37554_WALLACE, LARRY_20040302

CAMA / __ DREDGE & FILL 7
GENERAL PERMIT
Previous permit #
ZNew Modification I 'Complete Reissue GPartial 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
CI Rules attached.
Applicant Name c►t Project Location: County
Address { �! llw - d �'r Street Address/ State Road/ Lot #(s)
City State —ZIP
Phone # ( Sr) F ''' ' CZ Fax # O Subdivision
Authorized Agent r: � I rl
Affected ❑ CW ❑ EW ❑ PTA M ES Z PTS
AEC(s): ❑ OEA ❑ HHF ❑ IH ❑ USA ❑ N/A
❑ PWS: ❑ FC:
ORW: yes / no PNA yes / no Crit. Hab. yes / no
Type of Project/ Activity
Pier (d k I
Platfo
Finge
Groin
Bulkh
Basin
Boat
Boat
Beac
Othe
Shor
SAV:
Sand
Morr
Phot
Wah
City N-i , k'0, t„ ZIP__ (Y
Phone # O River Basin r'
Adj. Wtr. Body fat /man /unkn)
Closest Maj. Wtr. Body
(Scale: v
h
OC ) ��.b<��
rm(s) -
I i i i I
r pier(s) 1
i I I I
length
number
dl
i -
- -- --I- '— —i , -
P length
gt
avdstanceoffshore
max distance offshore
channel �._ �_� - - • � I�—� _._ _ I� � � 4`
i
11
cubic yards
ram ---
house/ Boatlift
I i /
Bulldozing__ I -
r--
-
;line Length _� o
not sure yes Mo
>ags: not sure yes lno .1
-- -- -- - -
torium: n/a yes (,o f - I r7j_ rf - I ff-
)s: yes AO
�f -
-r Attached- vac
A building permit may be required by: !"tovrr fr,, C See note on back regarding River Basin rules.
Notes/ Special Conditions ! rl,c f, 10 =' �� ►M ' u lia �' ! t el +*- - i CL v I
44-1
_ I c �
Agent or Applicant Printed Name
Signature ** Please read compliance statement on back of Spermit
M V
Application Fee(s) Check #
Permit Officer's Signature
i 6 i -y
Issuing Date Expiration Date
Local Planning Jurisdiction Rover File Name
A building permit may be required by: !"tovrr fr,, C See note on back regarding River Basin rules.
Notes/ Special Conditions ! rl,c f, 10 =' �� ►M ' u lia �' ! t el +*- - i CL v I
44-1
_ I c �
Agent or Applicant Printed Name
Signature ** Please read compliance statement on back of Spermit
M V
Application Fee(s) Check #
Permit Officer's Signature
i 6 i -y
Issuing Date Expiration Date
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, 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 F-1 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 (252-946-648 [)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.nccoastaimanagement.net
Revised 10/05/01

UNITED STATES . u - eoo
POSTAL SERVICE,
POS Al 1'�IOl�l.' Y ORDER
Goo
SERIAL NUMBER YEAR, MONTH, DAY POST OFFICE U.S. DOLLARS AND CENTS
0 6 7 3 5 5 37313 2004-02-24 285570 ps
fe
ucwoo4
AMOUNT ONE HUNDRED DOLLARS & 00**
PAY TO
ADDRESS
C.O.D. NO. OR
USED FOR
NEGOTIABLE ONLY IN T HL ! i. S.
SEE
FROM
1:00000,800 21: 06 7 2 S S 3 7 3 13n'
cam
CLERK

