37250_VANNARTICK, GEORGE_20040115

7 CAMA / ❑ DREDGE & FILL
GENERAL PERMIT Previous permit#
New El 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
O Rules attached.
Applicant Name *� + tt ���.,/lc� of Project Location: County
Address
'
City I
`<
State ZIP
Phone #('
Fax #( )
Authorized Agent
Affected ❑ CW
©EW
DPTA ❑ ES ❑ PTS
AEC(s): ❑ OEA
❑ HHF
❑ IH ❑ UBA ❑ N/A
❑ PWS:
❑FQ
ORW: yes / no
PNA
yes / no Crit. Hab. 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
Street Address/ State Road/ Lot #(s)
n. 1.,. v 4.1 1-1
1
Subdivision
City_ ' ' ZIP � 7
Phone # ( ) River Basin bi A • It I Cc, k
Adj. Wtr. Body A, oh A icldf rVVC, ! (nat /unkn)
Closest Maj. Wtr. Body
(Scale: )
cubic yards
Boat ramp _
Boathouse/ Boatlift
Beach Bulldozing_ -
Other
L� r
Shoreline Length ° r w V t (11r if
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
)A„,IeLS
Agent or Applicant Printed Name
,ram.. t .%la-_t-„ �t Y��--�•,�:�._
Signature Please read compliance statement on back of permit
Application Fee(s) Check #
See note on back regarding River Basin rules.
Permit Officer's Signature
I KSe1 l),Ps t-y
Issuing Date Expiration Date
T i. 115 (-/Ij
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 J 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 / 1-888-4RCOAST
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

CLARENCE E DANIELS
DBA DANIELS MARINE CONSTRUCTION
PH 252-726-7480
PO BOX 236
NEWPORT, NC 28570
';AY TO
ORDER
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2764
¢ 66-21/530
BRANCH 90331
DATG
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DIVISION OF COASTAL MANAGEMENT
AF.
DjACNI' RIPARIAN PROPERTY OWNER NOTIFICA"', WAIVER Fi?RM
07-i�iZ6- k!
Name of lndividual applying for Permit:-
/ Q T 4 i? I�
Address of Property;
(Lot or Strom #, Street or Rout. City do County)
I hereby certify that I own property adjacent to the above referenced proPertY. 'rnt individual
t has described to me shown an the attached dcawQr*a
applying for this perm provided
shouldthis
thcy are proposing. A description or drawir. , with dimensions, b,
letter.
_ I have rm objections to this proposal.
!f yprs have objections ro what is bving proposed. please write the Division of Coastal
erneve Keen Pfazz 11, 15.1-8, H)i.y. 24, Morehead City, NC, 28557 or call (252) 808-
Monag thrs nonce. No response is considered Vic same as too objection
2808 within 10 days of re_eiPe of
if you have been notifced by Certyled Maid.
WAIVER SECTION
I understand that a pier, dock, moorinP, pilings. breakwater, boat house. tilt or sandbags must be
set back a minimum distance of i 5' from my arm of riperlan access unie:s w&ved by ma. (If You
wish to waive the setback, you must initial the appropriate blank below.)
1 do wish to waive the 151 setback requirement.
do not wish to waive the 15' setback requirement-
� a3
Date. n �1 �
i ore l ._ `_-; iAvhES RO 4A4I Q �1wS
Pont a e
Telephone Number With Area Code

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Nov 12 03 09:59a Clarence Daniels 2527267400 p.2
DIVISION OF COASTAL MANAGEMENT
ADJACENT' RppARIAN PROPERTY OWNER NOTIFIC TWO I4VAIVERFORM
)Z / C�
Name of Individual applying for Permit:---
CYIJ! G—Y O 2
Address of Property:
(Lot or Street It. Str—tor Road, City 8c County)
I hereby certify that I awn property adjacent to the above referenced property. The individual
applyin& for this permit has described to me as shown on the attached dem
wing the developen
posing. A description or drawing, with dimensions, should be provided with this
they are pro
letter.
X 1 have no objections to this proposal.
-------�—" Coastal
ff you have objections to what is being proposed, please ►vrite the Division of
i5�-B, Hwy. ?ti, ly(orehead City, .PVC', 28557 or call (252) 8E18-
hianagement, H'estrorl plaza Id, objection
2$�& within IO days o� receipt of this notice. No response is considered the same as no obj
if you have been notified by Certified Mail.
WAIVER SECTION
40 or-
must be
1 understand that a pier, dock, mooring pilings, b a{'�warian accessr, boat ounleuse,ss waived by r e (If you
set back a minimum distance of 15 from my armriparian
blank below.)
wish to waive the setback, you must initial the appropriate
I do wish to waive the 15' setback requirement.
1 do not wish to waive the 15' setback requirement.
Dat
signature; �'�`,�
C• —
Print Name
Telephone Number With Area Code

96
Nov 12 03 09:59a Clarence Daniels
2527267400
ADJACENT RIPARIAN PROPERTY O v,VNER. STATEMENT
(FOR A FIERAWOORING .PILING S/BOATLIFT;BOATHOUSE)
I tereby certify that I own property adjacent to —E-c 12&-i l/t/ ���� / �T do's
(Dame of Property Owner)
property located at h` Z-6 cD 17 0 : i -/+ P- ,
/ (Lot, Bloch, Road, etc.)
on Xl >/� -- , in Z xAE Z�LLL
(Waterbody) (Town and/or County)
He has described to ►ne, as shown below, the deve oprrent fie is proposing at :hat Iocadon,
and, I have no objections to his proposal. I understand that a pier/rnoo-ng
piags/boatlift/bcathouse must he set back a minjmum disancp of Ffteen feet (15'; from my area
of riparian access unless waived by me.
I do not wish to waive the setback rNuirtment.
I da wish to waive that setback requirement.
DESCRLPTIQN ANUIOR DR. VVD G OF PROPOSED DEVELOPM-F-N-T:
(To be filled in by individual proposing development)
S ignatu: ems'
key
Print or Tvpi Name
()<(i "'),16'•10C)
Telephone Number
Date: l/ / -- 0.3
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