19860167 Ver 1_COMPLETE FILE_19860101

Permit Class
New
Permit Number
STATE OF NORTH CAROLINA 135-86
Department of Natural Community Development
a Mai

et0 res
e el nt; n..
L 1;1, t7 1b
to NCGS 113-229
Issued to John Ernest.Kirk, Route 2, Box 209, Belhaven, NC 27810
authorizing development in Beaufort Countyat Wri ghts Creek
as requested in the permittee's application dated 2/27/86 i ncl udi n
attached plats, work dated 2/20/86 and survey plat dated 8/20/86.
This permit, issued on July 11 , 1986 , is subject to compliance with the application (where consistent
with the permit), all applicable regulations, special conditions and notes set forth below. Any violation of these terms may subject
permittee to a fine, imprisonment or civil action; or may cause the permit to be null and void.
(1) The activity shall be conducted in such a manner as to prevent significant
increases in turbidity outside the area of construction or construction-related
discharge (increases of 25 NTUs or less are not considered significant).
(2) This permit does not authorize interference with the 8-foot-deep, 80-foot-wide
federal channel in Wrights Creek and the permittee will not be entitled
to compensation for damage or injury to the authorized structure or work
which may be caused from existing or future operations undertaken by the
United States in the public interest. The pier will not be constructed
closer than 80 feet to the near edge of the Federally maintained channel.
(3) No attempt will be made by the permittee to prevent the full and free use
by the public of all navigable waters at or adjacent to the authorized work.
(4) It is possible that the authorized structure may be damaged by wavewash
by passing vessels. The issuance of this permit does not relieve the permittee
from taking all possible steps to ensure the integrity of the permitted
structure and the safety of moored boats from damage by wavewash.
(See attached sheet for Additional Conditions) 1
This permit action may be appealed by the permittee
or other qualified persons within twenty (20) days of the
issuing date. An appeal requires resolution prior to work
initiation or continuance, as the case may be.
This permit must be accessible on-site to Department
personnel when the project is inspected for compliance.
Any maintenance work or project modification
not covered hereunder requires further Departmental
approval.
All work must cease when the permit expires on
December 31, 1989
In issuing this permit, the State of North Carolina
agrees that your project is consistent with the North
Carolina Coastal Management Program.
Signed by the authority of the Secretary of DNRCD and
the Chairman of the Coastal Resources Commission.
David W. Owens, Director
Division of Coastal Management
This permit and its conditions are hereby accepted.
Signature of Permittee
John E. Kirk
ADDITIONAL CONDITIONS
Permit #135-86
Page 2 of 2
(5) The permittee will maintain the authorized work in good condition and in
conformance with the terms and conditions of this permit. The permittee
is not relieved of this requirement if he abandons the permitted activity
without transferring it to a third party.
r -*
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APPLICATION ??V-??' s ` (7 ?.;?"r""??'?:?