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to L 0,r r LCL �a C� 1z' 's
(Name of 06perty Owner)
peat
Lot, Block, Road, etc.)
on NfAts e R -t vZ Y _ , in C 'm ti",� ��yL----� , N.C.
(Waterbody) (Town and/or County) /
He has described to me as shown below, the development he is proposing at that location,
and, I have no objections to his proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(To be filled in by Individual proposing development)
A -6u i I< head eiC�'�r1� �v) i�r-prn f- � AropeAy I t of iof (Z
Re r0 'LrC I ine �f p 1 to, Tkt lQU kAlt/ z Cp t(
t oLd w n 5 6L'c lad
0� r►larihe�rGtle 'frevteQ �cLmJ�r 0.hd WWII U� CL�Dr�X�lvl@��I�J 4FeE--
a�c�z c�r�i,v�d ievei o n the 4n� wl i ! tie. 6,LJck Ti I ted
" Q �o P e f 13, f kheaei- ark -ff lz 10A War s ► d e- , J-h e .3ul k�cocf uw k l l
i)l- locoLi<4 affmii'hdd/ --D Refit froM11r-{Qormg1 ujat fy'lIj7�-
--------------------------- ..... ......... ... .... ... ._..... - -- -r-----------------------------
-C
Signature
nit= OtiT r` Z IMIL
Print or Type Names
Y04 , 2-S--/- 3
Telephone Number �~ v
Date: 2-
' �'�

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own properly adjacent to I— a rr' JV/C� I iaC
(Nana of fmperty Owner)
property located at © , 5 ec o t� (\ ;y �"�- 1 u5
(Lot, Block, Road, etc.) r
on in �rA�en �t�` , N.C.
(Waterbody) (Town and/or County)
He has described to me as shown below, the development he is proposing at that iocation,
and, I have no objections to his proposal.
DESCRiP'T'ION AND/OR DRAWING OF PROPOSED DEVELoOPMEN'T
(To be JtUed in by individual proposing development)
l� tti �i��1�4d E'X �N�c�t�1 �ro ivy t�n� PrgP2'r��/ �nt p-�
to } to , I h e Otxf kl�e�c� be cc�rlslru�te�
of
WW'v cn P �r e'U L treQf1-j 11.►IAe,r CLVJJ wd e �t pPr'r�XwtaTe�y '� I ee�"
a6"./<- roLkNul 1CVJ cn .the- j,U4reYf�Ln� 0,J will b9, 4.tcK rc l lej
fc, f�e- 4o1 d-� e Qu t W6aj on Lvd&Yd Sid e e �,� i heaC� w
@ca�eCl Qrrrox1VnafC-) .30 Tee fraW, Ae ►orntkl wuIe'r l v►
l
-................................ .......................... ------- —It -----..--...................................
Print or Type Name
3( �- 37-2 -i-�I `) lb
Telephone Number t
Date: � 0 `f

�0"0AS4t APPLICATION FOR
CAMAMINOR
� DEVELOPMENT
PERMIT
In 1974, the North Carolina General Assembly passed the Coastal Area
Management Act and set the stage for guiding development in fragile
and productive areas that border the state's sounds and oceanfront. Along
with requiring special care by those who build and develop, the General
Assembly directed the Coastal Resources Commission (CRC) to imple-
ment clear regulations that minimize the burden on the applicant.
This application for a minor development permit under CAMA is part
of the Commission's effort to meet the spirit and intent of the General
Assembly. It has been designed to be straightforward and require no
more time or effort necessary from the applicant. Please go over this
folder with the Local Permit Officer (LPO) for the locality in which you
plan to build to be certain that you understand whatinformation he or
she needs.
Under CANOA regulations, the minor permit is to be issued within 25
days once a complete application is in hand. Often less time is needed if
the proiect is simple. The process generally takes about 19 days. You
can speed the approval process by making certain that your application
is complete and signed, that your drawing meets the specifications given
inside and that your application tee is attached.
Other permits are sometimes required for development in the coastal
area. While these are not CA,tilA-related, we urge you to check voth the
Local Permit Officer to determine which of these you may need. A
listing is included on page 2 of this folder.
We appreciate your cooperation with the North Carolina Coastal Man-
agement Program and your willingness to build in a way that protects
the resources of our beautiful and productive coast.
Coastal Resources Commission
Division of Coastal Management

