60215_MCCLOUD, ERNEST_20120626

CICAMA / ❑ DREDGE & FILL 1� �O. 60215
GENERAL PERMIT Previous permit #
❑New ❑Modification i-]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 #
Authorized Agent
Affected CW -' EW PTA ES PTS
AEC(s): _I OEA ' HHF IH --'UBA ❑ N/A
PWS: -' FC:
ORW: yes / no PNA yes / no Crit.Hab. yes / no
Type of Project/ Activity
Pier (dock) len h
Platform(s)
Finger pier(s)
Groin length
number
Bulkhead/ Ripr,
avg distan
Max dista
Basin, channel
cubic yan
Boat ramp _
Boathouse/ Bo
Beach Bulldozi
Other
Shoreline Len
SAV: not
Sandbags: not
Moratorium:
Photos:
Waiver Attach
Subdivision
City_ -
Phone # ( )
Adj. Wtr. Body -
Closest Maj. Wtr. Body
ZIP_
River Basin
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sure yes no
sure yes no
n/a yes no
yes no
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d: yes no�MEMNON�
A building permit may be required by:
Notes/ Special Conditions
Agent or Applicant Printed Name
Signature ** Please read compliance statement on back of permit
(� See note on back regarding River Basin rules.
Permit Officer's Signature
Issuing Date
Expiration Date
Application Fee(s)
Check # Local Plan ningJurisdiction
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:
El 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/ 1-888ARCOAST
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)

iFN Complete items 1, 2, and 3. Also complete
item 4 if Restricted Delivery is desired.
■ Print your name and address on the reverse
so that we can return the card to you.
■ Attach this card to the back of the mailpiece,
' or on the front if space permits.
1. Article Addressed to:
� �l �►t� .i�N B�taGE 0.�
� +��'k-.t �►.? �jb7�3 -9�5�
, f
/ ❑ Addressee 1
C. Date of Delivery 1
D. Is delivery address Brent from item 1? ❑ Yes
If YES, enter delivery address below: ❑ No
3. Sere Type
Certified Mail ❑ Express Mail
❑ Registered ❑ Return Receipt for Merchandise
❑ Insured Mail ❑ C.O.D.
4. Restricted Delivery? (Extra Fee) ❑ Yes
2. Article Number 7007 0710 0003 8862 1325
(Transfer from service label)
PS Form 3811, February 2004 Domestic Return Receipt 102595-02-M-1540

15
UNITED STA 'IS JSTAL SERVICE ny First -Class Mail
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'US'PS
Permit Nq._G-10__
• Sender: Please print your name, address, and ZIP' box
--T-P, Mv- 10 F-
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s , 16'I1*ER: COMPLETE THIS SECTION
■ Complete items 1, 2, and 3. Also complete
item 4 if Restricted Delivery is desired.
■ Print your name and address on the reverse
so that we can return the card to you.
■ Attach this card to the back of the mailpiece,
or on the front if space permits.
Article Addressed to:
KZN,Pt7i-I-t jr-- LLB/ 7 72- IC <-
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JE-c2)n1C' I?Sz(�
A. Signature 04 .-. . f) w �: �.. /'Vyly? ..,
X Agent y
?1� �����li� ❑ Addressee
B. Received by (Prinpd Name) C. Date of Delivery
i� L - + 2-
D. Is delivery address different from item 1 10 Yes
If YES, enter delivery address below: ❑ No
3. Sepper61ype
Certified Mail ❑ Express Mail
❑ Registered ❑ Return Receipt for Merchandise
❑ Insured Mail ❑ C.O.D.
4. Restricted Delivery? (Extra Fee) ❑ Yes
2. Article Number 7007 0710 0003 8862 1318
' (Transfer from service label)
PS Form 3811, February 2004 Domestic Return Receipt 102595-02-M-1540

UNITED STATES POSTAL SERVICE
• ls'-�Ok
Sender: Please print your name, addresg, and b P+4 in -this
f54S ALL 1�'TDV2.—
......... 11111 111111111 1 1 11111111t I III I I I It It It I It I I I) I III III III I III IN

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N.C. DIVISION OF COASTAL MANAGEMENT >
0
AGENT AUTHORIZATION FORM o
Date � l 2" , / l"—
Name of Property Owner Applying for Permit:
N
Mailing Address:
I certify that I have authorized (agent)''Z
r-5' a—:-� to act on my
behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to
install or construct (activity)
at (my property located at)
This certification is valid thru (date)
G
Date
Property Owner Signature
A
m
N

a
_ __
Jun. 12. 2012 2:20PM No- 1248 P. 1
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION FORM
CERTIFIED MAIL - RETURN RECEIPT REQUESTED
I hereby certify that I own property adjacent to 6Rki ;'f b,Yq 's
(Name of Property owner)
property located at 2 1,1 --st+0pnf�,S ."Z 5
(Acidness, Lot, Block, Road, etc.)
,.��;ve c .. - - in i'-ca� �i w CeLz,.,N.C.
(Waterbody) (City/Town anchor County)
Agent's Name* `i��
Agent's phone#' 2i co7r 3
Mailing Address:F.
He/She has desctlbed to me as shown below the development he/she is proposing at that loca6vn.
and I have no object'tons to the proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
andividuai proposing devefppment roust felt in description below or attach, a site drawing)
!Dcc ,
i r I►a, v114VL. �§ALic,rlr,1h
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tfyou have objections to whatis being proposed, you must notify the Division of Coaml Management
(DClog in ,+mating within tt? days of receipt of this notice. Contact information rear DCM offices is
avallreble at www.rrccaestalmengementneticontact dcm.hbn or by calving I-W84RCOAST. No
Les
ponse is considered the same as rro alocVan tf you have been natifled by Certified Mail.
(Pro erty Owner information) (Riparian Pr eryy er Information)
Signatrr� Signature
Print or Type Name
f.R! -A S
Malling A ddres
Cilyfstatelzip
Telephone Number
Date
/S?'t Rk k 'i
Print or Type Name
Mailing Address
,Caro ,, rX/ - ��,93
city/statemp - -
a6_ � j/6� i`se oca
Telephone Number
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Date

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PAGE
PAIVLI CO COUNTY 201 2 K06- 1 0- 2

'yM .
TERRY PRESCOTT
PH:[phone]
545 ALLIGATOR LOOP RD
MERRITT, NC 28556
he c_ D
border of
360
66-30/531
Date 471
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First Citizens
Bank
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