56981_FAIRCLOTH, MICHAEL_20101129

CAMA / 0 DREDGE & FILL
` GENERAL PERMIT Previous P ermit #
❑New ❑Modification ❑Complete Reissue ❑Partial Reissue fit 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
E Rules attached.
Applicant Name Project Location: County
Address
City
State ZIP
Phone # O
Fax # (`)
Authorized Agent
Affected 0 CW
❑ EW ®,PTA ❑ ES ❑ PTS
AEC(s): OEA
❑ HHF ❑ iH ❑ UBA ❑ N/A
❑ PWS:
❑FC:
ORW: yes / no
PNA yes / no Crit.Hab. yes / no
Street Address/ State Road/ Lot #(s)
Subdivision
City zip--,- 7
Phone # ( ) !i`l - 5 i� , River Basin
i
Adj. Wtr. Body %y i^J (nat /man /unkn}
Closest Maj. Wtr. Body
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Agent or Applicant Printed Name
Signature ** Please read compliance statement on back of permit **
Permit Officer's Signature
g
Issuing Date Expiration Date
Application Fee(s) Check # 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
❑ Neuse River Basin Buffer Rules
❑ Other:
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 City Headquarters
Mailing Address:
400 Commerce Ave
1638 Mail Service Center
Morehead City, NC 28557
Raleigh, NC 27699-1638
252-808-2808/ 1-888ARCOAST
Location:
Fax: [phone]
2728 Capital Blvd.
(Serves: Carteret, Craven, Onslow -above
Raleigh, NC 27604
New River Inlet- and Pamlico Counties)
919-733-2293
Fax:[phone]
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

N9 56981c
[�,CAMA /ENERAL r* DREDGE ��ILL MIT Previous permit #
G
I
:C-New ElModification C plete Reissue 0 Partial Reissue Date previous permit issued
As authorized by the State of North Ca ,min , Department of Environment and Natural Resources
and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC,
00 Rules attached.
Project Location: County C, iNrL
Applicant Name i -• L . I-c I C,
jj
Address—
e ZIP �31
Phone # Fax #
Authorized Agent
Affected OCw OSEW NPTA DES 0 PTS
AEC(s): 0 OEA OHHF DIN 0 USA D N/A
0 PWS: OFC:
ORW: 4es'J no PNA yes / fid, Crit.Hab. yes no
Street Address/ State Road/ Lot #(s)
21
Subdivision
City U zip
Phone# (-!jIQ River Basin—
Adj. Wtr. Body— k. (nat Jp�k-Lunkn)
Closest Maj. Wtr. Body —
nA
No
No=
LEIN
al
en ,or Applicant Printed Name
Signature Please read compliance statement on back of permit
Permit fficer'4,S' nature
Issuing date Expirat n Date
Local Plannine lurisdiction Rover File Name

PVC Division of Coastal Mgt. Habitat Impact Computer Shee
Applicant: Michael Faircloth
Date: 11 /29/10
Permit #: 56981 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
Shallow Bottom
Dredge ❑ Fill 0Both El Other 0
60
60
High Ground
Dredge ❑ Fill 13 Both El Other ❑
300
300
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.nccoastalmanagement.net revised: 02/03/ 4 )

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to A ` Aed G; ; ,d k 's
property located at
on J G "
(Waterbody)
(Name of Property Owner)
'21v �Aer t.,
(Lot, Block, Road, etc.)
G 41011
'ate �` 9%17
in it, t e-y'.7 (0.^'s [c,,w ) , N.C.
(Town and/or County)
Applicant's phone #:331- Ot -gi`73S_ Mailing Address: 023 WA- Ate.
,2 -? 31j
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 DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by property owner proposing development)
21z
(Information for Property Owner Applying
for Permit)
6 V3 i1J,al f tc f� t : Pd,
Mailing Address
iA-" ' , /��. 7 313
City/State/Zip
33 - 6W - 913s`
Telephone Number
AUJ &4o- a �p
Signature ate
k /O
(Riparian Property Owner Information)
Signature
E�J
Print or Type Name
Telephone Number
Date

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to lip d.) nz i �"/� ��+� 's 4�
(Name of Property Owner) O? 11.
I
on 6 tj , in �L4rll - � ( 0 "S 4-- ) , N.C.
(Waterbody) (Town and/or County) ff nn ''ii
Applicant's phone#:06' %935' Mailing Address: 6`1,6 L114t�elr' bi
Pf —&&J C -�-r-J dw.'C .2-731.3
property located at
,v.:11e-r W
(Lot, Bloch,
etc.)
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 DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by property owner proposing development)
(Information for Property Owner Applying (Riparian Property Owner Information)
for Permit)
Mailing Address Signature
&tw,,� 64r c,v . /Its 1/4 J x/ P % 7—
City/State/Zip Print or Type Name
33L
Telephone Number
W
Signature Date
3,) 13
Telephone Number
Date

NCDENR 'q, G ��
North Carolina Department of Environment and Natural Resources`��
Division of Coastal Managementp�
Beverly Eaves Perdue, Governor James H. Gregson, Director Dee Freeman, Secretary
Date l!j'.20 /()
Name of Property Owner Applying for Permit:
114 j A f tv . Fes, rc-/c, 41
Mailing Address:
I certify that I have authorized (agent) FJ(';q r��c� (> ; ; nnc,- S to act on my
behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to
install or construct (activity) ,
at (my property located at) 6F. ��� k,. A/
This certification is valid thru (date)
Property Owner Signature
Date
400 Commerce Avenue, Morehead City, North Carolina 28557
Phone: [phone] FAX: [phone] Internet: www.ncwastalmanagement.net
An Equal Opportunity 1 Affirmative Action Employer — 50% Recycled 110% Post Consumer Paper
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Q AND S MARINE CONSTRUCTION
1168 COREY DRIVE
WILLIAMSTON, NC 27892
PAY
TO THE
ORDER OF
1063
66-21/530
BRANCH 77639
DATE
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Mathrig Address: �--- . -;TER WRIGHT RD
Mailing City, State, lip: PYASANT GARDEN NC 27313
Sale Code:
Lattule; 34 654602 Longitude: -77.1162461.

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Disclaimer— Onslow County provides this GIS data as a public service. NO WARRANTY for the availability or accuracy is provided. �N
Pdnted:May 02, 2012

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Disclaimer— Onslow County provides this GIS data as a public service. NO WARRANTY for the availability or accuracy is provided. t- -+
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Printed:May 22, 2012
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