SITE DRAWING/APPLICATION CHECKLIST
I'leaw make sure your site drawing includes the following information required for a CA -MA minor develop►rrent
permit. The drawing may he simple and not necessarily to scale. hhe Local Permit Officer will help you, if
requested.
PHYSICAL DIMENSIONS
✓ Label roads
✓ Label highways right-of-ways
Label local setback lines
_ _V Label any and all structures and driveways currently existing on property
PHYSICAL CHARACTERISTICS
✓ Draw and label mean high water mark
N/R Drakv location of on -site wastewater system
If you will he working in the ocean hazard area:
d(A Drawand label dune ridges (note height)
71/A Draw and label toe of dune
9(n Identify and locate first line of stable vegetation
N41A Draw and label setback line under LAMA
NIR Draw and label topographical features (optional)
If -you will he working; in an estuarine shoreline area:
_ Dravv and label landward limit of AF.0
Describe terrain (slope)
DEVELOPMENT PLANS
✓ Draw and label are,is that %will be disntrbed
11 a house is to be placed on lot, describe location of house
Note size of piling and dc-pth to he placed in ground
tv/A Draw and label all areas to he paved or graveled
Describe composirion of surface
NtA ;dote and list fully all rrecs and vegetation to be removed or relocated
Show landscaping
NOTE TO APPLICANT
Have you:
• com )feted all hlanla ca nd / or indicated if nut applicable'
• notified and listed adjacent property owners
• included your site drawing/
• signed both application and statement of ownership'
• enclosed the S100.00 fcce
• completed an AEC Hazard Notice, if necessary;
FOR STAFF USE
Site Notice Posted Final Inspecilon Fee Received
Site Inspections
Marc ,f a�ri�,n I<•tred > xempted Denied Appeal Deadline (20 days)

Locality
Ocean Hazard Estuarine Shoreline
GENERAL INFORMATION
Permit Number
ORW Shoreline Public Trust Shoreline Other
(For official use only)
LAND OWNER
Cit% NCw&rn State - %ii, A56 o i,l,, (-�sE) 633-2152—
AUTHORIZED AGENT
;\ante
Add rc„
Girt' -- --- Stmc /.,p-- Phonc_ --
LOCATION OF PROJEICT: i \d,lr-r",, ,rrcel nArII(" IId/m- dir1rrtions `[o ,iIL. III Ilot u«aIIfront, what i, 1lic IIa[IIC ( �I�
tic adjacent �.�atc.vkody') rot- n R,V,_.rB14 fs � 10+ — fid(L`ood CQ-��.r�_,�VC �D�60
DESCRIP'TIONIOF PROJECT: it iu all pn,po„cd I Mln rructi„n and land di,turhancc.l /� �±rdX�RL�.Ic�/ loO
feet of bujkheaci �x}tnci;n ftoir� Pror�r�� �Evte of lot i� ;�1 Lf �z bucklt<ad io - er� A e�
�ot io (,,,;(� 4o;t /,f ro b4c�t%4d tr+an �e a� �atr�h will It rem" from fro'+J kWmad
SIZE OF LOT/PARCEL: 2+, 702—
PROPOSED USE: Comnlrricalllndustrial —
Othcr
TOTAL ENCLOSED FLOOR AREA OF A BUILDING IN THE OCEAN HAZARD AREA OF ENVI-
RONMENTAL CONCERN (AEC): square feet (include all door, and roof-covcrcd decks)
SIZE OF BUILDING FOOTPRINT AND OTHER IMPERVIOUS OR BUILT -UPON SURFACES IN
THE COASTAL SHORELINE AREA OF ENVIRONMENTAL CONCERN (AEC): sq. ft.
(Calculation, include tltc alca „t the roof/di-W line of all huddilws, driVcw:tY,, �.o%rrca dckks, c ,ncrCiC or nla,onrY patios,
cte. that arc wirllin the applicahlr :1I_ C:. Attach your calculation, with ncc project drawin".)
Choose the. AEC area that applies to your property:
within -5 fcel ol'Normal 1 ligh Wttier for the Estuarine Shorelinr AF(:
,widmi 5-S leer ot* Nornt.tl I lWh \Vi[cr for the I:,tuannc Shoreline :AEC. adjacent to Out,tandilW
Reourrc Ai'atcrs
(3) within 30 feet of the Public Trust Shoreline :Al:C:
(Contact your Loe,,l PCI-ITLIt OfIl(cr it )uu .ire not ,urc which AEC applies to your propertl•.)
STATE S`I'ORMWATER MANAGEMENT PERMIT. Is ncc pro)cct located Man area suhject to a
State Stormwater ,Atana0cnlcrtl Permit I„tled by thc• N.C. DIvlsion of Water Quality;
YES— - NO
list the total hulk -upon area/Impci- iou, ,urfacc allowed for your lot or parcel. squaw feet.

