55348_MICHALEK, TONY_20100524

❑CAMA / u DREDGE & FILL �'f
GENERAL PERMIT Previous permit #
[]New ` ❑Mod'fication [-]Complete 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
[� Rules attached.
Applicant Name ► Project Location: County to
Address Vft Street Address/ State Road/ Lot #(s)�'
City State N%C' zip.,-,-,. 5
Phone # ('i` ) )�.- �T 1 C Fax # Subdivision !� k
Authorized Agent ��'���11it aC •rt. City O� 0 ZIP—
G CW ElEW PTA J�[tS ❑ PTS Phone # River Basin rat/C''Cl t:{�
Affected / -7!
AEC(s): oEA ❑ HHF ❑ IH [IUBA N/A Adj. Wtr. Body ? ? f�> `'f c f'"N , natt /man /unkn)
❑ PWs: CFC: J'
ORW: yes / no PNA yes / no Crit.Hab. yes / no Closest Maj. Wtr. Body
Type of Project/ Activity (ir✓� ! ' ►�- fi ! f+-�
r, (Scale:
Pier (dock) length , "r X ( 2
Platform(s) k ( d
Finger pier(s)_
Groin length
number
Bulkhead/ Ripraplength_
avg distance offshore
max distance offshore
Basin, channel
cubic yards
Boat ramp
Boathouse/ Boatlift \`
r
Beach Bulldozing t
r
i
Other A
f
j
Shoreline Length
SAV: not sure yes no
Sandbags: not sure yes
Moratorium: n/ayes n
Photos: y n
Waiver Attached: is/r yes - -
A building permit may be require dby:i t)� pj
Notes/ Special Conditions ? _>r - .1
k
�J f
L
`,/
i
o�by-
rr Y See note on back
c> r- n 1 -
Y
o �
garding River Basin rules.
TAN/ ltlld-111^46'
i
Agent o plican Printed Name PermitO ice s Signature
Ps
Signature ** Please read compliance statement on back of permit Issuing D e Exp' tion Date
)73
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 CiV 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.
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

--'� ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/MOORING Pll INGSBOATI IFTBOATHOUSE)
Yam"'
I hereby certify that[ own property adjacent to dou c 's
(Nay a of property owner)
Property located at SucU�•A
(lot, block, road, etc.)
on C .i(,. "T -Aek , in <1-4-a6:J , N.C.
(Water body) (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.
I do not wish to waive the setback requirement.
I do wish to waive that setback requirement.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(to be filled in by individual proposing development)
(Applicant Information) (Riparian Prope ner Information)
J
Mailing Address Signature F4:
�� Ally
City/State /Zip Print or Type Name
Telephone Number Telephone Numb
' / /') o l C
Date Date
Foley Contractors, LLC.
252-229-6467
[e-mail]

: �-: i���G i to I L am. REG11U
2. '.ter.: L
Foley Contractors, LLC
212-C Kale Rd
New Bern, NC 28562

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/MOORING PILINGS✓BOATLIFTBOATHOIISE)
I hereby certify that I own property adjacent to oN o 0 �, /� 's
ame of property owner)
Property located at 166
(lot, block, road, etc.)
on C ku it 146w tlycle. C x*uJJ , N.C.
(Water body) (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.
I do not wish to waive the setback requirement.
LkI do wish to waive that setback requirement.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(to be filled in by individual proposing development)
(Applicant Information)
Mailing Address
City/State /Zip
Telephone Number
Date \
Foley Contractors, LLC.
252-229-6467
[e-mail]
(Ripa ian Property wn r formation)
Signature /
11 u_ r L V RLn_ 1 I I
Print or Type Name
5-)--3Q3-7y,,e'y
Telephone Number
5 /7—/ /-)
Date

.. y
y
WILL
Foley Contractors, LLC
212-C Kale Rda� _:�tistf�N
+ lF"
New Bern, NC .28§62
...........
1
Foley Contractors, LLC
212-C Kale Rd 1'
New Bern, NC 28562
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North Carolina Department of Environment Resources
Division of Coastal Management
Charles S. Jones, Director
Michael F. Easley, Govemor
Date A>7ri128, N 10
Applicant Name_ Tonv Michalek
Mailing Address 106 Sumter Ct
Havelock NC 28532
I certify that I have authorized (agent) Foley Contractors, LLC to act on my
behalf, for'purpose of applying for and obtaining all CAMA Permits necessary to
install of construct (activity) Dock
at (location) Same
This certification is valid thru (date) 1 year
Signature
William G. Ross Jr., Secretary
400 Commerce Avenue, Morehead City, North Carolina 28557
Phone: [phone]/ FAX: [phone]/ Internet: www.nccoastaliTianagement.net
An Equal Opportunity/ Affirmative Action Employer-500/oRecycled/10% Post Consumer Paper

