57955_KINSEY, ROBERT_20110519

CAMA / M DREDGE & FILL
GENERAL PERMIT jl, Previous permit #
❑New • ❑Modification ❑Complete Reissue El 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
EJ Rules attached.
Applicant Name
Address
City r r,„r . `'I C State ZIP
Phone # ( ) ` e.l _ 3-ZVFax # ( )
Authorized Agent
Affected ❑ CW DEW ❑ PTA
AEC(s): ❑ OEA ❑ HHF ❑ IH
❑ PWS: ❑FC:
ORW: iyes / no PNA yes / ,no,
❑ ES ❑ PTS
❑ UBA ❑ N/A
Crit.Hab. yes / no
Project Location: County
Street Address/ State Road/ Lot #(s)
Subdivision
City ZIP
Phone # () ra `i isIt River Basin L J
Adj. Wtr. Body hj 1�i (hat,/man /unkn)
Closest Maj. Wtr. Body n ' ►y'!
Type of Project/ Activity 11,
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Agent or Applicant Printed Name
Signature ** Please read compliance statement on back of permit
PermitOfRcer's Signature j
Issuing a eD 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 complywith 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)
Revised 08/09/06

Applicant: Robert Kinsey
Date: 5/19/11
Permit M 57955C
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
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 O Fill O Both ❑ Other O
—impact
86
86
High Ground
Dredge ❑ Fill O Both ❑ Other 0
750
750
Shoreline
Dredge ❑ Fill ❑ Both ❑ Other O
100
100
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.nccoastaimanagement.net revised.02/03/10

APR— 1 3-201 1 09 : 23 AM SH0F:EL I NE MAR..' I hJE F,F-1 W-T . 1 + 2 5 2+3 93+ ; 934
11004 Wo r %;Plwk q %J1 VVr1V 1 r1M �nr1..r�s+�.■la��. �
AGENT AUTHORIZATION FORM
Date -3 1-3 -11
Name of Property LOwner Applying for Permit:
*A$a
r
Mailing Address:
S'F;L`Y 6"4 1'r•►AC k- ed
P . 0 1
RECEIVER
APR 13 2011
DCM-MHD CITY
I certify that I have authorized (agent) AsAlry &o&4 to act on my
behalf, for the purpose of applyingfor and obtaining all CANIA Permits necessary to
install or construct (activity) 1 h►+f� + 1
at (my property located at) 343 �96:3► +'f t b+r Z 3 r
This certification is valid thru (date) & — 3 D '
/ -
Owner Signature
ax - / 1
Date

APR-13-2011 09:23 AM SHORELINE MARINE CONST. 1+252+393+7534 F.0
(Name of Pir"rl
"er)
pmpe y located at
3 �ECEIVgLa
�
(11t, Block, Road, etc.)on
Ar �jk/ in 0 4 SID &*j
(Waterbody) (Town and/or County) Ory
Applicant's hone # 0 3Q 4 ` M L adiAddress: ag �M Ck JQ`^ .
P1d '41-woo
He has descri t^ as shown below, the development he is pfoposing at that location, arid,
have no objecticros to his proposal.
]DESCRIPTION AND/OR DRAWU4G OF MOPOSED DEVEWPMENT:
(To b►e Ued In by pmPertj' awner propro ing d�►Mopme
_.._._.._..._...__ ...... _.._.......
._..._. _. ,..._...._.....
4b
r �.
�'- iZ,EPCAG�- �K,S`�'rr•IG S,EgwA �L- '�-•
gnformatiorn for Property Owner Applying
for Permit)
9 _.
XVlailing Address
0C.-O upfc-
city/Mate/Zip
_to utl - 3
Telephone Number
(Riparian Property owner information)
signazurc
Print or Type Name
Telephone Number
na�t

