31516_GAGNON, PHIL_20020228

117��z7Pw�ae"`v .*--
pCAMA / 7 DREDGE & FILL � H51 6_ C,
GENERAL PERMITPr
+'
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 i
and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC i
Rules attached. j
Applicant Name ny t {[„'� -( )� - - Project Location: County ; (..; �-A t.%.� i, t
Address Street Address/ State Road/ Lot #(s)
City__'_—_ t. _J, StateL ZIP A , . f (�
Phone # f Fax # ( )
f
Authorized Agent
Affected CW '%1 AW 1!�PTA )�ES ❑ PTS
AEC(s): OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A
PWS: ❑ FC:
ORW: yes / no PNA yes / no Crit. Hab. yes / no
Type of Project/ Activity
Pier (dock) length
Platforms)
Finger pier(s)__
Groin length
number —
i
Bulkhead/ Riprap length j
avg distance offshore
max distance offshore
Basin, channel - -- - — -- -
cubic yardsr
Boat ramp''
Boathouse/ Boatlift —
I
Beach Bulldozing'
Subdivision 4-4
City ZIP f
Phone # ( ) I River Basin
Adj. Wtr. Body _ + t ((nat /man /unkn)
Closest Maj. Wtr. Body k. t
Other 1 �• — --i
- i
Shoreline Length—
SAM not sure yes T no'
—
Sandbags: not sure yes no
Moratorium: n/a yes no t
Photos: yes no1r
(.
Waiver Attached: yes no ---. -- ---- -- --- -J- —
A building permit may be required by: E: See note on back regarding River Basin rules.
Notes/ Special Conditions
Agent or Applicant Printed Name
i�
Signature ** Please read compliance statement on back of permit **
Application Fee(s) Check #
Permit Officdiris Signature
Issui g 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 complywith 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

—TU Tna ANn BOTTOM
THIS MULTI -TONE AREA OF THE DOCUMENT CHANGES COLOR GRADUALLY AND EVENT I
r � -
ER 1000.00
NOf LIDOV $, 60957302
ISSUING BRANCH
93-5411920
DATE
PAY TO THE
ORDER OF _ �1 1�—
DOLLARS BY SIGNING YOU AGREE TO THE SERVICE CHARGE
AND OTHER TERMS ON THE REVERSE SIDE.
BB&T -�-u�� r►�► NER c-uw
UR IGNEOR AWERtR ��rR FDR
DRAWER: TRAVELERS EXPRESS COMPANY, INC.�.p�--
P.O. BOX 9476, MINNEAPOLIS, MN 55480 �n C E S r� ��S - 7 _
DRAWEE: FIRST INTERSTATE BANK, HELENA, MT Y 3 O (e t e�O.C}{ A_ —!
-- - �-l. ,-`" cm 8 STATE
CAO-A —PE-P-MR5 <fG� 6 N w- cal
II 0 9 5� 3alUv, I'f) f N I I� ❑A(�K.'1'I IC FROfJI ('E Till; D[kUMCNT HAS A MIC itl i Li r I �' S L 0 9 2 II'
e , II .09 200 54 31 E 0 L 70 7 L0
'�I�;NAILIIti'. 111:1� At�'ll I'���I'��I'it AItSI:N("I� OI� I III�CI! I�I'A fUIt IDS lVll.l INI I11 III' A t �)1'Y R
■ TIIIS rX\(VDIE4T HAS Av AK I Illy I %I I I \ k

S ■ Complete items 1, 2, and 3. Also complete
item 4 if Restricted Delivery is desired.
■ Print your name and address on the reverse
so that we can return the card to you.
■ Attach this card to the back of the mailpiece,
or on the front if space permits.
1. Article Addressed to:
1 50540) 13uF-6.41- ZF-
i) 4 3 a vPOa K5 R vE .
!, PH-Lf )6-8 , lJC-
A. Received by (Please Print Clearly) B. Date of Delivery
C. Signature
�I' ❑ Agent
X G�pvi2 C �Y C' 000 ]'Addressee
D. Is delivery address different from item 1? ❑ Yes
If YES, enter delivery address below: ❑ No
3. ice Type
FR
ertified Mail ❑ Express Mail
egistered ❑ Return Receipt for Merchandise
❑ Insured Mail ❑ C.O.D.
4. Restricted Delivery? (Extra Fee) ❑ Yes
2. Article Number (Copy from rvice la eq
� PS Form 3811, July 1999 Domestic Return Receipt 102595.00-M-0952 f
i
l i

UNITED STATES POSTAL SERVICE
First -Class Ma'.d
Postage & Fees Paio
USPS
Permit No. G-10
• Sender: Please print your name, address, and ZIP+4 in this box •
L Cr-4 � 0/J
E 4L-D ISLE /')e
Y,rt II;I,IIIIIHIIIiItIIHII�l�{f�,I�i�„�ff�i,�,fl{��,�fi,����fii

�Q *(a5a� 35 Y- 5c�
Er
O
IU
rrl
u-
rLl
C3
O
O
0
O
0
0
r—
plc
ags�y
U.S. Postal Service..
Provided)
Susl e
r
Postage
$
r�
Certified Fee
Postmark
Return Receipt Fee
(En d orsem enT-Regoired)
He©
Restricted Delivery Fee
(Endorsement Required)
-
$
Total Postage & Fees
I
Recipient 's,Alame rase POnnt Clearly) (to be
completed by maims
-----------'-----l---1---(-I'-/-,1--'--jy-1,�----------------------'-----Q--------'-------
Stre t, A t No.; or P Box No.
Of�Orn.��C,LCl.
p -
Crty State, ZIP+4
1 s (�
N c 2-,2 S 9

Feb 27 02 10; 008 Yvon Phil Gagnon 252-354-5989
5,
(FOR A PIERI UNCIOVr RED BOAT 1,;1FT
I hereby ce;tiFy that I o��rl Droperry adjac-ent '.o '-R��_
; e aC Fropertv Ober)
r
property located at cM'Ct-
(L..ot, Block, Road, etc.)
on )c u E S pv D in� _7L
oan(Vaterbody) !
nty)
He has described to me, as shown below, .he devc!opnrient he is proposixto at Lhar
lora.tion, and, I nave no objections to his proposQ.t, I understand ghat a pier/Lincoverd boat lift
must be Setback a minimum distance of fifteen Cert (I3') from my area 0f riparian access unless
waived by me.
y I
/ I do not wish to wa.ivc ft sGiback re,4virernent.
I dd wish to waive that setback re4uLr--meat.
DF-SCRl[Pft0N-A-ND/OR DRAW-E iG OF PRO POSED'DF-VELOFNMN-T,'
(l"o be,falXed in by individual pnVo5i 19 devel pment)
, �i�C� U� 5Qu (•! C7 l
I
la
t-------------
- -------------- -------------- ------
44r
J SignaturA
Trint or Type Naune
\ j
Telephone Numb, r
date: 2
0
P. 1
Z0 39dd A9b 30WtrSNI Q331S E96666Z9EE OT:TT Z80Z/LZ/Z0