49012_VAN ANDREWS, ROBERT_20070613

CICAMA / ❑ DREDGE & FILL
GENERAL PERMIT Previous permit#
L,New ❑Modification El 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 �.. 4�` �' Project Location: County
i
Address € 70 Street Address/ State Road/ Lot #(s)
City State ZIP
Phone # (} `i ` �✓ Fax # (_)
Authorized Agent
Affected ❑ CW ❑ EW ❑ PTA ❑ ES ❑ PTS
ElOEA ❑ HHF ElIH ElUBA ElN/A
AEC(s):
❑ PWS: ❑ FC:
ORW: yes / no PNA yes / no Crit.Hab. 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/ BoatlA
Beach Bulldozing
Other
Shoreline Length
SAV: not sure yes nog
a
Sandbags: not sure yes n
Moratorium: n/a yes
Photos: yes Vo
Waiver Attached: yes �-o
A building permit may be required by:
Notes/ Special Conditions
r
p ' S
Subdivision
City - ZIP f
Phone # ( ) River Basin
Adj. Wtr. Body !` ' v (nat /oan ,/unkn)
Closest Maj. Wtr. Body T'
Scale:
T I
r.'
Agent or Applicant Printed Name
Signature Please read. compliance statement on back of permit
!
r� !
L; !
I
❑ See note on back regarding River Basin rules.
Permit Officer's Signature
Issuing Date -'
r
Expiration Date
w
Application Fee(s)
Check# 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 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 how to comply with 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/ I-888-4RCOAST
Location:
Fax: [phone]
2728 Capital Blvd.
(Serves: Carteret, Craven, Onslow -above
Raleigh, NC 27604
New River Inlet- and Pamlico Counties)
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)
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

GAMA / DREDGE & FILL N 4 490124
LJ GENERAL PERMIT - Previous permit #
Pew ❑Modification ❑Complete Reissue I]Partial Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environment and Natural Resources % / /
and the Coastal Resour s C mmission in an area of environment concern pursuant to 15A NCAC ` rJ
rles attached.
Applicant Name LU� er- v iA '1 �� �j Project Location: County__
Address O 1 Street Address/ State Road/Lot #(s)_ _
City_ I 3 v State ZIP 2%d ---- /-7 d 3-- =Z _.--- � lyt4c,-, -
Phone # (a.)2r? Fax # ( ) Subdivision
Authorized Agent City __ _ ZIP
// AAt `
❑ CW �!W �A ❑ ES ❑ PTS Phone # ( ) _River Basin A)
It
AEC(s): ❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A Adj. Wtr. Body (nat an unkn
❑ PWS: ❑ FC:
ORW: yes / noy PNA yes no Crit.Hab. yes / no
Closest Maj. Wtr. Body C z -0
Type of Project/ Activity
Pier (dock) length
Finger pier(s)
Groin length
number
Bulkhead/ Riprap length_
avg distance offshore_
max distance offshore
Basin, channel
cubic yards
Boat ramp
Boathouse/ oatli 13 ?c
Beach Bulldozing
Other
Shoreline Length
SAV: notsure yes no ---.-- ---____-_
Sandbags: not sure yes n
Moratorium: n/a yes
Photos: yes
Waiver Attached: yes no -- - - -- - -- - ---
A building permit may be required by:
Notes/ Special Conditions
A rt
Agent or Applicant Printed Name
R
(Scale:—rS )
❑ See note on back regarding River Basin rules.
0
c
V
Signature "Please read compliance statement on back of ermit
Application Fee(s) Check #
Issuing Date
Local Planning Jurisdiction
Rover File Name

