57954_TILLEY, MIKE_20110526

❑CAMA / ❑ DREDGE & FILL
GENERAL PERMIT Previous permit #
❑New* ❑Modification El 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
Rules attached.
Applicant Name Project Location: County
Address Street Address/ State Road/ Lot #(s)
City
State ZIP
Phone # ( )
Fax # ( )
Authorized Agent
❑ CW
D EW ❑ PTA ❑ ES ❑ PTS
Affected
❑ OEA
❑ HHF ❑ IH ❑ UBA ❑ N/A
AEC(s):
❑ PWS:
❑FC:
ORW: yes / no
PNA yes / no Crit.Hab. yes / no
Subdivision
City ZIP
Phone # (_ ) River Basin
Adj. Wtr. Body (nat /man /unkn)
Closest Maj. Wtr. Body
Type of Project/ Activity
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Agent or Applicant Printed Name
PermitOfficer's Signature
Signature ** Please read compliance statement on back of permit
Application Fee(s) Check #
Issuing Date
Local Planning Jurisdiction
Expiration Date
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
landowners).
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/ 1-888ARCOAST
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

e
N9 57954 C
OCAMA /❑'DREDGE & FILL
GENERAL PERMIT Previous permit #
BNew []Modification ❑Complete Reissue []Partial Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environment and Natural Resources r-7
and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC ' ' = `
2kflules attached.
Applicant Named Project Location: County
Address (l � © J Street Address/ State Road/ Lot #(s)ifj',(�
G
City
CS 1
Stat
Phone # (} -�
Fax
Authorized Agent -
z"e co
❑ CW 'f�71M
_'!'PTA
Affected
AEC(s): ❑ OEA ❑ HHF
❑ IH
❑ PWS:
❑ FC:
ORW: yes ' n PNA
yes /(j
❑ ES ❑ PTS
❑ UBA ❑ N/A
Crit.Hab. yes 2"n�)
Subdivision �tZ41111 5—o '1
I �
City [:. !/1 C+� ZIP��%�"
Phone # _- River Basin A,
Adj. Wtr. Body <li v 5o1n C_ fmnn unkn
Closest Maj. Wtr. Body e,�x , R_ i ue..A_-
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or AppUcant Printed Name PermitOfficer's Si ature
ea
Signature ** Please compliance statement on back of `ermit *�`" Issui Date ` Expira on Date -
[
Application Fee(s) ..i
�,� heck# Local PlanningJurisdiction Rover File Name

AmT, 01 il; WA
'Ma
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
Beverly Eaves Perdue, Governor James H. Gregson, Director Dee Freeman, Secretary
May 26, 2011
B. Prescott Marine Construction
ATTN: Brandi Robertson
PO Box 874
Oriental, NC 28571
Dear Ms. Robertson:
Attached is General Permit #57954C
In order to validate this permit, please sign the permit as indicated. Retain the white copy for
your files and return the signed yellow and pink copies to us in the enclosed, self-addressed
envelope. If the signed permit copies are not returned to this office before the initiation of
development, you will be working without authorization and will be subject to a Notice of
Violation and subsequent civil penalties.
We appreciate your early attention to this matter.
Sincerely,
Brad Connell
Coastal Management Representative
BC/lsb
Enclosures
400 Commerce Avenue, Morehead City, North Carolina 28557
Phone: [phone] \ FAX: [phone] \ Internet: www.nccoastalmanagement.net
An Equal Opportunity \ Affirmative Action Employer — 50% Recycled \ 10% Post Consumer Paper

NC Division of Coastal Mgt. Habitat Impact Computer She
Applicant: Mike Tilley
Date: May 26, 2011
General Permit #: 57954C
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
impact 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
ow
Dredge ❑ Fill ❑ Both ❑ Other ®
419
419
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 ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
252-808-2808 :: 1-888-4RCOAST :: www.nccoastalmanagement.net revised:02/03/10