[.OR (. f p Tom.„c, ,,,,i I
PERMIT TO EXCAVATE AND/OR FILL WATER QUALITY CERTIFICATION
O
EASEMENT IN LANDS COVERED BY WATER LAMA PERMIT FOR MAJOR DEVELOPMENT
APR .? 0
Department of Administration State of North Carolina Department of tHd army
(GS 146-12) Department of Natural Resources and Community Development Corps of Engineers, Wllm ton District
(GS 113-229, 143-215.3(a)(1), 143-215.3(c), 113A-118 (33 CFR 209.320-329
46 ,p'
, '6V
Please type or print and fill in all blanks. If information is not applicable, so indicate by placing N/A in bla ?e?y
pQQ
1. Applicant Information
A. Name
Last n First Middle
B. Address 'A h [, e _, 8 Q u e 47
Street, P. O. Box or Route
LD ra / b a L1,e 7 , AJf) r f-A Caro / Ln a P 7k16 41- V9
City or Town State Zip Code Phone
IL Location of Pro used Project:
A. County =Lt -r- ?^ 1
J_
B. 1. City, town, community or landmark
2. Is proposed work within city limits? Yes No _
C. Creek, river, sound or bay upon which project is located or nearest named body of water to project
t S re- e-_ k
r
111. Description of Project
A. 1. Maintenance of existing project )- 2. New work - x
B. Purpose of excavation or fill
1. Access channel length width depth
2. Boat basin length width depth
3. V ill area length //.? -width depth
4. Other- tb 1 '- ! length -!®' width $ I depth
C. I. Bulkhead length Average distance waterward of MHW (shoreline)
2. 1 ype of bulkhead construction (material) _ N,/A
D. L xcavated material (total for project)
1. Cubic yards 2. Type of material , i _
E. I ill material to be placed below MHW (see also VI. A)
1. Cubic yards 4 / A 2. Type of material /)/J A
IV. Land Type, Disposal Area, and Construction Equipment:
A. Does the area to be excavated include any marshland, swamps or other wetland? Yes No-4A
B. Does the disposal area include any marshland, swamps or other wetland? Yes No
C. Disposal Area
1. Location
2. Do you claim title to isposal area?
D. I III material source if lill is to be trucked in
? s
I . How will excavated material be entrapped and erosion controlled? -
I I . I ype 01 equipment to be used
G. Will marshland be crossed in transporting equipment to project site? If yes, explain AJd
& F-B 1
1 V. Inwrided Use of Project Area (Describe)
A. 1. Private R a a 1r, De
2. Commercial

3. Housing Development or Industrial
4. Other
B. 1. Lot size(s) J _,;7_2.C X//.-Q Vq,
2. Elevation of lot(s) above mean high water.
3. Soil type and texture r) elsI - 1 D1??/rr
4. Type of building facilities or structures ,?t? n e -i-A m i V 1-4 ijl & // r, V
5. Sewage disposal and/or waste water treatment A. Existing
anned p dLo
B. Describe
6. 'Land Classification'(circle one) EVELO EP TRANSITIONAL COMMUNITY RURAL
CONSERVATION OTHER (See CAMA Local Land Use Plan Synopsis)
VI. Pertaining to Fill and Water Quality:
A. Does the proposed project involve the placement of fill materials below mean high water? Yes No_
B. 1. Will any runoff or discharge enter adjacent waters as a result of project activity or planned use of the
area following project completion? Yes-No--,X-
2. Type of discharge /I41
3. Location of discharge-- _AJ ' /AF
VII. Present rate of shoreline erosion (if known):
VIII. List permit numbers and issue dates of previous Department of Army Corps of Engineers or State permits for
work in project area, if applicable:
IX. Length of time required to complete project: (O m o n t A - s_
X. In addition to the completed application form, the following items must be provided:
A. Attach a copy of the deed (with State application only) or other instrument under which applicant
claims title to the affected property. OR if applicant is not claiming to be the owner of said property,
then forward a copy of the deed or other instrument under which the owner claims title plus written
permission from the owner to cai ry out the project on his land.
B. Attach an accurate work plat drawn to scale on 8%z X 11" white paper (see instruction booklet for
details). Note: Original drawings preferred - only high quality copies accepted.
C. A copy of the application and plat must be served upon adjacent riparian landowners by registered or
certified mail or by publication (G.S. 113-229 (d))Enter date served
D. List names and complete addresses of the riparian landowners with property adjoining applicant's.
Such owners have 30 days in which to submit comments to agencies listed below.
+ C r, 1& „z3dlx 2,0 t3 _Re/ a yen /Vi 0_ „1 78-10
QUO 8e_&d1JeA IUD C Qwla
XI. Certification requirement: I certify that to the best of my knowledge, the proposed activity complies
with the State of North Carolina's approved coastal management program and will be conducted in a
manner consistent with such program.
