31652_HOLLER, LARRY_20020408

CAMA / DREDGE & FILL
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 Project Location: County
Address ` f a „ Street Address/ State Road/ Lot #(s)
r
City--_ ,. i(, +.. State ZIP --
Phone # (_ _) l{ j I, Fax # O
Authorized Agent
Affected ❑ CW ❑ EW A ❑ ES ❑ PTS
AEC(s): ❑ OEA 11- tH ❑ UBA ❑ N/A
❑ PWS: CIFC:
ORW: yes / no PNA yes / no Crit. Hab. yes / no
Subdivision
City ZIP) ;C
Phone # ( ) River Basin ,
Adj. Wtr. Body (nat /man /unknj
Closest Maj. Wtr. Body
Type of Project/ Activity
(Scale:
Pier (dock) length
Platform(s) i I
Finger pier(s)
Groin length
number
Bulkhead/ Riprap length
avg distance offshore
max distance offshore_
— �..
Basin, channel
cubic yards 1
W t..
Boat ramp
Boathouse/ Boatlift I ' i
— r
Beach Bulldozing i
Other 1
Shoreline Length
v
SAM not sure yes no
Sandbags: not sure yes no
Moratorium: n/a yes no
Photos: yes no
.r
Waiver Attached: yes no — �1
A building permit may be required by: See note on back regarding River Basin rules.
Notes/ Special Conditions
r ,
Agent or Applicant Printed Name
Signature Please read compliance statement on back of permit
Application Fee(s) Check #
Permit Officer's Signature
Issuing Date Expiration Date
�OIO`11�A
Local Planningjurisdiction 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 thatthis 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

ERIC B. ELLIS NCDL 65047
2162
JASA M. ELLIS PH [phone]
205 NOTTINGHAM DR.
MOREHEAD CITY, NC 28557
Date Q 66-30/133
Paythe w
Order of___,/4 {(�
I $ /pc7, o0
Dollars
fiRs-r CITIZENS -
& T D /� ATi7 FirstCitizans Bank —Company
j�,jl/'u �1j� Atlantrc Bearh, N.C. 2851�
�L
For_
1:0531003001:0013174487801I'
02L62
GUABDIANBSAFM BLUE ESBL

APR-04-02 04:51 PM COPELRND&HOLLRND 252 504 2502 P,ri3
.83/29/2002 97:52 3367941445 LAWYd,CARLIN HOLLaP PA+.Ir- 92
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ADJACEN`r RIPARrA,rT PROPERTY p ��s:r7.a6 o',
(PDX A ,PISWUNCOVMD ,gp,) SWTATEMV*rr
t' hereby eertii� 'that Z own property adjacent to .1
- 6
Nime of opacty O%V�r)
PtOPa'tY loeaw at � f/ 0 7 �r_ _, -A
11•ot. BIOCk. Road, etc.) —'
OR .
�'l w lit N.C..
o,,, andior Cdust�Y)
He has described w me, es shown below, the ldeve2opmont 1ha is proposing i~t that
oaadon, ard, I have eta ob;ariwns to his proposal. 1 ��nderxtftnd that a pier/unta6vered bqat lifi
must be set back a minimum dist4moe of Mftggn fact (15,) from arcs of rtpazi� $ �tnfeas
waivw by me. my
--- Y AD 120t wish to Wive the setback regu ement,
1 j& wish to wtlive that setback reQuinment.
ASSCRTPI?pN Ah'b/OR D;RAwFN
G OF PROPOSED DzVrL,OPt►W-JVr=
(fib be,RlireQ in by fndr►�1 propodrsp drvslopmar+l)
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Print or Name _
elephonc Number
Date: —4, ,z._ D
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APR-04-02 04:51 PM COPELAND&HOLLAND 252 504 2502 P.02
e3/29/2002 97:52 3367941446 LARRY&CARLIN HOLLAFt h'AGE 03
ADJACENT ADPARMN PROPERTY OUNM STA.'TENICENZ"
(FOR A PIER1(JNC0VRR9D BAIT Z,IPn
I hereby terrify `that ! own property adjacert to ormaI— i ,
s
e Avperty Owner)
Droporty located at ` m A.1 *%5_;/_
mut, clock, Rgod etc.) '
on ©l
Or r N. C.
terbodY) (Town andlor County)
Hs has deseMbad to me, as $flown below, the denlopmcni he !$ p,roposf"S at that
10=don. and, I have -no objections to his p,roposat. I understud that a pier/uncove;*j bloat lift must be set back i minimuttt distance of f flt®n feet (i's') ft= my Ursa of rpazian access unless
waved by me.
I do not wish to waive the satbeck rot}uiren=t.
I & wish to wane that setback r09Uisunenc
I)FSC XVn0N AND/OR DUAe► rNG OF PROPOSED D.itVjWpMENT;
(7'o be fsiW fri by fisdttzdual pmpoAV devtlopmafto
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ph�o50A
is XIS' p i d+%r►"
st�uutn
Print or Type Name
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Telephone Numbest
Daw 3 - 'S, ( - o -�
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MONITORING & COMPLETION REPORT
[CAMA Major Development & State Dredge & Fill Permits]
PERMITTEE' S
LOCATION:
PHONE: C�N
DATE OF INSPECTION /
2)
ItL�C.�
PERMIT # S
FIELD REP. '—
t" DATE REPORTEDLY COMPLETE:L 0 --`)—
Do the easured dimensions of the development differ from those indicated in the permit and workplat?
YFS O [ ircle one].
COMMENT:
disturbed areas?
COMMENT:
CONTROL: Has Permittee seeded, grassed, or otherwise stabilized all
one]
3) FUTURE M ORING & ENFORCEMENT ACTION: Is further investigation or enforcement action
needed? YES/ [circle one].
COMMENT: