56961_MITCHELL HARBOUR DOCK OWNERS ASSOC_20101112

❑ DAMA /D DREDGE & FILL I
❑AGENERAL PERMIT /� Previous permit#
New ❑Modification ❑Complete Reissue [:]Partial Reissue 41 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 Nam I yxs
Address an
—
T-
City r' Mate' ZIP !6'1
Phone # () Fax # ( )
Authorized Agent
Affected - CW ❑ EW --'PTA - ES ❑ PTS
AEC(s): El OEA ❑ HHF - IH i- UBA Q N/A
❑ PWS: -FC:
ORW: yes / no PNA yes / no Crit.Hab. yes / no
Project Location: County
Street Address/ State Rotad/f Lo #(st)
V U JZ �..c''✓1�
Subdivision
City ZIP
t
Phone #ti' 1; 12 River Basin 'f� t1s o..
Adj. Wtr. Body.��_: �,�''^ k. fnat /man /unkn)
Closest Maj. Wtr. Body
■ems
■■■■■■i■��t. aeeee�e �■■■ei�■�■i■■■■i■
MM■■■■■■■Ke
,■■11111000�
■■■�
JOE=■�■..-•�....�■■■■■■■■■■■■■■■
■■[l,:�I
rri1A',Wj
iLgw%
��NElmo
■■■iIKIMAZWFULN,
WININKN■M■■■■■■■A■■■fl■■■N■■
. • ...
■■■/,!■:.w/■Lri!■N■I�ii�,ie`i■ri■■■■■■■■■■■■■■■■■
■■■r�■■Nee■■tee
�i■r,�e■■■■■■■■■■■■■■■■■■■■■
'.. •.
.
MEN
/■■■■■■
ee:"WRI.—
■■■■■■e■■■■■■■e■■■■
MWAM■■hilleNe
ii�"
NNNNIINNNNNNNe■■■■■■■
■■
■■■■■■■■■�1i■■■■■■■■■■
NOON■
■■■
ii■ice
■�■■Li■0■■■■■l�.�ii
■I■■■■■
NOON.
...■.l�l�
�
u■■►,�■■■■■■■■e■■■OMMU■■■■■
i■erg■tee■■eei��lir.mow■■■■■■eee■■■■■Nee■■■■
....
:.. M.
■■■■■■■■■■■■Itl
■■■■■■■■■■■■■NONE
■■■�■■■■�■■■���1�M■■■■■■■■■■■■ONION■■■■■
:..-
■■■■■■■■■■■■■■■■■■■
■■■■■■■■■■■■■■��1■■�■■■■■■■■■■■■■■■■■■■■■
MEMMINIMMEMEM■■■a
•
it■■■■■■■■■■■M.ENERNEW NOON
11■■Irill!■®■lill'l�■■l�!11■■■■■■■Gi N■■l■■■■■■■■■■■■
hieil'1■'JER 6■MERMINWIl■�I+iiliiiiSilii'ii■�iiii'�I�ilili� �uNIZ
■■■■■■■■■■■ela��■■■■■e■■■■■e:a■■■■■N■■■u■
•
■■■■Gil■■■■■■■III■■■■■■■■■■■e■■■■■■I■■!�■
�■■!�■■■Nei■■elf!■■■re■■®er■e■■■■■■■
Agent or Applicant Printed Name
Signature ** Please read compliance statement on back of permit **
Application Fee(s) Check #
Permit Officer's Signature
Issuing Date Expiration Date
r..
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
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