XII. Any permit issued pursuant to this application will allow only the development described in this appli-
cation and plat. Applicants should therefore describe in the application and plat all anticipated devel-
opment activities, including construction, excavation, filling, and land clearing.
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Applicant's Signature
&F-62 SEE REVERSE SIDE FOR MAILING INSTRUCTIONS
.ev. 10/78
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PLAN OF LAND 4
M , . SURVEYED
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MRSsGALLIEE*XIRK HEIRS
,? N•C.
BATH TOWNSHIP BEAUFORT COUN +
4 WALDUKE, RES. SURV. -- AUGn2Q1960
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awl $.Boor.
IPA 7'83#
ULVERT
47W
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&26°40E.
1093
® GUT TAKEN f1
5.26°404E. AERIAL P1401
Q 12204 1 \
® 127W
_ , , NJ2 ?; 3.25°304E.
0 1200' \
-u
10Z. ARf
? w.112.a'
a N.1111i.K11rS ?. ?
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.162.3'
WRIGHT'S CREEK
aidw.lts'
SAWYER 25.65 TOTAL ACRES
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(DJAMES $.KIRK 3.62 AC. Q) JOHN E.9109 '
>I. 404W.192.5' O2 WESLIE A.KIRK 3.62AC. V33 RS. GALLIC 1
DAVID LAURK 4.39 AC. AC 091'
DEPARTMENT OF THE ARMY
WILMINGTON DISTRICT, CORPS OF ENGINEERS
P.O. BOX 1890
WILMINGTON, NORTH CAROLINA 28402.1890
July 22, 1986
IN REPLY REFER TO
Regulatory Branch
SUBJECT: File No. SAWC086-N-007-0175
RECEIVED
Mr. John Ernest Kirk J O l 2 S 1986
Route 2, Box 209
Belhaven, North Carolina 27810 WATER QUALITY SECTION
C)PERAT10NS BRANCH
Dear Mr. Kirk:
Reference your application for a Department of the Army permit
to construct a pier on Wrights Canal off the Pungo River, near
Pamlico Beach, Beaufort County, North Carolina.
Your proposal has been reviewed and found to be consistent
with the provisions and objectives of general permit No. SAWC080-
N-000-0291. Therefore, you may commence construction activity in
strict accordance with applicable State authorization and the
enclosed plan. Failure to comply with the State authorization or
conditions of the general permit could result in a violation of
Federal law.
If any change in your work is required because of unforeseen
or altered conditions or for any other reason, plans revised to
show the change must be sent promptly to this office and the North
Carolina Division of Coastal Management prior to performing any
such change or alteration. Such action is necessary as revised
plans must be reviewed and the authorization modified.
Questions or comments may be addressed to Mr. Ken Jolly,
telephone [phone].
Sincerely,

4 > .r
-2-
Copies Furnished with enclosure:
Director, Atlantic Marine Center
National Ocean Survey, NOAA
ATTN: CAM04, 439 W. York Street
Norfolk, Virginia 23510
Mr. William Mills
Water Quality Section
Division of Environmental
Management
"North Carolina Department of
Natural Resources and
Community Development
Post Office Boa 27687
Raleigh, North Carolina 27611-7687
Mr. William L. Kruczynski, Chief
Wetlands Section
Marine and Estuarine Branch
U.S. Environmental Protection Agency
345 Courtland Street
Atlanta, Georgia 30365
Mr. John Parker
Division of Coastal Management
North Carolina Department of
Natural Resources and
Community Development
Post Office Box 27687
Raleigh, North Carolina 27611-7687
Ms. L. K. (Mike) Gantt
U.S. Fish and Wildlife Service
Post Office Box 25039
Raleigh, North Carolina 27611-5039
Mr. Randy Cheek
National Marine Fisheries
Service, NOAA
Pivers Island
Beaufort, North Carolina 28516
Mr. Charles Jones
Morehead City Regional Office
North Carolina Division of
Coastal Management
Post Office Boa 769
Morehead City, North Carolina 28557
Mr. David Gossett
Washington Regional Office
North Carolina Division of
Coastal Management
1424 Carolina Avenue
Post Office Box 1507
Washington, North Carolina 27889
c- '7
.,,,
LLIEE. KIRK HOURS
MRS*vA
BATH mWN8M? -* BEAUFORT COUNTY,N.C.
