55370_LILLY, HARVEY_20100414

❑CAMA / ❑ DREDGE & FILL
GENERAL PERMIT Previous permit #
❑ New ❑ 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 2,00c
© Rules attached.
Applicant Name
Address S Cluj- ;Vot Kdr-A'+ 0-t.
City �s wlo,e, s�e, o State ro -C ZIP `';C(I
Phone # (11! ;-) 39 -� Fax # ( )
Authorized Agent
Affected ❑ CW L EW %,PTA ❑ ES ❑ PTS
❑ OEA ❑ HHF ❑ IH ElUBA ElN/A
AEC(s):
❑ PWS: ❑FC:
ORW: yes / � no PNA yes / o Crit.Hab. yes / no
Project Location: County ( r j
Street Address/ State Road/ Lot #(s)
�+ " IrC J'e .2 C-ro
Subdivision IJI, �Jr r I<?t,.
City_ "WC'A S �14'a ZIP 2�S�(7l
Phone # (? 14) �tt0 fi "t�J'� River Basin t>'�
Adj. Wtr. Bod(na /mom an /un6)
Closest Maj. Wtr. Body
Type of Project/ Activity
/Is
(Scale: � O; )
Pier (dock) length j _£ C-
Platforms) t, G'
R,° t
Finger pier(s)
Groin length
number
Bulkhead/ Riprap length
avg distance offshore_
max distance offshore
Basin, channel
cubic yards
Boat ramp t
Boathous . Boatli 13, o S
Beach Bulldozing
Other
Shoreline Length 531
1
SAV: not sure yes CO
Sandbags: not sure yes no
Moratorium: n/a yes
Photos: yes fior^
Waiver Attached: iWss no
A building permit may be required by: nr . See note on back regarding River Basin rules.
Notes/ Special Conditions T �"' tb' ` < , < �. t.. 0", i
r
Agent or. Applicaift Printed Name
Signature ** Please read compliance statement on back of permit
Application Fee(s) Check #
Issuing
if
Date
!SWAA3 L-.ro ,ice o i m 19A
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 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/ 1-888ARCOAST
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

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/MOORING PILINGSBOATLIFTBOATHOUSE)
I hereby certify that 1 own property adjacent to f -i dtry Cy ' % 01W is
(Name 4f Property ner)
property located at 3,34 e r 1�Ga c,1, cc, t& r
(Lot, Block, Road, etc.)
on +e, o a k R► e— r, in 0 AS I oy , N.C.
(Waterbody) (Town and/or County)
Applicant's phone #: 0 ' Vy - O / Vlailing Address: 304 e r- Q eq C
to Vik
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)
�f �
>t`skt o • o
0 o dw o
(A
O0r-
(Information for Property Owner Applying
for Permit)
36 y-z R•ve-- Ra«!, C ).
Mailing Address
$�v a
City/State/Zip
6?1() -:31-I6
iqC- a�5by
oS q3
Telephone Number
Signature Date
(Riparian Property Owner Information)
LV Signature
CkZi-02-LZ
Print or Type Name
Telephone Number
Date

m
D

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/MOORING PILINGSBOATLIFTBOATHOUSE)
I hereby certify that I own property adjacent to /J w r r/ c y I , %/!I IS
(Name of PropertyOwner)
property located at 3 0 `t K► u e-
(Lot, Block, Road, etc.)
on w ► L 0.1k A• u Zr , in On510 C q , N.C.
(Waterbody) (Town and/or County)
Applicant's phone #: 910 - 3 YD 0 f �%� Mailing Address: 3 c6 `l — `2— R V Qf Q e a G k-
C o,r -\-
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)
�St�r
(Information for Property Owner Applying (Riparian Property Owner Information)
for Permit) /
3 © y-J L)Pr
Mailing Address Z Signature
City/State/Zip Print or Type Name
c?10- 31-10- G9413 Ito 3S6 P13
Tjho e Number Telephone Number
7�' Z�9�/� /o t' - / 0 t/
/f
Signature Date Date

NC Division of Coastal Mgt. Habitat Impact Computer Sheet
Applicant: Harvey Lilly Permit #: 55370C
Date: 4/14/10
Describe below the HABITAT disturbances for the application. All values should match the name, and units of measurement
found in your Habitat code sheet.
Habitat Name
DISTURB TYPE
Choose One
TOTAL Sq. Ft.
(Applied for.
Disturbance total
includes any
anticipated
restoration or
temp impacts)
FINAL Sq. Ft.
(Anticipated final
disturbance.
Excludes any
restoration
and/or temp
impact amount)
TOTAL Feet
(Applied for.
Disturbance
total includes
any anticipated
restoration or
temp impacts
FINAL Feet
(Anticipated final
disturbance.
Excludes any
restoration and/or
temp impact
amount
Shallow Bottom
Dredge 13 Fill ❑ Both ❑ Other ❑O
169
169
Open Water
Dredge ❑ Fill ❑ Both ❑ Other ❑x
169
169
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
252-808-2808 :: 1-888-4RCOAST :: www.nccoastalmana_qement.net revised:02/03/10

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66-7704/2531 6731
J. HARVEY LILLEY o8605624541
NANCY H. LILLEY NCDL 1591903
475 HUBERT BLVD. 353-4523 DATE
HUBERT, NC 2853..9 Cif
47 � )AF ,- /Q- $ C�64
DOLLARS �
State Em to 'ees' Credit Union'
aMl c�caselle, North Carolina
42 G✓� 7v (J li'
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