30968_COON, BILL_20020228

nCAMA / FYDREDGE & FILL T 96 98-
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GENERAL PERMIT Previous permit
❑New ❑Modification El Complete Reissue ❑Partial Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environment and Natural Resources I
and the Coastal Resources Commission in an area of environmental concern pursuant to I SA NCAC I
ErRules attached.
Applicant Name Project Location: County % !
Address �,} t� ,.F.} i� i. i '_�. I ';< Street Address/ State Road/ Lot #(s),G
City State ZIP
Phone # (� } Fax # ( )
Authorized Age4 _ _
Affected ❑ CW VEW �3 TA 'YS ❑ PTS
AEC(s): ❑ OEA O HHF ❑ IH ❑ UBA ❑ N/A
❑ PWS: ❑FC:
ORW: yes / no PNA yes / no Crit. Hab, yes / no
Subdivision 1� , 1
City ;F i. i, 1 ZIP
Phone # ( )''%i River Basin
Adj. Wtr. Body (/ 1
� - l(� .'/man /unkn)
Closest Maj. Wtr. Body t -
Type of Project/ Activity
(Scale:rl:� )
Pier (dock) length
Platform(s)
Finger pier(s)
Groin length
number r ., Y _ ly -- - -'�-
Bulkhead/ Riprap length
avg distance offshore— "� e CA
max distance offshore
Basin, channel
�.
cubic yards
Boat ramp
Boathouse/ Boatlift
. ' t Beach Bulldozing t:
Other l
Shoreline Length
Shornot sure no
---_ - -- -
24
�.
Sandbags: not sure y aq - " - - -
Moratorium: n/a ,y' ° _
Photos: ye_ no
Waiver Attached: yes now IF
A building permit may be required by: ❑ See note on back regarding River Basin rules.
Notes/ Special Conditions
Agent or Applicant Printed Name
Signature Please read compliance statement on back of permit
Application Fee(s) Check #
Permit Officer's Signature J
Issu ng Ite Expirati Date
Local Planningf urisdiction Rover File Name

t
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 L I Other:
n 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 / 1-888ARCOAST
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

w.— ROTH TOP AND BOTTOM
THIS MULTI -TONE AREA OF TtiE DOCUMENT CHANGES COLOR GRADUALLY AND
IT
NOT VALID OVER $1,000.00 60957302
ISSUING BRANCH
93-541 /920
DATE
PAY TO THE �r I
ORDER OF
DOLLARS 6V SIGNING
IOE
OTHER TERMS ONTI EREVERSE CE CHARGE
SE SIDE
DRAWER
BB&T -t-u N __►�n 1NF__� ER
- - �q IGNER FOR
DRAWER: TRAVELERS EXPRESS COMPANY, INC.
P.O. BOX 9476, MINNEAPOLIS, MN 55480 - -- .---.1._.--
DRAWEE: FIRST INTERSTATE BANK, HELENA, MT C EEJ54
StA _CITY &STATE
II'609573021" 1:0920054111:01707L045L09211'
■ TIIIS [X,( l'\II I I �t AN AIIFIFI('IAI IVATFRNIARK PRINII'D ON TI1!? BACK. THE FRONT OF THE LXWUMI(N' I W; A A11(Rni'RINI G(INA I UIZI I I'.I W n
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I.S. Postal Service
:ERTIFIEID MAIL, RECEIPT
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Return Receipt Fee
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(FOP, A PIER/ITN'' >VERED BOAT LiIT7j
I hereby cer:iPy that I ov n proper'-y adjacent. 'o
e of Propertv Owuer)
property (crated at-- b�� �m — )-121W-6
(Lot, Block, Road, etc.)
T3oGU� Sour•ID Ern 3L't T LE C'�
on (Town and/or ounty)
(Waterb<.�dy)
He has desc bed to me, as shown below, the deve'.oprinent he is proposing at ci at
Ioc.ation, and, I have no obj�tions to his proposal. I understand ghat a pieriuncoverpd boat lir:
must be set back a minimum distance oc rire✓a Ems: (15) from m;r,a pa or riparian acwss unless
waived by me.
I do not wish to waive the setback re~uirement.
—�/ I do xish, to waive that setback requirement.
-----------------
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(To be jUed in bY irI&Viduc.1 Prnposzrcg devel�Prrtent)
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Date:

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