W ILUUKE, RE6. SURV. - AVW 45 ,1 960
_ s 1
w CULVERT
4,7W
1095
4
GUT TAKEN F!
m.t6KWE. AERIAL P"T
law;
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7
ARF
5.'!ifF'?• V. ,.,.per 45
?1.WtI•i[Iti1S W. It 2.5,
162.5' ,
WRIGHTt CREEK 4
a
t1e+1?s. ER 25.65 TOTAL ACRES
JAMES SJUIM SAP AC. s ? JONME.1CiRK.41
Y WE SUE A.KIRK 3.82 AC. S MRS. 9AL.1•K ?.
GRADO't DAVID L.KIRK 4.3! AC. ) LINWOOQ KIRK
.f3 AG.
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DEPARTMENT OF THE ARMY
WILMINGTON DISTRICT, CORPS OF ENGINEERS
P.O. BOX 1880
WILMINGTON, NORTH CAROLINA 28402.1880
March 19, 1986
IN REPLY REFER TO
Regulatory Branch
SUBJECT: File No. SAWC086-N-007-0175
RECEIVED
MAR 2 4 1986
WMEN 0ALITY SECTION
OPERATIONS BRANC!l
Mr. John E. Kirk
Route 2, Box 209
Belhaven, North Carolina 27810
Dear Mr. Kirk:
On February 6, 1986, we renewed general permit No. SAWCO80-N-
000-0291 (enclosed), which provides Federal authorization for
construction activities that receive authorization from the State
of North Carolina.
A review of your application received March 4, 1986, for a
Department of the Army permit to construct a pier on Wrights Canal
off the Pungo River near Pamlico Beach, Beaufort County, North
Carolina, indicates it to be a candidate for Federal authorization
under this general permit. Accordingly, the administrative
processing of your application will be accomplished by the North
Carolina Division of Coastal Management. Comments from Federal
review agencies will be furnished to the State.
If your application must be withdrawn from this general permit
process for any reason, you will be written and informed of its
further management. If there are no unresolved differences of
State-Federal positions or policy, the final action taken on your
application by the State will result in your receiving written
notice from us that your application has been successfully
processed under our general permit. Only after receiving such
confirmation should you begin work.
Your application, pursuant to Section 10 of the River and
Harbor Act, has been assigned No. SAWC086-N-007-00175 and will be
coordinated by Mr. Ken Jolly, telephone [phone]. He is
available to address questions or comments you may have.
Sincerely,
Charles W. Hollis
Chief, Regulatory Branch
Enclosure
-2-

Copies Furnished (without enclosure):
Mr. John Parker
Division of Coastal Management
North Carolina Department of
Natural Resources and
Community Development
Post Office Box 27687
Raleigh, North Carolina 27611-7687
Mr. William Mills
Water Quality Section
Division of Environmental
Management
North Carolina Department of
Natural Resources and
Community Development
Post Office Box 27687
Raleigh, North Carolina 27611-7687
Mr. Charles Jones
Morehead City Regional Office
North Carolina Division of
Coastal Management
Post Office Box 769
Morehead City, North Carolina 28557
Ms. L. K. (Mike) Gantt
U.S. Fish and Wildlife Service
Post Office Box 25039
Raleigh, North Carolina 27611-5039
Mr. Randy Cheek
National Marine Fisheries
Service, NOAA
Pivers Island
Beaufort, North Carolina 28516
Mr. William L. Kruczynski, Chief
Wetlands Section
Marine and Estuarine Branch
U.S. Environmental Protection Agency
345 Courtland Street
Atlanta, Georgia 30365
Mr. David Gossett
Washington Regional Office
North Carolina Division of
Coastal Management
1424 Carolina Avenue
Post Office Box 1507
Washington, North Carolina 27889

DIVISION OF ENVIRONMENTAL MANAGEMENT
WATER QUALITY SECTION
J,'