AF'R-113-2011 0`i:24 Am S-HORELIHE r1i::;F-:I[-4E F-'ONST. 1 -1-252-+-393-+- 9934 P. 03
PL I hereby ccrfify that I own property adjacent to ley -
(Name of Pro oerj
'rr . UR
Property located at t,"L•. z -I I.
(Cot, Bloekq Rmdj etr-) 1XV-411D Crry
on in 0 #,SID 10�/ 1! N.C.
(waterbody) (Tmn and/or County)
,kmWeantls pboat Jq 4- 6W.4-t
PWManing Addreus
or t
He has described to me, as shown below, the development he is proposing at that location, and, I
have no objdalons to WS ptoPosal-
DESCRIPTION AND/OR DRAWING OF PROPOSM DEVELOPMFM:
(To be In by pvpwV owmff PrvPuifig dtwl4w6ew)
.. .. ....... .... . ......... ..
00,
rian
(information for Property Owner Appbin(R]"Property Owner Information)
g �Q /
for Permit) 01Owner
5;442LCI C' 10
4t
A .
Mailing Address ign
d1ary
Jq�App
oldle 0C..' 21"o
prid or Type Name
city/state/zip
&J
& A -_J� - Tolephone Number
Telephone Number

SHORELINE PIERS & BOAT LIFTS, INC
SBA SHORELINE MARINE CONSTRUCTION
580 PEARSON CIR 252-393-7934
NEWPORT, NC 28570
PAY_ /I� ` Ltj
TO THE )v)1G
ORDER OF
1205
DATE " " O� �66-30/531
341
First Citizens
)�% ff Bank DOLLARS
FOR / 1' Q
M
II100 120 Sirs ro
■0 5 3 100 300�:00 2 308 90 21I
-----
:r
m

INC.
BOAT LIFTS,
SHORELINE PIERS & RUCTION
DBA SHORELINE MARINE CONST
580 PEARSON GIR 252-393-7934
NEWPORT, NC 28570 DATE
...... ......
1254
66-30/531
341
$ ,:2 00, '-"'
PAY
TO THE
ORDER OF DOLLARS
First Citizens
Bank
FOR 34123
I 1150012SL.11. I:OS31003001:0 0... .
� J�-
4

ADJACENT RIPARIAN PROPERTY OWNER
I hereby certify that I own property adjacent to a &00-� '` iois is
(Name of Propertyner)
property located at 3-4-3 RI1 S Poqd 44Le4- zF5 3
(Lot, Block, Road, etc.)
on ry ''M , in 0 4 510 0% , N.C.
(Waterbody) (Town and/or County)
Applicant's phone #. q 3a4 - 324PMailing Address: J.2 664*t RfclAa Q`^
c 11, NG IX,640
He has described to me, as shown below, the development he is proposing at that location, and,
have no objections to his proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be felled in by property owner proposing development)
�2EPC.A�C9\ 171�u
RrqN P
(Information for Property Owner Applying
for Permit)
5,4al &WAA gratAA- kd-
Mailing Address J/
City/State/Zip
IM 3a4 -3 20
Telephone Number
Bo4reAP
(Riparian Property Owner Information)
i
►ignaturc
/KQ y L . r�� � �
L /
Prid or Type Name
Tel Number

ADJACENT RIPARIAN PROPERTY OWNER STATEJ I H L
I hereby certify that 1 own property adjacent to a�
property located at 343
(Name of Property a
(Vot, Block, Road, etc.)
3
on W IA , in 0 4 5/0 il , N.C.
(Waterbody) (Town and/or County) p nn
Applicant's phone J19 ID) 3a 4 ` 320Mailing Address: ;1 644�ftt g/ ► K� '
c of 11,
He has described &xne, 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)
- I i►© d —
REP
ACE 7MI(
49-- R.EPI.Ac� Existj,�G
(Information for Property Owner Applying
for Permit)
5,426M 8rftAA RJ-
Mailing Address
dc.-, ZED
City/State/Zip
$6 3A4- — 3 2ter
Telephone Number
R04rE44
(Riparian Property Owner Information)
ii
Signature
Print or Type Name
Telephone Number
nat.-