59311_HARGROVE, NORWOOD_20111104

❑CAMA / ❑ DREDGE & FILL�o)_
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
❑ Rules attached.
Applicant Name__-__
Project Location: County
Address
Street Address/ State Road/ Lot #(s)
City_.. - - - State -.. - ZIP
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 / no Closest Maj. Wtr. Body
Type of Project/ Activity
(Scale:'
)
Pier (dock) length
Platform(s)
FingerJr
Bulkh
Boath
Othe
SAV:
Sand
Mora
Waiv
A building permit may be required by:
Notes/ Special Conditions
El See note
on
back
r
` y
%"
E
regarding
River Basin
rules.
pier(s)
Agent or Aant Printed Name
IX,-
pplic
Signature ** Please read compliance statement on back of permit"
Application Fee(s) Check #
Permit Officer's Signature
Issuing Date Expiration Date
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, certifythatthis project is consistentwith 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/ 1-888-4RCOAST
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

BOGUE BANKS CONSTRUCTION, LLC
P.O. BOX 196
SALTER PATH, NC 28575
8417
11 /2/2011
a
PAY `o
TO THE Management N.C. Division of Coastal Mana
ORDER OF g $ ""`400.00 �
d
Four Hundred and 00/100""****.**w*******.***.*******************.*********«********,************,.**.* DOLLARS
z
N.C. Division of Coastal Management
MEMO
CAMA permit fee for bulkhead --Lot 27-A
S
66-1246-531
11400841711' �:053112466�: 00016403ii'
8
AUTHORIZED SIGNATURE

N.C. DIVISION OF COASTAL MANAGEMENT
AGENT AUTHORIZATION FORM
Date 3� - b r 1 e
Name of Property Owner Applying for Permit:
Oi�Lk) tic-d
'Q
Mailing Address:
tic A(e
�d -Bog ot-5 00 /V/;F-t
I certify that I have authorized (agent) (.(C s M (�- to act on my
behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to
install or construct (activity)G(%
at (my property m�' located at)0�
This certification is valid thru (date)
Property Owner Signature
3 �1 Z-Pl )
Date

C>=RMFIED MAIL , RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ALE)JACEN'T R1PAR,AN PROPERTY OWNER *ICTIFICAT110`11NA1VFR FORT M
Name of individual applying for Permit. 41-Q k S"AA
A,irlra�� of.mrarty' Ap� Z �o 4A1�1��i�s�l�6�eQ�/Eirt� A!"A
— r is
(Lot or Street #, Street or Road, City & County)
I hereby certify. that I own property adjacent to the above referenced property. The individual
applying for this permit has described to me as shown on the attached drawing the development
they are proposing. A description or drawing, with dimensions, should be provided with this letter.
— I have no objections to this proposal.
If you have objections to what is being proposed, please write the Division of Coastal
Management, 400 Commerce Avenue, Morehead City, NC, 28557 or call [phone] within
10 days of receipt of this notice. No response is considered the same as no objection if you
have been notified by Certified Mail.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boathouse, boatlift or sandbags must
be set back a minimum distance of 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.)
1 do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(Applicant Information)
Mailing Address
/<A.'rsA. �** e
City/State/Zip
4?/?- aec- 5zfl
Telephone Number
/0 - /0 ' zz
Date
(Rip tan Property Owner Information)
Z
Signatu
�51Le, / 4.
Print or Typ,pi. Name
��2
Telephone Number
Date

CERTiFJED MAIL, RJETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJAC-.NT RIPARIAN PROPERTY OWNER NCTIFICATIOHPIAIVER FORM
Name of Individual applying for Permit: AIA211VV % ,�qrg rG vf-
b _C�rck.�t rf
^, Irlrg_lz,-)f Prnrerty- A f3T
(Lot or Street #, Street or Road, City & Count`)
1 hereby certify that I own property adjacent to the above referenced property. The individual
applying for this permit has described to me as shown on the attached drawing the development
they are proposing —A description or drawing, with dimensions, should be provided with this letter.
i
have no objections to this proposal.
If you have objections to what is being proposed, please write the Division of Coastal
Management, 400 Commerce Avenue, Morehead City, NC, 28557orcall [phone] within
90 days of receipt of this notice. No response is considered the same as no objection if you
have been notified by Certified Mail.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boathouse, boatlift or sandbags must
be set back a minimum distance of 15' from my area of riparian access unless waived by me. (If
you:=I
back, you must initial the appropriate blank below.)
sh to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(Applicant Information)
?o f q K-Td�e�ivd
Mailing Address
/J. ` a7�}Sr
City/state/Zip
'?19 8 ec- ,37Qrl
Telephone Number
Date
Propett}t,�ner Information)
K00Nv-Z z 1 G�i�-l��
'Print or Type Name
JSa-sa 3 3 00 o
Telephone Number
( { �--) ) I
Date