Comments concerriing an application for ?State Federal CAMA Permit (s) from
A. PERMIT:
This office cannot comment on this project until after the close of the Section
401 Certification Public Comments Period.
This office has no objection to the issuance of the permit(s) for the proposed
project with the following conditions.,
That the activity be conducted in such a manner as to prevent significant
increases in turbidity outside the area of construction or construction-
related discharge (increases of 25 NTU's or less are not considered
significant).
That the instream turbidity not be increased by more than 50 NTU's as a
result of the proposed activity after a reasonable opportunity for dilu-
tion and mixture.
That turbidity levels in shall not be increased
by more than 10 NTU's as a.result of the proposed activity after a reason-
able opportunity for dilution-and mixture.
B. CERTIFICATION STATUS:
certification is not required
for this project.
Certification is required for
this project. Such action to
process the certification has
been initiated. Proposed
Certification will be acted on
or after
The proposed project is certified.
under General.Certification
A) No. 1179 issued on January 25,, D) No. 1431 issued on October 16,
1977, for sewer line construction 1980, for boat ramp construction.
B) No. 1272 issued on November 10, E) No. 1664 issued on September 8,
1978, for bulkhead construction. 1983, for Rip-Rap Placement.
C) No. 1273 issued on November 10, F) No. 1665 issued on September 19,
.1978, for discharges of liquid 1983, for incidental bridge
effluent from diked upland disposal construction.
areas.

WATER QUALITY SECTION
DIVISION OF ENVIRONMENTAL MANAGEMENT
DIVISION OF ENVIRONMENTAL MANAGEMENT
.:WATER QUALITY SECTION
Comments concerning an application for State. Federal CAMA Permit(s) from
?.. lip k::Et On
A. PERMIT:
This office cannot comment on this project until after the close of the Section
401 Certification Public Comments Period:
This office has no objection to the-issuance, of.the permit(s) for:the.proposed
project with the following conditions::
____ That.the activity be conducted in such a manner as to prevent si nificant -
g
increases in turbidity outside the area of construction or construction-
related discharge (increases.of 25 NTU's. or less are not considered
significant)
The proposed project is.c.ertified
under General.Certification
A) No. 1179 issued on January 25, D) ' No' 1431 issued on October 16,
1977, for sewer line construction 1980, for boat ramp construction.
B) No. 1272 issued on November 10, E) No. 1664 issued on September 8,
1978, for bulkhead construction. 1983, for Rip-Rap Placement.
C) No. 1273 issued on November-10,; F) No. 1665 issued on September 15,
1978, for discharges.of liquid 1983, for incidental bridge
effluent from diked upland disposal. construction.
areas.. r .

WATER QUALITY SECTION
DIVISION OF ENVIRONMENTAL MANAGEMENT

NKDAT A
'
` DF°r C:A NA 4 0 + REV DATE 05/21/86
.iC
.
T :1:ON J ADD FILE DI° C:AMA401 P iWD ? FORMAT NRDI:..CAMA NEXT RC D ? 0005','
ACTION ADD, ENTER DATA, REC. ADDED IS 00 057 FRD DATA
'FiO JO : 000 58 i='RCJ•.J
ASSIG : KIRK JOHN COUNTY: A:{ 1::: r°i t.l FC 1 Fi .'i'. REGION: 0 7
NED TO : t,1•.JM JOINT NOTIC : N
YpI::: CERTIFICATION RECOMME NDATION DATE,' S'-'
104 PN : 401 RE T ISSUE: Y RECEIVED: 86052(i
!AMA ONLY: Y
' GC: DENY: :I:NIT-IAL.
