60168_LONG, RONALD_20120410

CCAMA / E DREDGE & FILL el 05 NO. 60168
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
rRl hd
Applicant Name
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onc
Address
City �41 �C ;
Iy� ��
State .
ZIP % zLj
Phone # O
Fax # )
Authorized Agent:,
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K T
Affected Cw
EW
El PTA )] ES
PTS
AEC(s): -' OEA
❑ HHF
❑ IH ❑ URA
C N/A
PWS:
❑ FC:
ORW: yes / no
PNA
yes / (�i Crit.Hab. yes / no
Type of Project/ Activity
Pier (dock) length
Platform(s)
Finger pier(s)
Groin length
number_
Bulkhead/ Riprap length 10 y
avg distance offshore 1-6—
max distance offshore__`
Basin, channel
cubic yards_
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing
Other
Shoreline Length a2- %i'(�
SAV: not sure
yes
tno
J
Sandbags: not sure
yes
tto
Moratorium: n/a
yes
no
Photos:
yes
no
Waiver Attached:
yes
fq
u es attac e .
Project Location: County
Street Address/ State Road/ Lot #(s)
Subdivision
City_ TWr, 4 ZIP 's5116
Phone # (_i) ' tl 1 'roc' River Basin
Adj. Wtr. Body e,. �hat' man unkn
Closest Maj. Wtr. Body —
fr
(Scale: _ V, ` )
A building permit may be required by: . I . j r • ❑ See note on back regarding River Basin rules.
Notes/ Special Conditions
Agent or Applicant Printed -Name }—
Xx
Signature Please read compliance statement on back of permit
Application Fee(s) Check #
j-_J� rti
Permit Officer's' Signature
r
3 � j
Issuing Date Expiration bate
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 ❑ 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)

BROOKS DREDGING & MARINE CONSTRUCTION INC
507 BAYVIEW DR PH. 252-728-6886
HARKERS ISLAND, NC 28531
m: •
DATE Z/ _ Z Z 66-1246/531
PAY J
TO THE
ORDER OF
DOLLARS
it L
I� B u( rt, NC 285 6 -�
I•i i ?
FOR ----- _.. _ ,_... M.
II00048 260 1:053 L L 24661: 000 L379
i

From -.Goldsboro Pain Medicine 19197510890 04/04/2012 12.46 #706 P.002/004
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
Beverly Eaves Perdue, Governor James H. Gregson, Director Dee Freeman, Secretary
Date
Name of Property Owner Applying for Permit:
L-6 /" RECEIVED
Mailing Address: APR 10 2012
p•1,•f-'^_':'�CiTY
I certify that I have authorized (agent) A��� RR0q1CS to act on my
behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to
install or construct (activity)
5&A74
ffZL--
Rc—/>Iq1 ;? 3 ,
at (my property located at)
OU-1 -c.
PCI P /
/�' D . Q (4✓/� l NG
This certification is valid thru (date)
/Z__
Property Owner Signature // Date
400 Commerce Avenue, Morehead City, North Carolina 28557
Phone: [phone] FAX: [phone] Internet: www rccoastalmanagementnet

04/08/12 12:19pM Nick Johnson Accountant 2522475624 p.01
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to _, Q� �__.'s
_ (Name of Pro_ Owner)
property 1 ocated at bd ! /� _ U / &- z A
(Lot, Block, Road, etc.)
on 1j,1114"k CA (�rleo_ 4' -A V
Waterbody) _ ( own and/or County)
Applicant's phone #: �� � j �U Meiling Address: 7i
fie 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 f &-d in by property owner proposing development)
(Information for Property Owner Applying
for Permit)
Mailing Address _
Ra NC. �ZS'�3o_
City/Stare/Zip
Fele hone Number
Signature vale
(Riparian Property Owner Information)
011
TSi attire
Print or Type Name
�VI- (7,?
Telephone Number
Date

Frcm:Goldsboro Pain Medicine 19197510890 04/04/2012 12:47 #706 P.004/004
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to i i t. 's
(Name of Pr erty Owner)
property located at
(Lot, Block, Road, etc.)
on %kP�- � _ Vla12, , in N.C.
(Waterbody) (Town and/or County)
Applicant's phone 7-3k-#,0VlailingAddress: U/
&.
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)
ail
(Information for Property Owner Applying
for Permit)
/-7!7— W, NE&cf
Mailing Address
6Z>Lp5aoxo Ivc-
City/State/Zip
g191 738 4zNS'-
Telephone Number
Signa re ate
(Riparian Property Owner Information)
Signature
CJ
Print or Type Name
Telephone Number
Date