54376_ALFORD, MIKE_20090812

MA / ❑ DREDGE: & FILL. 5
G FDA E RAL PERMIT Previous permit #
ew' JModification E�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 f environmental concern pursuant to 15A NCAC � i r r�(
a �^f4KIes a hed.
Applicant Name Project Location: County
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City ' State ZIP 1
Phone #,`�' Fax # ( ) Subdivision
AuthorizedAgent i "'�' City ZIP
Affected ❑Cwlow, ❑ El ES ❑PTS Phone # ` River asin _,,
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AEC(s): ❑ OEA ❑ HHF ❑ 1H ❑ UBA ❑ N/A Adj. Wtr. Body00 ` nat man unkn
❑ Pws: ❑ FC:
ORW: yes / now% PNA yes / } Crit.Hab. yes / no Closest Maj. Wtr. Body � o�1-1
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OCAMA / ❑ DREDGE & FILL
r. GENERAL PERMIT Previous permit#
ENew ❑Modification ❑Complete Reissue f artial 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 I SA NCAC
1 ❑ Rules attached.
Applicant Name ' ' Project Location: County
Address Street Address/ State Road/ Lot #(s)
City State ZIP
Phone # (_) 1 Fax # O
Authorized Agent
Affected ❑ CW ❑ EW ❑ PTA ❑ ES ❑ PTS
AEC(s): ❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A
❑ PWS: ❑FC:
ORW: yes / no PNA yes / no Crit.Hab. yes / no
Subdivision
City
ZIP
Phone # O River Basin
Adj. Wtr. Body (nat /man /unkn)
Closest Maj. Wtr. Body
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Agent or Applicant Printed Name
Signature ** Please read compliance statement on back of permit
Application Fee(s)
Permit Officer's Signature
Issuing Date' Expiration Date
Check# Local Planning Jurisdiction
Rover File Name

} '16
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 (910-796-7215) for more information on how to comply with these buffer rules.
Division of Coastal Management Offices
Raleigh Office
Morehead City Headquarters
Mailing Address:
400 Commerce Ave
1638 Mail Service Center
Morehead City, NC 28557
Raleigh, NC 27699-1638
252-808-2808/ 1-888-4RCOAST
Location:
Fax: [phone]
2728 Capital Blvd.
(Serves: Carteret, Craven, Onslow -above
Raleigh, NC 27604
New River Inlet- and Pamlico Counties)
919-733-2293
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)
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
910-796-7215
Fax:[phone]
(Serves: Brunswick, New Hanover,
Onslow -below New River Inlet- and
Pender Counties)
Revised 08/09/06

PERMITTEE
LOCATION:
MONITORING & COMPLETION REPORT
[CAMA Major Development & State Dredge & Fill Permits]
PERMIT # -i 4
FIELD REP.
MONITORED BYW_
PHONE: DATE REPORTEDLY COMPLETE:
DATE OF INSPECTION
1) Do the measured dimensions of the development differ from those indicated in the permit and workplat?
YES/ O circle one].
COMMENT:
2) SEDIMENTATION & E9QSION CONTROL: Has Permittee seeded, grassed, or otherwise stabilized all
disturbed areas? YES/ O circle one]
3)
COMMENT:
FUTURE MONUORING & ENFORCEMENT ACTION: Is further investigation or enforcement action
naarlari7 VRC/ irrin nnPl

A-DJACENT RIPARIAN PROPERTY OWNER STATEN1ENT
(FOR A B BB1.900RING PILIAGSXB OA TLIFTIB OA THO VSE)
r I hereby certify that I own property adjacent to 's
(Narne of Property Owner or Applicant)
Mailing address if different from location address q—�
(town, state and zip) 2 23 47: : s �t 61 Lr 14 2"'-R q L,
phone numbers you can be reached�Gl�
ff q � I+ f_ ..� ,
property located at l © 1 b 0 Pb L-E C�F
`( (Lot, Block, Road, etc.)
on L'f' �`� l ti C.1 `� in C—%PTt-Izi�dl�.C.
(waterbody) (Town and/or County)
He has described to me, as shown below, the development he is prop i t IYIat vcation,
and, I have no objections to his proposal. I understand that a pier/mooring pilings/boatlift/ oathous f i��
ss
must be set back a minimum distance of fifteen feet (15) from my area of riparian acceuhless
waived by me.
d® not wish to waive the setback requirement, V
initials
01 I Rio wish to waive that setback requirement.
initials
DESCRIPTION ANTD/OR DRAWING OF PROPOSED DEVELOPIMEN T:
(fib be filled in by individual ro ggqs P&lo rnent
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L
is
Ail ent �A-Ryqe Name
7!;�'7 :� �;7-7?
Telephone Number

Na"CO'El M4
Ncdth Carolina Departi-nent of Envirol-rMel-It a N,,abjral R.e-SOUrces
Division irij, Coastal Manag-snient
Mich,aei F. Etasley, Governor Charles S. Jon -es, Dirsctor William G. Ross Jr., Secret j,,,,j
Dote 3"- -3 - D!2 .--
Applicant Nal-A)e
l$/Iafflncr Address
pp aiatffik)'Hzed (agent) to act On. in-,.'
I certify that
behalf, for the purpose r,- appiying for and obtaining all C.A.Alk Femaits necessa tO
install or Construct (acti, ity
at (location)
This certification is vahAt'
S g i.natuire J04k-

ADJACENT RIPARIAN PROPERTY OWNER STATEIvMNT
(FOR A PIER/MOORING PIEINGS/BOATLIFT/BOATHOUSE)
I hereby certify that I own property adjacent to I'Y� I C� fi--p 1� 's
(Name of Property Owner oor,,A,pyplicant)
Mailing address if different from location address_ q� ? I ,1� F-t Lj. b
(town, state and zip) R-Z� +
phone numbers you can be reachedct
q,
property located at 16 t R b d f Pb L-:E PTL-q�-M C—
i (Lot, Block, Road, etc.)
on i�
(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. I understand that a pier/mooring pilings/boatlift/boathouse
must be set back a minimum distance of fifteen feet (15) from my area of riparian access unless
waived by me.
do not wish io walvc, the set -ack requir;,munt.
I do wish to waive that setback requirement.
DESCRIPTION AND/OR DRAWING OF PROPOSED DUJU'V ;LGPMTENT
(To be filled in by individual proggs'yjf*&lopment)
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Telephone Number

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R & J GROUP 1403
P. O. BOX 1885 6E112/531
Morehead City, NC 28557
252-72 -1253
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BRANCH BANKING AND TRUST COMPANY
1-800-HANK BST BBT.com
FOR Q44 c aLqo ((�!ZdUu M,
118000O L403,10 i:053 LO L L 2 Ll:0005 2976879 23"'
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