REPORT:
1F
/CAMA :
:ECE7:VING STREAM: GC:
WRIGHTS CREEK HOLD:
CLASS
: SA .
FINAL REF'ORT : 860521
BASIN: TAR
:OMMENTS : SITE LO CATED ON WRIGHTS CREEK NEAT PAMLIC O BEACH
'ROPONAL.. TO EXTEN D WOODEN PIER FROM 60 FT TO 110 1=..T.
1C71']:I':S: WA,F:CI....C: ENT RAL.•-M7:1_.L..S-GCISSETT
R E C Ei V E D
Pal AY 2 ; 1986
Iva th tQUALITY SECTION
OFFICE OF COASTAL MANAGEMENT FAST TRPiCK
FIELD INVESTIGATION REPORT
1. Applicant's name John E. Kirk
2. Location of project site Beaufort County, Wrights Creek off of Pungo River-Estuarine
Waters AEC, photo # 12-19-84; 78-1017, U-12
3. Investigation type: Dredge & Fill CAMA X
4. Investigative procedure: (A) Dates pf site visit 5-16-86
(B) Was applicant present Yes
5. Processing procedure: Application received 5-14-86 Office Washington
6. Site description: (A) Local Land Use Plan Beaufort County
Land classification from LUP Conservation
Development constraints identified in LUP None
(B) AEC(s) involved: Ocean Hazard Estuarine shoreline
Coastal wetlands Public trust waters
Estuarine waters X Other
(C) Water dependent: Yes X No Other
(D) Intended use: Public Private X Commercial
(E) Type of waste water treatment: Existing Septic tank
Planned None
(F) Type of structures: Existing Pier
Planned Pier extension
(G) Estimated annual rate of erosion N/A
7. Habitat description:
(A) Vegetated wetlands:
8.
Source N/A
AREA
Dredged Filled Other
None None None
(B) Non vegetated wetlands:
(C) Other:
(D) Total area disturbed: N/A
Project summary The applicant is proposing to extend an existing 60' long pier to
110' in length.
Frmvirorm-ental setting
The applicant awns + 4.0 acres of land bordering Wrights Creek in Beaufort County.
Located on the land is a single family dwelling which is served by a septic tank
sewage disposal system. The portion of the property on which the dwelling is located
has had riprap placed along the shoreline in the past to retard erosion.
Located on the property is a 60' long pier which the applicant uses to moor his
oaaoercial fishing vessel. Wrights Creek has a federally maintained channel.
Proiect proposal
The applicant is proposing to lengthen the existing 60' long pier to 110' in length.
The additional length is needed for properly mooring the commercial vessel. The water
depth at the wateiward end of the proposed pier will be -9' at normal water. Also
the waterward end of the proposed pier will be 83' from the near edge of the federally
maintained channel.
Environmental impact
The project as proposed should have a minimal environmental impact.
David L. Gossett - Washington Office - 20 May 1986
y
APPLICAT ION W'- S F 6
FOR ?i 16
PERMIT TO EXCAVATE AND/OR FILL WATER QUALITY CERTIFICATION -
O
EASEMENT IN LANDS COVERED BY WATER CAMA PERMIT FOR MAJOR DEVELOPMENT
Department of Administration State of North Carolina
(GS 14612) Department of Natural Resources and Community Development
(GS 113-229, 143-215.3(a)(1), 143-215.3(c), 113A-118
,P3
Please type or print and fill in all blanks. If information is not applicable, so indicate by placinA i
of ab llf 0
Applicant Information r A. Namc U-0
??__Z" h n j.)" ti 44-S
Last 8 Q First Middle
B. Address ? A , e- _ oZ . creel, P. O. Box or Route
Be /?ra /e? CAr-,c o?7946 !f UB ? y
City or Town State Zip Code Phone'
