32378_CYBRYNSKI, RONALD_20020820

CAMA / DREDGE & FILL
BEi
✓� '` ` ', -. -,' li
GENERAL PERMIT
Previous permit #
New Modification 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 of environmental concern pursuant to 15A NCAC
© Rules attached.
Applicant Name < < nr ;,I >r
Project Location: County / .?; 4 r- r
Address -'� %. Q rf • �,
Street Address/ State Road/ Lot #(s)
City u, i �� ( State N( ZIP ii 5)Ea
of - I r t
Phone # (_` _) ', ' E I Fax # O
Subdivision 10446
Authorized Agent r
City v. t. tf, .4 ZIP
Affected ❑ CW E EW m PTA El El
Phone # ( ) River Basin
❑ OEA ElHHF ❑ IH ❑ UBA ❑ N/A
AEC(s):
Adj. Wtr. Body `� i j R r v f ' - (nat /man Junkn %
_
❑ PWS: ❑ FC:
r
ORW: yes / ;n9` PNA yes / Crit. Hab. yes / no
Closest Maj. Wtr. Body Aky f` ' ► F v _
Project/
r
a.
Type of Activity
f -
(Scale: NGNf )
Pier (dock) length
Platform(s)
-` -
-
-
—
Finger pier(s) —1
— + :—r-
J
: >t t/
} ✓i ''�
Groin length
—
I
number
t--- -
-
Bulkhead/ Riprap length
avg distance offshore
max distance offshore
l
Basin, channel
—i
cubic yards
L
•_'. y
-
.
�'
Boat ramp
Boathouse/ Boatlift
j
Imo,
�
—y
t
Beach Bulldozing
I
Other
- � �
— .
-
fanlot'!—
Shoreline Length i
-
.N-
-f
SAV: not sure yes no
_
NI
f
Sandbags: not sure yes no
-
Moratorium: n/a yes no
Photos:
�14
yes no
7
--
-'--
Waiver Attached: yes no
A building permit may be required by:
C See note
on back regarding River Basin rules.
Notes/ Special Conditions
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Agent or Applicant Printed Name Permit Officer's Signature
k [
Signature ** Please read compliance statement on back of permit
co
rf G) 2
Application Fee(s) Check #
Issuing Date Expiration Date
Local Planning Jurisdiction Rover File Name

I V 9 ,
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 / 1-888-4RCOAST
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/C

RQNALD W.
TERESA g, CYBRYNSKI 66-7611/2531 9935
207 S. RIVER DR. PH B 52 Ne 6I81 6003900
BEAUFORT, NC 28516 DATE�f
PAYTO THE
ORDER OF`_c-- z $ �J
c
0-S"SUN'trmnlit Credit Union
GREENSBORO. NORTH ROLINA 27405
MEMO�K
1: 253 0E Ijjjj:
8 003900I) 9935
DOLLARS U`

07/22/02 15:44 TERRY CYBRYNSKI###### 252 249 3537 N0.119 002
•• , ADJACENT RIPARIAN PROPERTY OWNER STATEMI T
I hereby certify that I own property adjacent to I Is ,' s
(Name of PropertOwn r)
property located at � 0 7 X,' ff On _
(Lot, Block, Road, etc.)
on 5�il U2✓ , in a rIn- f .re N.C.
(Waterbody) (Town and/o 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.
DESCRIMON AND/OR DRAWING OF PROPOSED DEVELOPME- T
(To be filed is by individual proposing development)
r
Signature
S . —77) o!-? nl g ✓r
Print or Type Name
tilZc�
Telephone Number
Datr:

s K T I r i� �t4� � RFT� R'v RE(�EIP`� PIE. ED
DIVISION OF COASTAL )ti ANAGENIENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Individual applying for Permit:
.-.ddress of Pro. LV. :
a
bPCW0 rt� C &
(Lot or Street :°, Stme, or Road, City & Counrv)
•t- -e:e"e^��c ^"„-V. Tine :^e'_`!'_cL'a
1 hereby ce uIy teat i own property adjacent Lo -::� a✓o !'�"i""`
aoniying for this permit has described to me as shown on the attache: drawir:g the deve:opme;:t
are proposing. A desc—�ption or drawing, with c. pensions, s:could be provided with this
letter.
I have no objections to this proposal.
If you have objections to what is being proposed, please write the Div'is<on of Coaxal
Management, Heston Pla= II, 151-B, Hwy. 2-4, Morehead City, NC. 28557 or call (252) 808-
2808 within 10 days of receipt of this notice. No response is considered the scree as no OOTecZon
it you have been notified by Cerrij ed Mail.
N AINT-R SECTION
I _:,derst=nd that a tier, dock, mooring piiings, breas,%-ate-, boa: house. lit: or sandbags must be
vack a minimumdiStanc� OL 15' L7orn my area of r-;rar;a n access uniesz waived by me. (I you
to waive the setback you must initial the appropriate ciank below.)
I do wish to waive the 1 5' setback re-uire-:ent.
I do not wise to waive t:1ne 15' setback rec'_,irement.
Sig::ature Date f'' f
'e. &J. CiPAFT 6 fZsi 0Z
P—int Name
- 7.;�8'��'�
Teieohone Number With Area Code

= ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to q6yA ti �� �, 12� �r IS
(Name of Property wne )
property located at b S:- r ICY r ,
(Lot, Block, Road, etc.)
r
onoc N.C.
(Waterbody) (Town and/or unty)
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)
d•
l
Signature
Print or Type Name
Telephone Number
Date:

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