1Jq:CAMA / ® DREDGE & FILL
GENERAL PERMIT
VNew OModification ❑Complete Reissue ElPartial Reissue
N° 56961�-
Previous permit #
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 �- i �L v
11 ules attached.
Applicant Name l�11 trA4,ll l� AC- r OC 1 Project Location: County
Address J .'e G1•� ',�
City _ Li r': • Stat", C- ZIP_, Z7Z�11
Phone # (_)
Fax # O
Authorized Agent
Affected ❑ CW
SLEW
t31 PTA ❑ ES ❑ PTS
AEC(s): ❑ OEA
❑ HHF
ElIH ElUBA ❑ N/A
❑ PWS:
❑FC:
ORW: yes / na
PNA
esi / no Crit.Hab. yes / no
Street Address/ State oad/ Lot #(s)
Subdivision ryry11 (A"-tL � c•r�, ..•r
City h��J� C" ZIP
Phone # (;5�) '144 - S.Zt2 River Basin zv3 -
Adj. Wtr. Body 1-rc �t�l `•-�- V nat, man unkn
Closest Maj. Wtr. Body Z? ° 1
■E■E■■■■■■■ ■■■■. �_�■ ■■■■■ ■ ■ ■
■E■■■■■■■■ m�1�1�' E ME■■■■■■■■■ ■ ■
MEMEME
• .
.
.
■A■i■i■■■ii■■■i■■■■■■
■■■%ii
��%
■■■ri■■�i■■■
■■■■■■■■■■■■■■■■■■■■■
NEEN■:
a
�
No,
■■■■
:■■■■■■■■■■■■■■■
�E�..:
■Cow
�■:WE
:
HE
■■■■■■■
01■E
■■
Emma
■■■■■■■■■■■■■■
■
■■■■■
■iiri
OEM
■■.■■■■■■■■■■■■
■■■■■E
ON"S
omm
■.■■■.■■.■■■■■■
EE■MEE©E
Elm
E■■■mE■
■
■E■■■■■■■
■E■
■■■■■■■m■■m
■■IEE■E■E■o■■■■■■■■■■
MEN
■■mm■■mm■m
■E■■E■
m■m■E■mm■mmmm■
MEN
m■m■■■EE■E
■��v■mE■E■■EmEm■Emmet
EE■E■■EEEE■■E■■,�1■!��
rI.I+.�.Em■■m■m■■■met■■Em
■■■DA■gym■■mE■
11■E■EmE■
■■E��:�iit��i�mE■Em
M
.Eraw
r
■■■■..
IC.....Em■■
.............�.
■E■■
■E
I IE�Ei►.�L�■■■■Eu!����i-
■0
1�■■=■
■■■■
mm■■m■E:�■■EEE:A■EEI
E
■
r:
E■■■
HOME
EEmin
mmE■■EEm■■G;:J
m�EE■■wl
■�7■■�
m
.
EE■■■■■■
E�mElm■Emmm
11■■E■EE■®■EE■.EEEH
ent r Applicant Printed Name Permit(
Signature Please read compliance statement on back of permit * Issuing(
I ul 2
Application Fee(s) Check # Local PI
Rover File
0

ALA
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
Beverly Eaves Perdue, Governor James H. Gregson, Director Dee Freeman, Secretary
November 12, 2010
Jim Ray
151 North Mitchell Way
Havelock, NC 28532
Dear Mr. Ray:
Attached is General Permit #56961C to construct a 22x15 Boatlift and a 22x15 Platform at Lot
B Windtide Lane, Mitchell Harbour, in Havelock, NC.
In order to validate this permit, please sign the permit as indicated. Retain the white copy for
your files and return the signed yellow and pink 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,
Barry Guthrie
Coastal Management Representative
lsb
Enclosures
400 Commerce Avenue, Morehead City, North Carolina 28557
Phone: [phone] \ FAX: [phone] \ Internet: www.nccoastalmanagement.net
An Equal Opportunity \ Affirmative Action Employer — 50% Recycled \ 10% Post Consumer Paper

NC Division of Coastal Mgt. Habitat Impact Computer Sheet
Applicant: Mitchell Harbour Dock Owners Ass.
Date: 11 /11 /10
Permit #: 56961 C
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
Open Water
Dredge � Fill ❑ Both ❑ Other O
330
330
Dredge ❑ Fill 0 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 ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
252-808-2808 :: 1-8884RCOAST % www.nccoastaimanagement.net revised:02/03/10