I A* 6;- A'- -
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
Michael F. Easley, Governor Charles S. Jones, Director William G. Ross Jr., Secretary
June 13, 2007
Robert VanAndrews
PO Box 711.9
Wilson, NC 27895
Dear Mr. VanAndrews:
In order to validate this permit, please sign the permit as indicated. Retain the white copy for
your files and return the signed pink and yellow copies to us in the enclosed, self-addressed
envelope. If the signed permit copies are not returned to this office before the initiation of
development, you will be working without authorization and will be subject to a Notice of
Violation and subsequent civil penalties.
We appreciate your early attention to this matter.
Sincerely, / n
�-04
�oJe
Ryan Davenport
NC Coastal Management Representative
lsb
Enclosures
400 Commerce Avenue, Morehead City, North Carolina 28557
Phone: [phone]a0$1 FAX: [phone] Internet: www.nccoastalmanagement.net

ROBERT VAN ANDREWS, CLU, CHFC
9815
CAMA
Date Type Reference
5/30/2007 Bill
►7&:� E
Robert Andrews -First
5/30/2007
Original Amt. Balance Due Discount Payment
100.00 100.00 100.00
Check Amount 100.00
a
Morehead City DGM
100.00

ROBERT VAN ANDREWS, CLU, CHFC
CAMA
Date Type Reference
4/3/2007 Bill Permit
5/3/2007
Original Amt. Balance Due Discount Payment
100.00 100.00 100.00
Check Amount 100.00
TPI gTj
MAY t 7 2007
Mgrehead City DCM
Robert Andrews -First 100.00

Locality
Ocean Hazard Estuarine Shoreline ORW Shoreline
(For official use only)
Permit N �j
Public Trust Sho
J
MAY 7 2007
GENERAL INFORMATION ? 7' 116 / D LAND OWNER ' Morehead City DCM
Name 17?0 6 E,2T V A.✓`�—
Address 1703
City ATIA-i k (c U ; �A< Statc� " G Zip Phone
AUTHORIZED AGENT
Name N— /
Address
City State Zip Phone
LOCATION OF PROJECT: (Address, street name and/or directions to site. If not oceanfront, what is the name of the
adjacent waterbody.) -6 o fa(1 E s nV^O / 70 3 45, F% /47A6e nl /eo,4.0
DESCRIPTION OF PROJECT: (List all proposed construction and land disturbance.)
l o, r000 46 CA-A*C`r4/6 LAND `17 (S Tu.c�6rtn/c
SIZE OF LOT/PARCEL: square feet acres
PROPOSED USE: Residential (Single-family" /Multi -family ) Commercial/Industrial
Other
TOTAL ENCLOSED FLOOR AREA OF A BUILDING IN THE OCEAN HAZARD AREA OF ENVIRON-
MENTAL CONCERN (AEC): n/ . A square feet (includes all floors and roof covered decks)
SIZE OF BUILDING FOOTPRINT AND OTHER IMPERVIOUS OR BUILT -UPON SURFACES IN THE
COASTAL SHORELINE AREA OF ENVIRONMENTAL CONCERN (AEC)- square feet
(Calculations includes the area of the roof/drip line of all buildings, driveways, covered decks, concrete or masonry patios,
etc., that are within the applicable AEC. Attach your calculations with the project drawing.)
Choose the AEC area that applies to your property:
(1)within 75 feet of Normal High Water for the Estuarine Shoreline AEC
(2)within 575 feet of Normal High Water for the Estuarine Shoreline AEC, adjacent to Outstanding Resource Waters
(3)within 30 feet of the Public Trust Shoreline AEC
(Contact your Local Permit Officer if you are not sure which AEC applies to your property-.)
STATE STORMWATER MANAGEMENT PERMIT: Is the project located in an area subject to a State Stormwater
Management Permit issue y the NC Division of Water Quality?
YES NO
If yes, list the total built upon area/impen-ious surface allowed for your lot or parcel: square feet.

