31617_BURNETTE, BERLEEN_20020516

-ICAIIVIIA/ DREDGE &FILL NO 31617
GENERAL PERMIT Previous errs mit #
'New Modification Complete Reissue 17 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 I SA NCAC
F-1 Rules attached.
Applicant Name x, Project Location: County (I r -i 4,:
Address -1• 1 � ,c Street Address/ State Road/ Lot #(s) -�4'
City -N State h.j C zip
Phone # -U7
I Fax # Subdivision-
-1 ZIP Authorized Agent City
Affected Ll CW CHEW E�' A EVES C PTS Phone# River Basin
11 OEA ❑EJ HHF El 1H El UBA ' N/A
AEC: EJ PWS: 0 FQ Adj. Wtr. Body (60 /man /unkn)
ORW: yes/ , ri-6 PNA yes kro Crit. Halb. yes no Closest Mai.
Wtr. Body vc,
Type of Project/ Activity cam~044, IA1,
(Scale:
Pier (dock) length
Platform(s)_
Finger pier(s)
Groin length
number
Bulkhead/ Riprap length
avg distance offshore _ C- ,.
max distance offshore
Basin, channel
cubic yards
Boat ramp - ------
Boathouse/ Boatlift
Beach Bulldozing
Other
Shoreline Length
SAM not sure yes no J
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 1� �, 1
--7
E See note on back regarding River Basin rules
J
Agent or Applicant Printed Name Permit Officer's Sigl*ture
, I.A,
Signature Please read comllia
e statement on back of permit Issuing Date Expiration Date
Application Fee(s) Check # 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 I) 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, certifythatthis project is consistentwith 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 / 1-8884RCOAST
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)
Revised 10/C

BERLEEN BRYANT BURNETTE 66-85/531 1616
BERLEEN B. BURNETTE REVOCABLE TRUST D393039407
1812 WILLIAMSON DR. PH. 252-633-4815
NEW BERN. NC 28562 DATE ' - J S O Z
PAY TO THE d
ORDER OF
pp.
L A R S
Centura Bank®
New Bern, NC 28560
':053 1008501:0393039407u
ESTEEM

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
that I own property adjacent to C�k�� Is
I hereby certify r r Y J
(Name of Property Owner) 1
property located at
(Lot, Block, Road, etc.)
in �t4 , N.C.
on
(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 fn y individual proposing development)
V�4
'e
Y .�
2V
Signature
Print or Type Name
U�-26
Telephone Number
Date: j y
—29—

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to '6
(Name of Property Owner)
rty located at
19,
P
roPe
and, I have no objections to his proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(To befilled i by individual proposing development)
vy�A[
�D �T ri-
-,� f -� z/
ry
Signature
Print or Type Name
Telephone Number
Date: Al q a 0 O
—29—