Ake WA
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
Beverly Eaves Perdue, Governor James H. Gregson, Director Dee Freeman, Secretary
Date )Zb)I17
Name of Property Owner Applying for Permit:
M A-CL'41 �t't� �o v rz bc>�e- D.0 ► rZ S s u
Mailing Address:
141 9. M Ac.1t-U W ►�►
-AA,\jP-lcv,1c- [,Lc- Z�s3Z
I certify that I have authorized (agent) �M to act on my
behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to
install or construct (activity) r �O lt►� Q\ Ve bw� c I
at (my property located at) �l l � l LA,*-3E
This certification is valid thru (date) 12-Z-A —I b
0 '
/�
kU6,,00-,-r YA/1/0
roperty Owner Signature (� Gc1 N z-� J �sS oC • Date
400 Commerce Avenue, Morehead City, North Carolina 28557
Phone: [phone] \ FAX: [phone] \ Internet: www.nccoastalmanagement.net
An Equal Opportunity \ Affirmative Action Employer - 50% Recycled 110% Post Consumer Paper

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/MOORING PILINGSBOATLIFTBOAT HOUSE)
I hereby certify that I own property adjacent to 104^6 11 4A0b00l is
(Name of Property Owner)
property located -at t"Z'�`
on LA-r- le It (.' eX-e k
(Waterbody)
(Lot, Block, Road, etc.)
in 4Age1cc.1c
(Town and/or County)
N.C.
Applicant's phone #: 25ZQ�}4�Z 12 Mailing Address: l S ( N1 at WAD -It W 0&
tie 2-S \
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 DEVELNT:
(To be filled in by individual proposing development)
OP 4-A
O
O
(Information for Property Owner Applying (Riparian Property -Owner Information)
for Permit)
Mailing Address Signature
1`tlock KI C 2EtS3Z
City/State/Zip Print or Type Name
Z is2 4-44
elep ne N er Telephone Number
ature Date Date

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/MOORING PILINGSBOATLIFTBOAT HOUSE)
I hereby certify that I own property adjacent to M 1-66 11 440boure- is
(Name of Property Owner)
property located -at �-04- '�E) t �d `� c L p.%J-E
(Lot, Block, Road, etc.)
on M tA-r-le l l CIO o a k , in N.C.
(Waterbody) (Town and/or County)
Applicant's phone #: VSZ-4445Z 12 Mailing Address: I S t a I-44-0-lt W IAA
V6,W `cx1k Ale ZS S3Z� \
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
1/ I do wish to waive that setback requirement.
--------------------------------------------------------------------------------------------------------------
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOP ENT:
` 1 (To be filled in by individual proposing development) LP+a
2=�Cls i EXCS-E�irJ�'�
O 01.1
o
(Information for Property Owner Applying (Riparian Property Owner Information)
for Permit) 3=h�,Rst
l 5 t 1� Wl��r�-1 1 lx� � ��' .•�- -
Mailing Address Signature
i�tR�lelock 1IC Z,$5-6Z Ja,-tCS A. JL--,Nv-rik,s
City/State/Zip Print or Type Name
Z S2 4-44
Date
ZsZ_ 6�S L62,s
Telephone Number
o� 16z/0
Date

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/MOORING PILINGSBOATLIFTBOAT HOUSE)
I hereby certify that I own property adjacent to 1166 it gPrK`00uV is
(Name of Property Owner)
property located -at l`'a�" 'IFS 1"p..ie
(Lot, Block, Road, etc.)
on CWP o a k , in 4Aq E,bc, lC , N.C.
(Waterbody) (Town and/or County) ` q
Applicant's phone #: 2SZ-4445Z 12- Mailing Address: 0-kt C0' MI w Gam(
i kkmelec� TA01 29532 0
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
4-- 1 do wish to waive that setback requirement.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOP
(To be filled in by individual proposing development)
O
---
(Information for Property Owner Applying
for Permit) —T=h�RPtj
l 51 g . illt+C1W -1 t Ltd �•.►
Mailing Address
.HA.\le c>c-k KIC 22�55Z
City/State/Zip
L +A
(Riparian Property Owner Information)
0
ka
Signature
-I L F �lG'C_ T f141�.J
Print or Type Name
Telephone Number
Date