11. Location of Propined Project:
A. County ZL -42A
B. 1. City, town, community or landmark l;C' _n_ RP_ [_.
2. Is proposed work within city limits? Yes No _ X
C. Creek, river, sound or bay upon which project is located or nearest named body of water to project
A. 1. Maintenance of existing pmjcct t 2. New work X
B. Purpose of excavation or fill
Ill. Description of
I. Access channel length width depth
2. Boat basin length width depth
3. Fill area length width depth
4. Other 12; e r length JJ#_?_width 9 l depth
C. 1. Bulkhead length _A , Average distance waterward of MHW (shoreline)
2. Type of bulkhead construction (material) 1A
D. Excavated material (total for project)
1. Cubic yards - NUA 2. Type of material - N/
E. F ill material to be placed below MHW (sec also VI. A)
1. Cubic yards - All R 2. Type of material N/ A
IV. Land Type, Disposal Area, and Construction Equipment:
A. Does the area to be excavated include any marshland, swamps or other wetland? Yes No
B. Does the disposal area include any marshland, swamps or other wetland? Yes No ef4141
C. Disposal Area
1. Location
2. Do you claim title to
D. Fill material source if fill is to be trucked in
L. How will excavated material be entrapped and erosion controlled?
I . I ype of equipment to be used
G. Will marshland be crossed in transporting equipment to project site? If yes, explain
D& F•81
Rev. 10/78
A. f. Private
2. Comme
3. Housing Development or Industrial
4. Other
8. 1. Lot size(s)-

2. Elevation of lot(s) above mean high water-
3. Soil type and texture .?Q h U / A V
4. Type of building facilities or structures -, ?, t. e e_ -?o M : w r l " J 'a I/
5. Sewage disposal and/or waste water treatment A. Existing
B. Describe
6. 'Land Classification' (circle one) EVELOPE TRANSITIONAL COMMUNITY RURAL
CONSERVATIO OTHER (See CAMA Local Land Use Plan Synopsis)
VI. Pertaining to Fill and Water Quality:
A. Does the proposed project involve the placement of fill materials below mean high water? Yes No.-X_
B. I. Will any runoff or discharge enter adjacent waters as a result of project activity or planned use of the
area following project completion? Yes_ No _X-
2. Type of discharge -- N/A4
3. Location of discharge-- N/R
VII. Present rate of shoreline erosion (if known):
Vill. List permit numbers and issue dates of previous Department of Army Corps of Engineers or State permits for
work in project area, if applicable: _"
IX. Length of time required to complete project:
X.
In addition to the completed application form, the following items must be provided:
A. Attach a copy of the deed with State
( application only) or other instrument under which applicant
claims title to the affected property. OR if applicant is not claiming to be the owner of said property,
then forward a copy of the deed or other instrument under which the owner claims title plus written
permission from the owner to carry out the project on his land.
B. Attach an accurate work plat drawn to scale on 8'h X 11" white paper (see instruction booklet for
details). Note: Original drawings preferred - only high quality copies accepted.
C. A copy of the application and plat must be served upon adjacent riparian landowners by registered or
certified mail or by publication (G.S. 113-229 (d))Enter date served
D. List names and complete addresses of the riparian landowners with property adjoining applicant's.
Such owners have 30 days in which to submit comments to agencies listed below.
C iNlo
Tha (I/) rc?n k-, 4P aY .? 1 n 13 11,n,??.. >? t? a78/a
Q Certification requirement: I certify that to the best of my knowledge, the proposed activity complies
with the State of North Carolina's approved coastal management program and will be conducted in a
manner consistent with such program.
11. Any permit issued pursuant to this application will allow only the development described in this appli-
cation and plat. Applicants should therefore describe in the application and plat all anticipated devel-
opment activities, including construction, excavation, filling, and land clearing.
Applicant's Signature
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10/78 SEE REVERSE SIDE FOR MAILING INSTRUCTIONS