ARA
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 I C(O l I
Name of Property Owner Applying for Permit:
rh k 'Iri I I al-
Mailing Address:
so P—Von
loe)
U I-
2.
I certify that I have authorized (agent) PY2 6 I I q 0 ale l) Yish VC t I� [1 to act on my
behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to
install or construct (activity) 4- bocl,-.t I
at (my property located at)
This certification is valid thru (date),�� D I I
care
400 Commerce Avenue, Morehead City, North Carolina 28557
Phone: [phone] FAX [phone] Internet: www.nccoastalmanapment net
An Equal Opportunity \ Affirmative Action Employer — 50% Recycled 110% Post Consumer Paper

Pc Connell,
LnacurJ is +he
A A d
A -nt PQI?m �or- -�kL
6itn
T(12�1
jo eProJect Ct� Cc�,vc�
- please le-� me. �na.�_�-�__
y6U n-ced, cchyi-h��' elSt �a
5sv - fke
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5Aa.Ad� "oh"4Yton

RECEWEI)
ADJACEff RWARMN PRoPIMw owNM 3fATFAC T 19 ZO i
I hereby certify tw I own property adjacent to f DCM Mft Cffy
(Name of Prop V Owner)
„
located at r� (� rU, I � �_ �. 1�-� ,
(L04 Bloch, Road, Or.)
onyalk)SDh`S Cxe-
(Watertody)
Applicant's phone M
(Towli and/or Coxmiy)
VIA,
s
m-,
He has described to me, as shown below, the development he is proposing at that location, and, I
have no objections to his proposal-
Johne"
P(-O�rep-� Y
3ti
� E- s+e�p Davin
I
TOlcy -Buc1t-
Ruper+y RorJe(-4\,/
(hWOrmati•on for Proper own,,r A.
for Fe nu t)
Mailing Address
Telephone Number
SigmaWre I
ow
i� Property QWNW n)
G�
Signature
Print or Type Name
Telephone Number
Date
/* I�sra
le,

O-nc( PAT,)I n+ }0lo- -h e ea m p
Jo Jane P,-cj(c+ �jc, ime+ a6f
a we (! ks ogo .
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CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY (OWNER NOTIFICATIONIWAIVER FOR �q
Name of Property Owner:
Address of Property:
Lu , e- Ln' . ho WC, �1
� j /(Lot
Ior Street #, Street or Road, City& County)it
Applicant phone #: "1 lq ' `�{� 1 - Mailing Address: T660 .
r
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, must be provided with this fetter.
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 10 days of receipt of this notice. Contact information for DCM offices is
available at www.nccoastalmangementnet/contact dcm.htm or by calling 1-888-4RCOAST. No
response is considered the same as no objection if you have been notified by Certiried 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 initial the appropriate blank below.)
I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(Property Owner Information)
Signature
fb *I eJ, l i
Print or Type Name
�D ) I ►ym 8d
Mailing Addre s
/rk rC( r a-wt)c 0 bi
City/State ip 7
Telephone Number
(Ripariawproperty Owner Information)
Si
Print or Type Name
G,se,
Mailing Address
ct a0/0
City/ tatelZip
70-
Telephone Number
Date IDate

■ 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:
Viol COV�WaAftj�-
q.Q,,fv, n zi.X� I
A.
X I ❑ Agent
❑ Addressee
eceived by (f a Name) Date of elivery
D. Is delivery address different from item 1? u Yes
If YES, enter delivery address below: ❑ No
3. Service Type
Certified Mail ❑ Express Mail
❑ Registered ❑ Return Receipt for Merchandise
❑ Insured Mail ❑ C.O.D.
4. Restricted Delivery? (Extra Fee) ❑ Yes
2. Article Number 7004 1350 0001 '6538 3608 '
(Transfer from service label)
PS Form 3811, February 2004 Domestic Return Receipt �� ��� 102595-02-M-1540

UNITED STATE8-'06 f 'L'SERVIct
07 NAY wC-
• Sender: Please print your name, address, and ZIP+4 in this box •
1�rescolf
-pC, -60X TH
ovccnJa9, NC �BS�I

B PRESCOTT MARINE CONSTRUCTION
PO BOX 874 252-249-0149
ORIENTAL, NC 28571
PAY
TO THE
ORDER OF C-1 I
2426
DATE /' �% / (, 6630 472
$
DOLLARS "•�
First Citizens
Bank
frstcitizens.com
FOR_
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