1-7:-=--
■ 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.
1. Article Addressed to:
C.
Z b&2-
A. Sig
X lk ,U�J ❑ Agent
z-
❑ Addressee
B,Aeceived by ( Printed Name) C. Date of Delivery
D. Is delivery address 1? ❑Yes
If YES, enter d ress ❑ No
3. Service Type �✓
Certified Mail ail
Registered ❑ Rettittl'Aeceipt for Merchandise
❑ Insured Mail ❑ C.O.D.
4. Restricted Delivery? (Extra Fee) ❑ Yes
2. Article Number
(Transfer from service label) 7 010 1670 0002 3478 1290
PS Form 3811, February 2004 Domestic Return Receipt 102595-02-M-1540

UNITED STATES`, OMSE1 iOliLL"a--,'::: �:;: 'L r F 7 Pft ..
A.65 :�«x ,mid W. 4++a,.
• Sender: Please print your name, address, and ZIP+4 in this box •
I
2 la-
r"r:ri��r,l►�tl,:rr,,,��rr�,i„rr"r��r��,rr��r,rt.,�rra,i�:�

September 13, 2010
RE: Scott and Robin Puckett Property
103 Windtide Lane
Havelock, NC 28532
BB&T
301 College Street
Greenville, SC 29602
Attn: Claims
To Whom It May Concern:
Please find attached an "Adjacent Riparian Property Owner Statement" required by CAMA, to inform you of
our intentions to install a floating dock within the confines of our slip located on Lot `T" Windtide Lane
Havelock, NC. CAMA requires this notification because you are the owner of record of Lot "C" Windtide
Lane which is the property adjoining ours. Please complete and sign the enclosed form at your earliest
convenience and return to my address listed below.
If you have any question please feel free to call me at the number listed below.
Sincerely,
Jim Ray
151 N Mitchell Way
Havelock, NC 28532
252.444.5212

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/MOORING PILINGSIBB OATLIFTB�OjjAT HOUSE)`�
I hereby certify that I own property adjacent to M►� I/ 1-LAo00uV-- dJ is
1 j1 (Name of Property Owner)
property located at �a'}" t'''d T� c L PPv-*54 ,
1 (Lot, Block, Road, etc.)
on Ar-1It �'I-e e k , in AN1e6e-1G , N.C.
(Waterbody) (Town and/or County)
Applicant's phone #: �SZQ44SZ12 Mailing Address:
14av�l t1e 2�SsZ-
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 DEVELOP ENT:
(To be filled in by individual proposing development)
O O �xcs g.. 6c-�tsjcl
�'l
_ �� a_ce __ � 0�►►�1 i,, ---'-----'� _1,,�_i-t-ki N +z�q 3l gip- 5.....
-----.....
(Information for Property Owner Applying
for Permit) _T=m"rRP,
1.51 lL . R t A-cl t( W A4__
Mailing Address
H R\t e 6c-k 1I C ZE5-6Z
City/State/Zip
ZS2 444 .52-/2
i WJi , Pic ZAV AWA
(Riparian Property Owner Information)
Signature
Print or Type Name
Telephone Number
Date Date

iTDOCAr
JET DOCK®
�DOCK PLANNER DIAGRAMS
Drive -On Docking
/Or
.Your Ticket To Ride's Universal Combination Doers
(16' Boat Dock w/Universal RD PWQ
ISO -
tY l
UNIVERSAL. 1.1 Combo Dock
Size: 15' wide x Wet" long 1 II
Cubes: 83 ��
Item No.: T.B-D.
Expand as needed
LEGEND
PIVOTING PEDESTAL WINCH
%v/MECHANICAL ASSIST LAUNCH SYSTEM
- PEDESTAL WINCH w/ STRAP &
HOOK
- PERIMETER TIE -OFF CLEAT
- MODULE ASSEMBLY
- CUSTOM ADDED LANE
i

JAMES & NANCY RAY 66.112/531 1433
151 N. MITCHELL WAY
HAVELOCK, NC 28532 DATE
PAY -: THORDFE $ 2�ow/xr
114)dmv DOLLARS Fea oataga
on Back..&.
BUT
BRANCH BANKING AND TRUST COMPANY
HAVELOCK, NORTH CAROLIN/A
MEMO/%l/ - - - — -- -- - --- nr
1:053101120:00051972431 is 1433
D,Iphins NZ210 'tJ2004 Thp Styles Check Company 1-800-356-U353—.styleschecks.— ©2003 St... Sundr— Applelack Licensing.