47074_SEXTON, DAVE_20070320

[ICAMA / FJ.DREDGE & FILL
GENERAL PERMIT Prey-
❑New ❑Modification []Complete Reissue []Partial Reissue Date
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
it #
permit issued
Applicant Name ;; V Project Location: County
Address �' A: Street Address/ State Road/ Lot #(s)
St t ZIP r' - i _4
rty
Phone # {)
Fax # { )
Subdivision
'V �S
ZIP
117
Authorized Agent
r c'
City
❑ Cw
❑ EW ❑'ETA ❑ ES El PTS
Phone # O
River Basin
/I1 I 64 `
Affected
AEC(s): ❑ O�
ElHHF ❑ IH El USA El N/A
Adj. Wtr. Body �i i JG i (
{ ( f 1.;�` i u L
(nat /man /unkn)
❑ PWS:
❑ FC:
'
Closest MaWtr. Body
j.
ORW: yes / no
PNA yes / no Crit. Hab. yes / no
Type of Project/ Activity
Pier (dock) length
Platform(s) - —I - -- — ---- - ---
Finger pier(s) i _
Groin length —
I �t
number
Bulkhead/ Riprap length !
avg distance offshore
max distance offshore
Basin, channel j
cubic yards
Boat ramp - - — — - _ - —
Boathouse/ Boatlift l
Beach Bulldozing
Other
Shoreline Length
SAV: not sure yes no ----.------
Sandbags: not sure yes no
1Y
Moratorium: n/a yes `no
Photos: yes -no
Waiver Attached: yes nuc 1
A building permit may be required by:
Notes/ Special Conditions
��. Ali
Agent or Applicant Printed Nam /,
Signature * Please read compliance statement on back of permit"
Application Fee(s) Check #
i
(Scale:
�I See note on back regarding River Basin rules.
Permit Officer's Signature
Issuing Date '�' piratio . 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:
LJ Tar - Pamlico River Basin Buffer Rules ❑ Other:
[J 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 (910-796-7215) for more information on how to comply with these buffer 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
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 CiV District
400 Commerce Ave
Morehead City, NC 28557
202-808-2808/ 1-888-4RCOAST
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
910-796-7215
Fax:[phone]
(Serves: Brunswick, New Hanover,
Onslow -below New River Inlet- and
Pender Counties)
Revised 06/29/05

A -
AMA,. ►
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
Michael F. Easley, Governor Charles S. Jones, Director m G. Ross Jr., Secretary
Date 3 - j ` '7
Applicant Name U� OIF- S iF�T-61
Mailing Address 1 D rs
NICZ
9AR I !ZD
2007
11��r�hQaa City ACM
I certify that I have authorized (agent) �RnB8 I f� UA& to act on my
behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to
install or construct (activity) 5<6P(hJPH-L- ,
at (location) c9 O H T16Rb Nz-
This certification is valid thru (date)
Signature
Via. b
400 Commerce Avenue, Morehead City, North Carolina 28557
Phone: [phone] \ FAX: [phone] \ Internet: www.nccoastalmanagement.net
An Equal Opportunity \ Affirmative Action Employer — 50% Recycled \ 10% Post Consumer Paper

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(FOR COf17' II I hereby certify that I own property adjacent to
(`i6.1e of Proper-tY Otirner
1�r1DDR
- ..�;��;• -; property located at o'ZOL( l U
c r (Lot, Block, Road etc.)
f ` one.
(Waterb in
(Toy
andiorl C:ounty):
He has desi ;-ibe i : to: -me, as shown beIou the ~ vo► n
r de e.opr►lent. he. p.ropesing. at that
Ioc3tion, and, I riay. a no' .abj•tions to his: proposal. I underst=�.nd Ghat a ncovered bgaE lii{
.i must be setback a fniniiriurt distance of F1tteYn 1" t (IS') born my far _o.i
waived by me.
.notxsh to waive.tha setback requirement.
MA R .1 2007
____✓ I do wish .tb.- waive that s [back require .
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Print or Typ•2 r•i;une
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Date:

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(FOR A PIFP,1MYC'OV'-5'D BOAT 11
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I hereby c-rtiFy that r own propertyy adjacent to
(`�:hrt.re of Property OtiTne1—
`•� "��;. ; property located at
L4 P ©t4D
(dot, Black', Road, etc.in
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must be set�ac?c a minirriiirt dstancy of rreY,n fec (i5`') rron m �a�-;o:f
waived by me: Fp -s tints ( .
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