51004_ATLANTIC BEACH KING MAC. TOURNAMENT_20070824

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F-1 CAMA / E DREDGE & FILL
GENERAL PERMIT
Previous permit #
NNew ElModification EComplete Reissue El 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 I SA NCAC
J)'Rules attached,
Applicant Name '16
Project Location: County
Address—
Street Address/ State Road/ Lot #(s)
City State ZIP
Phone # I V7. 31/ V Fax #
Subdivision
Authorized Agent
City ZIP
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Phone# O River Basin
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AEC(s):
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ORW: yes Vno PNA yes / no Crit.Hab, yes no
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Agent -or App)iry Printed'Name
Signature **Please read compliance statement on back of permit"
Application Fee(s) Check #
PermitOfficer's Signature
Issuing Date Expiration Date
Local Planning Jurisdiction Rover File Name

Jt
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
Mailing Address:
1638 Mail Service Center
Raleigh, NC 27699-1638
Location:
2728 Capital Blvd.
Raleigh, NC 27604
919-733-2293
Fax:[phone]
Morehead City Headquarters
400 Commerce Ave
Morehead City, NC 28557
252-808-2808/ 1-888-4RCOAST
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

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ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/MOORING PILINGS/BOATLIFTIBOATHOUs`E)
I hereby certify that I lease property adjacent.t.o McCurdy's Restaurant / ABKMT is
(Name of Property Ownp.r)
property located at
505 Atlantic Beach Causeway
(Lot, Block, Road, etc.)
on in Atlantic 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 roust initial the appropriate blank
below.)
I do not wish to waive
I do wish to waive that setback requirement. GZQ.e ja-a-
--------;--------------
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To. be filled in by individual proposing development)
------------------------------------------------------------------- ----- -----------
Signature
Cannon & Gruber
Print or Type Name
Telephone Number
Date

CERTIFIED MAIL — RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER
FORM
Name of individual applying for the permit' Atlantic Beach King Mackerel Tournament
Address of property- 505 Atlantic Beach Causeway
(Lot or streetN, street of road)
Atlantic Beach, NC 28512
(City & County)
I hereby certify the I own property adjacent to the above referenced property. The
Individual applying for this permit has described to me (as chnwn on the attached
drawing) the development they are proposing. A description or drawing, with
dimensions, should be provided whit this letter.
XI have no objections to this proposal
If you have objections to what is being proposed, please write the Division of Coastal
Management, 400 Commerce Ave., Morehead City, NC 28557 or call [phone]
within IO days of receipt of the notice. No response is considered the same as no
objection if you have been notified by Certified Mail.
Waiver Section
I understand that a pier, dock, mooring pilings, breakwater, boathouse, lift or
sandbags must be set back a minimum distance of 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 wish to waive the 15' setback requirement
I do not wish to waive the 15" setback requirements
i-\ A- ilzQ 9 _l�_o-?
Snalfre Dare -
Print Name
jo
Telephone number with area code

ATLANTIC BEACH KING MACKEREL TOURNAMENT 2213
PO BOX 8
ATLANTIC BEACH, NC 28512
�• 1 66-30/131
DATE
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