NC Division of Coastal Mgt. Habitat Impact Computer Sheet
Applicant: Tony Michalek
Date: May 24, 2010
General Permit #: 55348C
Describe below the HABITAT disturbances for the application. All values should match the name, and units of measurement
found in your Habitat code sheet.
TOTAL Sq. Ft.
FINAL Sq. Ft.
TOTAL Feet
FINAL Feet
(Applied for.
(Anticipated final
(Applied for.
(Anticipated final
DISTURB TYPE
Disturbance total
disturbance.
Disturbance
disturbance.
Habitat Name
Choose One
includes any
Excludes any
total includes
Excludes any
anticipated
restoration
any anticipated
restoration and/or
restoration or
and/or temp
restoration or
temp impact
temp impacts)
impact amount)
temp impacts
amount
HM
Dredge ❑ Fill ❑ Both ❑ Other N
510
510
OW
Dredge ❑ Fill ❑ Both ❑ Other ®
20
20
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑

1
•�- h
Serial Number Year, Month, DaysPost office U.S. Dollars and Cents
17346633750 r 201 Z-4 M01 $1.000.00 �
Amount
I" !y ttl�r�y�► +[VI1?t�6� rC 1 l�i� Address f
Memo ��)
®zooeumiadstates Postal Sq— All Rights R.sarvod. SEE REVERSE WARNING •NEGOTIABLE ONLY IN THE U.S. AND POSSESSIONS
1:00000800 21:

BUFFER AUTHORIZATION CERTIFICATE
FOR PIER AND DOCKING FACILITIES ACCESS WAY
A riparian buffer authorization is required for pier and docking facilities access ways through the Tar-I"amlico &
Neuse River Riparian buffer per Division of Water Quality (DWQ) regulations 15A NCAC 02B.0233 & .0259.
The Division of Coastal Management (DCM), through a Memorandum of Understanding with the Division of
Water Quality (DWQ) has reviewed your project proposal, determined that the project as proposed complies
with the aforementioned regulations, and made a "no practical alternatives" determination per those
regulations.
Those activities covered by your Coastal Area Management Act (CAMA) permit have received Buffer
Authorization as long as the project is constructed in a manner that continues to meet all of the conditions
listed below. Failure to comply with this Buffer Authorization shall subject the property owner & the party
(contractor) performing the construction Wor land clearing to a civil penalty of up to $25,000 per day per
violation.
1. Crossing is Perpendicular: Pier and docking facility access way must cross the 50 ft. riparian buffer
perpendicularly (which is defined as between 75 and 105 degrees) unless otherwise approved by DCM.
The alignment shall minimize the removal of woody vegetation to the greatest extent practicable.
2. Pervious Materials: All reasonable measures shall be taken to ensure the access way is made of
pervious materials like open -slatted wood or composite, mulch, or grass to meet the intent of the rules
to the maximum extent practicable.
s. Access Width: The width of the pier or docking facility access way shall be limited to six (6) feet.
4. Project Drawing: The drawing on the CAMA General Permit is considered the project drawing of your
property indicating the relative location of the pier or docking facility and any requested access way.
This drawing will be used to aid in compliance and monitoring efforts.
By your signature below you agree to be held responsible for meeting all of the conditions listed above and
verify that all information provided is complete and accurate.
Cc
CAI �i�
or, plican Prr a me Permit Off'cer's 7S7ature
;�
en or Applicant ign Issue ate
CAMA GENERAL ERMIT #: - .�Ynl
Washington Office Morehead City Office
943 Washington Square Mall 400 Commerce Avenue
Washington, NC 27889 Morehead City, NC 28557
Phone [phone] Phone [phone]
An Equal Opportunity/Affirmative Action Employer— 50% Recycled/10% Post Consumer Paper
Version 5, 09/2009