30508_BRYANT, RANDY_20011213

• CAMA / DREDGE & FILL
GENERAL PERMIT
- New Modification Complete Reissue Partial 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 I SA NCAC
Applicant Name k'or rj j ' i-i{ta'i
Address l[77 Cfd �d ` rl
City State ZIP
Phone # ( 2Sz) Sc r z`:GFax # O
Authorized Agent L a,j ki c. (J
Affected ElCW El EW [ PTA ElES ElPTS
AEC(s): ❑ OEA ❑ HHF ❑ IH ❑ USA ❑ N/A
❑ PWS: ❑FC:
ORW: yes / no PNA yes / rho 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
cubic yards
Boat ramp
Boathouse/Vao m►ifE
1�'.� flNlcbr .,i
Beach Bulldozing
Other
Previous permit #
Date previous permit issued
C, Rules attached.
Project Location: County
Street Address/ State Road/ Lot #(s)
Joe -
Subdivision to � r1
3050$-4�
City Wile, ZIP
Phone # ( } j° Me River Basin
Adj. Wtr. Body Pr far>r r nat /man /unkn)
Closest Maj. Wtr. Body 1�4;wE'U'g''
7
rr��sfrl b��rl-�
(Scale: N
Shoreline Length
SAM not sure yes
Sandbags: not sure yes (no
Moratorium: n/a yes no I
Photos: yes no
74, f It
Waiver Attached: yes no --
A building permit may be required by: t/ See note on back regarding River Basin rules.
Notes/ Special Conditions r^ t' r _ 1 C r �� �. I r �, I; 11 { < I,r wr : > �•,.: a l
Agent or Applicant Printed Name
Signature Please read compliance statement on back of permit
Application Fee(s) Check #
Permit Officer's Signature
12 1 j rZ.
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, 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 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)
Revised 10/05/01

owl I rLor a 1/11 =210 15-800
SER POSTAL MONEY ORDER 000
SERIAL NUMBER YEAR. MONTH, DAY POST OFFICE U.S. [DOLLARS AND CENTS
OSTAL VICE
PAY TO A 'M�FCII 1111, 1;
'RINI AW
, A D
DDRESq I I:<IM L.
AODR
C.
O.D NO. O
._.._-
USED FOR
O(J!f Ara .5 J�
I.:00000800 21: 9000 281, 58 5 So

ADJACENT RIPARL�N PROPERTY OWNER STA-MMEN~T
(FOR A PIER/MOORING PILING IBOAIZ.IFT/80ATH%7SE)
/7— 5 e/f ---�JrP
I hereby certify that'I own property adiacent to Y Ga+�Oe
's
(Name of ftop
property located at
(Lot, Block, Road, etc.)
on ��Jn , N.C.
(Waterbody) (Town and/or County)
He has describer) 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 pierimooring
pilingslboatlif (boathouse must be se: back a minimum distance of fifteen feet (15') from my area
of riparian access unless waived by me.
I Sao nQt wish to waive the setback requirement.
I da wish to waive teat setback re uirement.
_______- -- -
DESCRIPTION AN-D/OR DRAWL;G OF P OPOSED DEVELOPNfE'\-F:
(To be filled in by individual pro using development)
0�x r..l r • r�,sf or"a
--------------- __-----
Sio7ature
Print or Type Name
252- aZ-7 -3Ct-z�
Telephone Number
-Date: /'�9\ 3 - 0
s

ADJACENT RIPARL-�N PROPERTY OWNER STATE-NIEINT
(FOR A PIER/MOORING PILINGSIBOATLIFTIBOA HOUS ) 3SOF
I hereby certify that I own property adjacent to s
(Name of Property 0 er)
property located at
(Lot. Block, Road, etc.)
on OY , in , N.C.
(Waterbody) (Town and/or County)
He has described to me, as shown below, tt-,e development he is proposing at that location,
and, I have no objections to his proposal. I understand that a pier/mooring
pi in ps/boatlift/boathouse must be se: back a minimum distance of fifteen feet (15') from my area
of riparian access unless waived by me.
I do not wish to waive the setback requirement.
I �4 wish to waive t;-at setback requirement.
------------------------------------------------------------------------------------------
DESCRIPTION AND/OR DRAWS' G OF P OPOSED DEVELOMEN-T:
(To be filled in by indivfdual prosing development)
J V
6&�12a i����r_S 1
Print or Type Name
�2 7Z
Telephone Number
I -Date: j .2 - � ._ U ( I