing developme► t)
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Print or Ty'l e Name
Telephone Number m
Date: _ -3 — ;2 0 i2 0 v -1 _

MAR-17-2004 WED 12:23 PM NC DIV OF COASTAL MGMNT FAX NO, 4 P. 03
A.I)JACEM' xRTPAItYAN PROPERTY OWNER S'I'ATEMEN'X'
(FOR A PIE, RIM PILINGSIBOATLIITIBOAMOU .)
I herchy certify that I own property adjacent to W �� C - i
(Name of Propeily Owner)
pfol-.10--r-ty 10C(Mcd at
(Lot, Bloch, Road, etc.)
on Pry �_. , N.C.
(Watcrhndy) (Town 'lnd/or County)
IIr has described to Inc, as shown below, the development he is Proposing at that location,
and, I have no objections to his proposal. 1 understand that a pier/mooring
pilinc,.s/bo:rtlilUl)oathouse must be set back a minimum distance of fifteen feet (15') from my ml
Of riparian access unless waived by me.
I t�Q_.I14t W1Sh lil Wa1VC the SCLI)aCk TCCjl1iTZI11Cnl. MAR 2 9 C004
I wish to waive Mat setback Tcquircmcnt.
I11,13CRII''I ON AND/OR DRAWING Oh PROPOSED UE FILOPMENT.,
(1b be filled in by individualproposing development)
---- -----------------.------------------------------------------------------------ *11mure-
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Telephone Numbfr
Date:

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MAR-17-2004 WED 12:25 PM NC DIV OF COASTAL MGMNT FAX N0, 4 P. 10
llisturyhbn•: AutheirilvG.S. 11 t•I-107(u); 113.4-1U7(b); 113.4-113(b); Il3A-118.1: 113.4-124;
ilurctrckdkf/: Docentbor 1, 1991; Alup 1, 1990: Alurcb 1, 1990;
RKC..' Ub%cctiwt dw ra trnthi itity kf. Afarch 18. 1993;
Auicaded 1:fJ: Augutr 1, 1998; Apr!123, 1993;
Tt mlwr<u_v ehircvrJnrent L:;J] Devotrbet• 20, 2001;
.dnuvtded Eff April 1. 2003