53681_LAND, LARRY_20090521

[�CAR11A / ID DREDGE & FILL Z�09
GIENERA, %?ERMIT Previous permit#
. N^ ❑Modification ❑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
1-1 Rules attached.
Applicant Name — j L G"GI Project Location: County
Address 1 '4 Street Address/ State Road/ Lot #(s)
City r, State C. ZIP ` S
Phone # ( ) � 1I !� j e�(, Fax # (,) Subdivision
Authorized Agent Cityi ZIP c5 S 7U
❑ CW C7EW [PTA ❑ ES ❑ PTS Phone # ( ) River Basin
Affected ElOEA ElHHF ElIH ElUBA ❑ N/A
AK(s}: Adj. Wtr. Body--- ('nat /man /unkn)
❑ PWS: ❑ FC:
ORW: yes / no PNA yes / : no Crit.Hab. yes / no Closest Maj. Wtr. Body
Type of Project/ Activity
Pier (dock) length
Platforms) --
Finger pier(s) j
Groin length
number —
Bulkhead/ Riprap iength
avg distance offshore
max distance offshore
Basin, channel. '' x ' - ' -:i
cubic yards
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing
Other
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 dq11
Agent or 4pplicant,Pi
Signature � C� PI ase read compliance statement on back of permit
ApplicationFee(s) ,��Chhecck# (#
(Scale:
See note on back regarding River Basin rules.
11;
Permit Officer's Sigr)ature
Issuing Date Excpirati nDtte
Local Planning Jurisdiction { Rover File Name

Jr r
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

CERTIFIED MAIL - RETURN RECEIPT REQUESTED
DIVISION OF COASTAL_ MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Individual applying for Permit:
Address of Property:
(Lot or Street #, Street or Road, City & C
mailipa addre s if diffe ent !� �Y C MAY i 2009
//"'
telephone nu7byou can be rched � � �18'$� cityC`j
at
I hereby certify that I own property adjacent to the above referenced property. The
individual applying for this permit has described to me as shown on the attached drawing
the development they are proposing. A description or drawing, with dimensions, should be
provided with this letter.
I have no objections to this proposal.
If you have objections to what is being proposed, please write the Division of
Coastal Management, 400 Commerce Avenue, Morehead City, NC, 28557 or call (252)
808-2808 within 10 days of receipt of this notice. No response is considered the
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boat house, 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.)
111114 I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
Telephone Number With Area Code
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MAY 11 2009
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ADJACENT RIPARIAN PROPERTY OW7iER STATEMENT
I hereby certify that I own property adjacent to 's
(Name of Property Owner)
property located at /(L
(Lot, Block, Road, etc.)
on 1Y, e5K, L�Zj in r , N.C.
(Waterbody) (T wn and/or County)
Z31Applicant's phone #: �r( r 4(� Tailing Address:
He has described to me, as shown below, the development he is proposing at that location,, and, I
have no objections to his proposal.
--------------------------------------------------------------------------------------------------------------
DESCRIPTION AND/OR PROPOSED DEVELOPMENT:
P� / (To be filled in by rop rty owner proposing development)
xlr� C� TINGk�e o �o'Tes
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"AY 1 g 2009
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MoretlGiaU City DCM
---------------------------------------------------------------------------------------------------------------
(Information for Property Owner Applying (Riparian Property Owner Information)
for Permit) /I ,-) //'} , ,
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Mailing Addrdss
City/State/Zip
Telephone Number
-Vq,-1qW
Signature Date
/lIZ17L:�;I&
Signature
P(t or Type Name
Telephone Number
Date

Ili
DAVID A. HORTON 4924
KAREN D. HORTON
BUSINESS ACCOUNT PH 252-504-1966 C pate 66-30/531
604 BLAIR POINTE RD Z�� /137
w MOREHEAD CITY, NC 28557
® Pay to the $ 4400, 0U
Order of �y / ✓ "�
(��/ fZtin G� tC l•C_ Dollars s�
Fa.tue.
Bat.u. o.
Back.
First Citizens)
_ Bank /
firs idzens,pom
For kO rvh t i T« — "—P
i:053L00300':OO13L7428C3?Sum 04924

(Do estic kit Only; No
For ivery in��rmation visit
f1J(Endor
;ertified Fee
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Receipt Fee
Required)
Delivery Fee
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Total Postage $ Fees
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----------------------
� Street, Apt. No.;
or PO Box No.
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----------------- ----- --------------
City, State, ZIP+4
IN
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-- NC 2b5
----

Certified Mail Provides:
■ A mailing receipt �
■ A unique identifier for your mailpiece
■ A record of delivery kept by the Postal Service for twos years
Important Reminders:
■ Certified Mail may ONLY be combined with First -Class M, ile or Priority Mail®.
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valuables, please consider Insured or Registered Mail.
■ For an additional fee, a Return Receipt may be requested to pr wide proof of
delivery. To obtain Return Receipt service, please complete and a ach a Return
Receipt (PS Form 3811) to the article and add applicable postage to cover the
fee. Endorse mailpiece "Return Receipt Requested". To rect;ive a fe '`Waiver for
a duplicate return receipt, a USPS® postmark on your Certified Mail receipt is
required.
■ For an additional fee, delivery may be restricted to the address " Or,
addressee's authorized agent. Advise the clerk or mark the mailpiece with the,,
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cle at the post office for postmarking. If a postmark on the Certified Mail ?
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IMPORTANT: Save this receipt and present it when making an inquiry.
PS Form 3800, August 2006 (Reverse) PSN 7530-02-000-9047

■ Complete items 1, 2, and 3. Also complete
Item 4 If Restricted Delivery Is desired.
■ Print your name and address on the reverse
so that we can return the card to you.
■ Attach this card to the back of the mailpiece,
or on the front if space permits.
Article Addressed to: j
c
1
A Signature
X ❑ Agent
Addressee
B. Received by ( Printed N (e) C. D to of Deli,
D. Is delivery address clifferedi from ltem T1 ❑ Yes
If YES, enter delivery address below: ❑ No
3. Service Type
❑ certified Mail ❑ Express Mail
❑ Registered ❑ Return Receipt for Merchandise
❑ Insured Mail ❑ C.O.D.
4. Restricted Delivery? (Extra Fee) ❑ Yes
2. Article Number
(Transfer from service labeq 7008 3230 0002 9026 2295
PS Form 3811, February 2004 Domestic Return Receipt 102595-02•M-1540 i

UNITED STATES POSTAL SERVICE rs
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MAY 11 20091
Morehead -City -DC - -