47862_SHIVER, MICHAEL_20070202

❑CAMA / [ DREDGE & FILL IiU C
GENERAL PERMIT Previous permit#
❑New ❑Modification ❑Complete Reissue El Partial Reissue Date previous permi 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 Street Address/ State Road/ Lot #(s)
Citv
Phone # ( )_
Authorized Agent
Affected ❑ CW
AEC(s): ❑ Ora
❑ PWS:
ORW: yes / no
State ZIP
Fax # ( )
❑ EW XTA
❑ HHF ❑ IH
❑ FC:
PNA yes / no
Type of Project/ Activity
Pier (dock) length
Platform(s)
Finger pier(s)
Groin length
number
Bulkhead/ Riprap length
avg distance offshore
max distance offshore
Basin, channel
cubic yards_
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing
Other
❑ ES ❑ PTS
❑ UBA ❑ N/A
Crit.Hab. yes / no
Shoreline Length "?
SAV: not sure yes
no ---
Sandbags: not sure yes
no
Moratorium: n/a yes
no
Photos: yes
no
Waiver Attached: yes
no
A building permit may be required
by:
Notes/ Special Conditions
Agent or Applicant Printed Name
Signature ** Please read compliance statement on back of permit
Application Fee(s) Check #
Subdivision
City ZIP
Phone # ( ) River Basin
Adj. Wtr. Body (nat /man /unkn)
Closest Maj. Wtr. Body
(Scale: )
❑ See note on back regarding River Basin rules.
PermitOfficer's Signature
Issuing Date Expiration Date
Ilk-'
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 (910-796-7215) for more information on howto complywith these buffer rules.
Division of Coastal Management Offices
Raleigh Office Morehead City Headquarters
Mailing Address: 400 Commerce Ave
1638 Mail Service Center Morehead City, NC 28557
Raleigh, NC 27699-1638 252-808-2808/ 1-888-4RCOAST
Location: Fax: [phone]
2728 Capital Blvd.
Raleigh, NC 27604
919-733-2293
Fax:[phone]
(Serves: Carteret, Craven, Onslow -above
New River Inlet- and Pamlico Counties)
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)
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 08/09/06

ADJACEtN7 RL'ARLkIN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to 471JGAt f,t�i�#& is
(i\ame of Property Owner)
property located at 2 3 9 &I vrA-w PA -
(Lot, Block, Road, etc.)
C•7f
(Waterbody)
in A7, N.C.
(Town and/or 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.
DESCI"IPTION AND/OR DRAWC' G OF PROPOSED DEVELOPMENT
(To be filled in by indiv-idual proposing dei•eloprnent)
1 �> I -�� 1 0
w
fGrre
Nkw 7Q ` vAti ►� Clvi F��""
JAN 1 7 2007
Morehead City DCM
za, � � � I - 0—k ���_
Signature
--T��C2_5 ca-- C - L -\�^\- n
Print or Typc Dame
Telzc)hone N'umbcr
C\M `b Icy " C $

ADJACENT RYPARYAN PROPERTY OWNER STATEMENT
(FOJ? A PI'ERIMOO.RM0 PIUNGS/BOATLIF7'YBOA'1'I10ME)
1 hereby certify that 1 own property adjacent to
(Name o[Property Owrior)
property located at t
(Street Address, Lot, Block, Ruad, etc.;
Oil,in � �J./�Uj lid. _#N.-.
(Waterhody) (Town an&or Couri�y)
He/she has -described to me, as.sbown below, the development he/she is proposing at that
location anal I have no objections to this •pmposal: 1 widerstand brat a pierfmooring
pilings/boatiiftlboaihouse must be setback a minimum distance of fifteen feet (15') from my 4rea'of
riparian access unloss valved by me. I have indicab my intentions by initialing below:
.I do 14at-agm to waive thr, 1 :5' sttlLa,k L mi uuCintm L
(initials)
'7 do agree to waive the 15' setback requirement.
DES(.RIMON AND/OR DRAWING OF PROPOSER DEVELOPMENT:
(To be jWed In by huUvidrW proposing dev-ploprnem)
New 7
JAN 1 7 2007
91 --, Morehead Q
Prim or Type ?game
36q /
7elepb.one Number
Late:

ft
WDENR
North Carolina Uepartment of Environment and Natural Resources
Division of Coastal Management
Michael F. Easley, Governor Charles $. Jones, Director William G. Ross Jr., Secretary
Date I - / 5 - 0
Applicant Name 411G IfOci 5"d /VH-A-
Mailing Address tg,?L i- M
I certify that I have authorized (agent) lc— iT a l.-,,4.(.b.i to act on my
behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to
install or construct (activity) a,,�nr a 111� ,
at (location) 1= 3 Z tip !'rp,) 4 u°
JAN 1 7 2007
This certification is valid thru (date) _
��
SignatureIM � , 4.0 /L
,/_ C'7
d
orehead City DCM
400 Commerce Avenue, Morehead City, North Carolina 28557
Phone: [phone] \ FAX: [phone] \ Intemet: www.nccoastalmanagement.net
An Equal Opportunity \ Affirmative Action Employer — 50% Recycled \ 10% Post Consumer Paper

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