OTHER PERMITS MAY BE REQUIRED: The activity you arc plannin, may require permits other than the CAMA minor
development permit. As a service Nve have compiled a list of the kinds of permits that mighr be required. We suWOest you check over the list
with your LP( ) to determine it any of these apply to.your project: Zoning, Drinking Water Well, SepricTank (or other saninary Wasrc
'trcanncnr sysrcm), Building, Electrical, Plumbing, Hcatin� and Air Conditioning, Lrasularion and L-nergy Conservation, FIA Certification,
Sand Dune, Sediment Control, Subdivision Approval, Mobile Home Park Approval, Highway, Connection, and others,
STATEMENT OF OWNERSHIP:
I, the undersigncd, an applicant for a LAMA minor development permit, being either the owner of property in an AEC or a
person authorized to act as an agent for purposes of applying for a CAMA minor development permit, certify that the person
listed as landowner on this application has a significant interest in the real property described therein. This interest can be
described as: (check one)
A/ --an owner or record title. Title is vested in see L)ced Book
page , in t}te _ C rave. � County Registry of feeds.
an owner by virtue of inheritance Applicant is an heir to the estate of
probate was in
County.
ifother interest, such as written ct)ntracr or lease, explain below or use a separate sheet and attach to this application.
NOTIFICATION OF ADJACENT PROPERTY OWNERS:
I furthci-morc certify that the following persons are owners ofproperties adjoining this property. I affirm that I have given
ACTUAL NOTICE to each of them concerning my intent to develop this property and to apply' for a CAM.- permit.
(Name) (,Address)
(1) R ic�arJ E. Rae ;n�� wig 3005umvAers:5hre_ tS,;{� 15 C rl~e on �V�S3N -167�
(2) ; o K -�-- $�nTa �- !0 es �l�reet" t [le M�a,ci��,SySSn?
(3)
(4)
FOR DEVELOPERS IN OCEAN HAZARD AND ESTUARINE HAZARD AREAS:
I acknowledge that tic land owner is ,twarc that the proposed development is planned for an area which rn)av he susceptihlr to
erosion and/or flooding. I ackno�wlcclge that the local permit officer has explained to me the particular hazard problems associ-
ated with this Im. This explanation swan accompanied by recomrncndations c,,nccrning stabilization and doodproofing tcch-
niques.
PERMISSION TO ENTER ON LAND:
I furthcrtnorc ccruk, that I ant authorized to grant and do in fact grant permission to the local permit officer and his agents to
enter on the aforretncntionc(i lands in connection wirh evaluating information related to this permit application.
This application includes: general information (this farm ), a site drawing as described on the hack of this appliuttion, the
ownership statement, the AEC hazard notice where ncccssarn, a check fear S100.00 made payable to the locality, and any infirr-
mation as may be provided orally by the applicant. The details of the application as described by these ,ources arc incorporated
without reference in any permit which naay be issued. DC%IJtitua trom these details will constitute a violation of any permit. Any
person developing in an AEC. ssithout permit i, subject to civil, criminal and administ ativc action.
2 day of AI -C-h_ , 20 04
�rV
r
Landowncr or person authorized ,,, ent for purpose ofiiling a CAMA permit application.

NOTES:
A PORTION OF THE PROPERTY PLATTED HEREON /S LOCATED WITHIN
A FLOOD HAZARD AREA BASED ON 'FLOOD INSURANCE RATE MAP" PANEL
NO. 3 700 72 0340 B, ZONE A6, EL. 9, DATED MAY 4, 1992,
FOR REFERENCE, SEE DEED RK. PG• , ALSO SEE
PLAT CAB. E SLIDE 317, CRAVEN COUNTY REGISTRY.
REVISED JANUARY P2, 1993 - IMPROVEMENTS SHOWN ON PROPERTY.
IPF IRON PIN FOUND
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