60343_FULCHER, JAMES E_20120710

No. 60343
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I
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
Applicant Name Project Location: County
Address Street Address/ State Road/ Lot #(s)
City State ZIP
❑ Rules attached.
Phone # ( ) Fax # ( ) Subdivision "
Authorized Agent - City '. ZIP -
Affected CW EW PTA ES PTS Phone # { ) River Basin
AEC(s): OEA HHF IH UBA N/A Adj. Wtr. Body (nat /man /unkn)
PWS: FC
ORW: yes / no PNA yes / no Crit.Hab. yes J no Closest Maj. Wtr. Body
Type of Project/ Activity
(Scale:
)
Pier (dock) length
Ai
Platfo
Finger
number_
Agent or Applicant Printed Name Permit Officer's Signature
Signature Please read compliance statement on back of permit 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 E] 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: [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)

WDENR
ram .
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
Beverly Eaves Perdue, Governor James H. Gregson, Director Dee Freeman, Secretary
Date 7— 1 0
I
Applicant Name
Mailing Address
I certify that I have authorized (agent) IA ( to act on my
behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to
install or cox
at (location)
This certification is valid
Signature
(date) D
l
400 Commerce Avenue, Morehead Cit�Nork Carolina 28557
Phone: [phone]$a1 FAX: [phone] Internet: www.nccoastalmanagement.net
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