60166_TERRY, ROBERT_20120418

❑CAMA DREDGE & FILL NO. 60166
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 I SA NCAC
_ I] Rules attached.
Applicant Name c r a r Project Location: County
Address_.. � � � � -�«' E" Street Address/ State Road/ Lot #(s)
City 1 r s k? State ZIPstlC�;`,
Phone # (__)ij -i iC��� Fax # ( ) Subdivision
Authorized Agent `j r c r C�� i s r 3 City ZIP
Affected 71 Cw '❑ EW p PTA ❑ ES ❑ PTS Phone # (_ ) 'i t� 5- i 13S River Basin
❑ OEA —] HHF ❑ IH [IUBA ❑ N/A t W
AEC(s): Adj. Wtr. Body -L (pat /man /unkn
ORW: yes / no PNA yes / no Crit.Hab. yes / no Closest Maj. Wtr. Body .L w
Type of Project/ Activity
Pier (dock) length
Platform(s)
Finger pier(s) _
Groin length
number
Bulkhead/ Riprap length
avg distance offshore _
max distance offshore
Basin, channel
cubic yards_
Boat ramp
Boathouse/ Boazlift I 1
Beach Bulldozing Other !tt
,')
r" IS6
Shoreline Length
SAV: not sure
yes
j
Sandbags: not sure
yes
Moratorium: n/a
yes
nd
Photos:
yes
ho
Waiver Attached:
yes
no
A building permit may be requirea Dy:
Notes/ Special Conditions
(Scale: % )
y l— z)ee note on DacK regaramg river tsasm roves.
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 ❑ 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/ 1-888ARCOAST
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)

0
B AND B MARINE CONSTRUCTION
PH. [phone] 1046
PO BOX 2574
SURF CITY, NC 28445 (�L7r66-112/531
T;2Y 0611.
�ULCQ/%'j% t Doieia on
BacY_
B NCH BANKING AND TRUST COMPANY
t-800-BANK WIT B .eom
1:053 1011 2 11:0005 L0245504B11•01046
Harland Cia,kc

03/22/12 11:02 AM
Page 1
i
N.C. DIVISION OF COASTAL MANAGEMENT
AGENT AUTHORIZATION FORM
Date b r
fZ2 k -- - --.- . , -
NamRor
e_kZ
of Property Owner Applying for permit:
--- - --;?z
Mailing Address:
e/�Ya
I certify that I have authorized (agent)
r4 �.,P-f _ to act on my
behalf, for the purpose of applying for and obtaining all LAMA Permit-4 necessary to
install or construct (activity) Z; I
at (my property located at)
This certification is valid thru (date) �" •� � /
—Q
Property Owner Signature Date

,)3/22112 11:02 AM Page 2
t
CERTIFIED MAIL -_RETURN RECEIPT REQUEST
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNE NC3TIFICATIONIWAIVER FORM
Name of Property owner:
Address of Property: 2 d 6nf,,�
(Lot or Street #, Street or R d, City & County)
Applicant phone #:
b ?'- Mailing Address:
I hereby certify that I own property adjacent to the above referenced prtI erty_ The individual
applying for this permit has described to me as shown on the attached drawing the development
they are proposing. A desroidon or dLaWJpg,,with dime s must be 12rovidDd wit is I er.
I have no objections to this Proposal. I have objections to this proposal•
if you have objections to what Is being proposed, you mustnotify the Division of Coastal Management
(DCM) in writing within 10 days of receipt of this notice. Contact information for DCM offices is
available at www•nccoestalmangement.neticontact dcm.htm or by calling 1.8884RCOAST. No
response is considered the same as no objectlon ff you have been notified by Certffled Mail.
. WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boathouse, or lift 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 Inloll the appropriate blank below.)
I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
6
(Property owner Information)
Signature
Pant or Type Name
Mailing Address
Ci4ostatelzip t
tir 4 GW �ti lt<M �) ID - 5C1 0-5'70
slephone Number
Dale
(Riparian 7operty Owner Information)
Signature
al,-1 G Yv /X
not or Type Name
1�a
Mailing Address
Citylstatealp
Telephone Number a
Date

03/22112 11:03 AM
CERTIFIED MAIL • RETURN RECEIPT REQUESTED
.. l
a
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFIICATIONAAIVER FORM
Name of Property Owner.,
Address of Property, w r4
Lott or Street #, Street or Road, City & County)
Applicant phone #: ' . YMailing Address: Aoft f OIC • rr
4 ,�A
I hereby certify that 1 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 must be provided wish this I tter.
- I have no objections to this proposal I have objections to this proposal.
if you have objections to what is being proposed, you must notify the Division of Coastal Management
(DCM) in writing within is days of receipt of this notice. Contact information for DCM offices Is
available at www.nccoastaimangement.not(contact_dcm.htm or by calling: f-WS-41RCOAST. No
nasporzse is considered the same as no objection if you have been notified by Certified Mall.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boathouse, or lift 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 dust initial the appropriate blank below.)
'f I do wish to waive the 15' setback requiremer�. s
I do not wish to waive the 15, setback requirement.
(Property Owner Information)
Signature
Print or Type Name
Mailing Address
CitylStatelZip
Telephone Number
Dare
(RI Ti/a�n Property/Owner information)
Signature
AM)o". �w Ao,0.
rintbr Type Name
"OP /Z�f
Mailing Address
i L-1-"
Cr /SYate/Zip G / r]
gl e- 7 Y- (-/ I f-
Telephone Number
/-
Dare
Page 3
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03/22112 11:03 AM
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