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❑ CAMA / ❑ DREDGE & FILL
• GENERAL PERMIT
❑New ❑Modification ❑Complete Reissue ❑Partial Reissue
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_
Applicant Name 1 P L C
Address
City State ZIP_
Phone # (�-) -- Fax #
Authorized Agent
Affected J CW ❑ EW PTA
OEA HHF J IH
AEC(s):
❑ PWs: `. FC:
ORW: yes / no PNA yes / no
Type of Project/ Activity
Pier (dock) length
Platform(s) H X
Finger pier(s)
Groin length
number
Bulkhead/ Riprap length
avg distance offshore
max distance offshore
Basin, channel
cubic yards
Boat ramp
Boathouse/ Boatlift '
Beach Bulldozing
Other
Shoreline Length
LC
SAV: not sure
yes
Sandbags: not sure
yes no`
Moratorium: n/a
yes no
Photos:
yes no
Waiver Attached:
yes `1no
A building permit may be required by:
Notes/ Special Conditions
Agent or Applicant Printed Name
ES PTS
UBA N/A
Crit.Hab. yes / no
Signature ** Please read compliance statement on back of permit
Application Fee(s) Check #
No.
Previous permit #
Date previous permit issued
❑ Rules attached.
roiect ocation: ounty
Street Address/ State Road/ Lot #(s)
Subdivision
City ZIP_
Phone # (_ ) River Basin
Adj. Wtr. Body (nat /man /unkn)
Closest Maj. Wtr. Body
(Scale: J )
__ See note on back regarding River Basin rules.
4
Permit Officer s S. mature
Issuing Date Expiration DatT e
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:
J 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 City Headquarters
Mailing Address: 400 Commerce Ave
1638 Mail Service Center Morehead City, NC 28557
Raleigh, NC 27699-1638 252-808-2808/ 1-888-4RCOAST
Location: Fax: 252-247-3330
2728 Capital Blvd.
Raleigh, NC 27604
919-733-2293
Fax:919-733-1495
(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:252-264-3723
(Serves: Camden, Chowan, Currituck,
Dare, Gates, Pasquotank and Perquimans
Counties)
Washington District
943 Washington Square Mall
Washington, NC 27889
252-946-6481
Fax: 252-948-0478
(Serves: Beaufort, Bertie, Hertford, Hyde,
Tyrrell and Washington Counties)
Wilmington District
127 Cardinal Drive Ext.
Wilmington, NC 28405-3845
910-796-7215
Fax:910-395-3964
(Serves: Brunswick, New Hanover,
Onslow -below New River Inlet- and
Pender Counties)
B PRESCOTT MARINE CONSTRUCTION 3136
PO BOX 874 252-249-0149
ORIENTAL, NC 2857166-30/531
p
DATE (L/ Ll 472
PAY
TO THE
ORDER OF I VEN
lv .aL � AlooLL�I J1-k2— � f" D O L L A R S
f
First Citizens
Bank
J'
FOR
e003136e 1:0531003001:00471 20 20497i1'
Department of Coastal Management i
TO` Fax 252-247-3330
ATTN: Brad Connell --�
B. Prescott Marne Construction
Prom' Date: July 23, 2012
Brandi Prescott Robertson
Re: Flaherty Project
Pages: 3
❑ urgent For Review 0 Please Comment ❑ Please Reply ❑ Please Recycle i
( Dear Mr_ Connell,
jj Attached Is the appropriate paperwork for the project that we visited last week at Dolphin Point.
!�! Please contact me If you need anything further before issuing the permit.
i Thanks,
I Brandi Prescott Robertson
j 2SZ-617-9797
N.C. DIVISION OF COASTAL MANAGEMENT
AGENT AUTHORIZATION FORM
Rate l
Name of property owner Applying for Permit:
FJ.a er+
Ma linng Address.
UUDo 1 &4) 9 -
I certify that I have authorized (Wat) & i ( AY 1 n C COT, to act on my
behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to
install or construct (activity) I ho * � a � n j . jw� u4e tiS i o1
at (my property located at)
This certification is valid thru (date) -131/) f--
7110
owner Sigry4ture (f Date
DMSION OF COASTAL MANAGEWNT
71
ad nt to �%mcS �--S o
1 fisereby car that I own property jaae
i (Name Of Prtrty Owner)
property located at 0T7
(Address, Lot, Block,11 Road etc.)
on , in G , N.C.
(Waterbody) (Ctty[To" andtor County)
Agents Name #: Aabdi�--I�bn Ma Addres: t S�
4
AWnfa phone #: � +�'Y-1 ` ' � _ ient t , 1� �2ss-1 1 �,
HelShs has described to me as shown below the development he/she is proposing at that coca ion,
and i have no objections to the proposal.
DESCRIPTION ANDfOR DRAWING OF PROPOSED DEVELOPMENT
0ndIVkft t proposing devekWamnt must ff l in descdp6w below or axtach a site draWng)
ea n
F1al CY4Y NPCOY T(DP
TY you nave owns to w"t is being pro posed, yw must notify *eDHision of Coastal Afanagwnent
(DCA9 in writing W Mn 10 days of receipt of thfs rrvltiae.. Coma" frrfonna8orr for DCU oft7cm is
av~M at www necoasWmangmnad m #lcantact,dcm.Nm or by csaffirg 14ft- RCOAST. No
is conskkwW the same as no qyj2gMan g you have been nodfled by CerdHed MaN.
Matting A Wrens
Ciiy StataOp
Telephone Nt MtW
Date
(Riparian Property Owner Information)
Slynatme
Print or Type Name
Marling Ad6drEw
QIY1SWWz0 - —
T'efephone Number
Date
DIVIVON OF COASTAL WANAGEMENT
I hereby certify that i own propadjacent to �a��Ial C1 Q 'serty
(Name of Pmprmty Owner)
property locaw at��hrr�kd - I
i (Address, Lot, Block. Road, etc.)
on
C Z►,, I C N.C.
(Waterbody) (City/Town andkw County)
Agent's Name It � i� Mailing Address: T')n
� i
Agenfs phone #/: - l' .i Ojitntdll L t�1 G 5 j
He/She has described to me as shaven below the development Wshe is proposing at tttat iocatian,
and i have no objections to the proposal.
DMCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(Wiv/dual proposing development must fill In descrip6m baba► or attach a site drawing)
G T Ex
'Fcan
�iahcr�-y Q�oper+� ���pe�
7 vu have objectiiorm to ~Is being prnposad, you must noW fire Division of CaasW Alpra+ger mW
MCM) in w►iTbing whiOb 10 dso of r9ecdpt of fhhr nofbL Coaftci IntommWon for DCM oil/ces is
avaftwe at www.rwcoast&tmngenmotnWcont&cLolonJdw or by calTr V 141IM- MAS-T. No
e Is considered the same as qq.qWREffw If M hove bow notbed Calftd ".
(Property Owrrwr Information)
Signature
Print or Type Name
Maumg Addy m
cityl,W000
Telephone Number
Pate
Print or rype Narrre
Marling Addt*ws
Telephone Nwabor
date