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ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIERIMOORING PILINGSBOATLIFTBOATHOUSE)
I hereby certify that I own property adjacent to RobeAt Andreems tr(cs,
4.�"
(Name of Property Own
P rh V
Mq y`� zj�
� zoos
1703 E. FoAt Macon Road
1property located at OtAF.,, _
(Lot, Block, Road, etc.)
on Bogue Sound , in Attantic. Beach , N.C.
(Waterbody) (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. I understand that a pier/mooring pilings / boatlift / boathouse
must be set back a minimum distance of fifteen feet (I 5') from my area of riparian access unless
waived by me. (If you wish to waive the setback, you must initial the appropriate blank
below.)
II do not wish to waive
` I do wish to waive that setback requirement.
------------------------------------------------------------------------------------------------
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
Boat Lift
Signature
Print or Type Name
r7 Telephone Number
Date: J / --0 7
pity ` cu

ADJACENT RIPARIAN PROPERTY OWNER STATEMEN
(FOR A PIER/MOORING PILINGSBOATLIFTBOATHOUSE)
I hereby certify that I own property adjacent to Rvbeh t Andnew.6
(Name of Property Own I
�r
L��
property located at 1703 l . hart Macon Road
(Lot, Block, Road, etc.)
on Bogue Sound in A;ttant-%c Beach , N.C.
(Waterbody) (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. I understand that a pier/mooring pilings / boatlift / boathouse
must be set back a minimum distance of fifteen feet (15') from my area of riparian access unless
waived by me. (If you wish to waive the setback, you must initial the appropriate blank
below.)
I do not wish to waive
I do wish to waive that setback requirement.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
Boat Li. t
-------------------------
��� ; ,
Signature
�raRk L , Chioma.n.
Print or Type Name
�Z b L) v27 - 1 z 3
Telephone Number
Date: %'i e;- y I y 2y o 7

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/MOORING PILINGSBOATLIFTBOATHOUSE)
I hereby certify that I own property adjacent to AAWs�%*�
(Name of Property Owner)
property located at
(Lot, Block, Road, etc.)
on M,tN IQ
, in N I % C B LC , N.C.
aterbody) (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. I understand that a pier/mooring pilings / boatlift / boathouse
must be set back a minimum distance of fifteen feet (15') from my area of riparian access unless
waived by me. (If you wish to waive the setback, you must initial the appropriate blank
below.)
I do not wish to waive
I do wish to waive that setback requirement.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
1"� z�,' �Z' A,,,,
WSro42 (3 ACG� f -� ,p, Signature'l%�u�
A SSOG, 4 ri 0.1
Print or Type Name
qfq 77 - 7 -93 .8
Q Telephone Number
Date:

gOBERT VAN ANDREWS, CL.U, CHFC
j= THE PLANNING GROUP INC.
t a, P.O. BOX 7119i
WILSON, NC 27895 fr'«
I i [phone] yI
i3Ft 1.13r (its dL
FIRST CITIZENS
1ISO ill 66 30 531
5/30/2007
ri
P;+f`�
PAY TO THE LAMA '
ORDER OF:
One Hundred and 00/100****,�««******,.**,«***«,.*�**�t*.**�*��«**��,.****�****�.**..*�***«*..*****�****�********************.�**�
�y CAMA
'i I ..j� �1i{ft�-2f�1S^��al� � FIF^• ... _ { V �' ""Sj - � ra��V
..il! t•. � a}!� � � � 1, � ..sir � i � AUTHORIZED SIGNATURE
MEMO �OC' � -�.�� I h ;'
115000098 L Slim 1:0 S 3 L00 3001I:00 366 26 2889 11
ROBERT VAN ANDREWS, CLU, CHFC �i FiAsrCITIZENS
THE PLANNING GROUP, INC. BANK
P.O. BOX 7119 66-30/531
-->WILSON, NC 27895
[phone]
5/3/2007
PAYTO THE
ORDER OF CAMA $ " 100.00
One Hundred and 00/100*..*..***....******..*„****.*.*************.*****,*************�**.**.******«******,
CAMA
MEMO: Ll .9_6
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111009769119 1:0S31003001:003662628897
9`815
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