59782_WILLIAMSON, URLENE_20120416

Q/
`❑CAMA / ❑ DREDGE & FILLS
GENERAL PERMIT
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
❑Rules attached.
Applicant Name
Project Location: County
Address
Street Address/ State Road/ Lot #(s)
City_State ZIP
Phone # O_ Fax #
Subdivision
Authorized Agent
City ZIP
Affected ❑ CW ❑ EW ❑ PTA DES _I PTS
Phone # ( ) River Basin
s ElOEA ❑ HHF ❑ IH [IUBA El N/A
AEC:
/ / Adj. Wtr. Bod nman unkn
y (nat )
1-1 PWS: El FC:
ORW: yes / no PNA yes / no Crit.Hab.
yes / no Closest Maj. Wtr. Body
Type of Project/ Activity
(Scale: )
Pier (dock) length
Platform(s)
Othe
SAV:
Sand
Mor
Phot
Waivery
A building permit may be required
Notes/ Special Conditions
by:
'
'
�'
El See note
on
back
regarding
River
Basin
rules.
Finger � I .
r pier(s)
I
n length
number
I
head/ Riprap length
i
avg distance offshore
max distance offshore
i
channel
cubic yards
i
ramp
i---- -- - I
house/ Boatlift
i
I
h Bulldozing _
r
eline Length !,
not sure yes no -
bags: not sure yes no � r
atorium: n/a yes no
os: yes no ,
Attached: es no
Agent or Applicant Printed Name
Signature
Signature ** Please read compliance statement on back of permit Issuing Date
Expiration Date
Application Fee(s) Check # Local PlanningJurisdiction Rover File Name
Agent or Applicant Printed Name
Signature
Signature ** Please read compliance statement on back of permit Issuing Date
Expiration Date
Application Fee(s) Check # Local PlanningJurisdiction 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, certifythatthis project is consistentwith 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/ 1-888-4RCOAST
Location:
Fax: [phone]
2728 Capital Blvd.
(Serves: Carteret, Craven, Onslow -above
Raleigh, NC 27604
New River Inlet- and Pamlico Counties)
919-733-2293
Fax:[phone]
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

MUD BUCKET DREDGING INC 5641
907 HEDRICK BLVD
MOREHEAD CITY, NC 28557-3045 66-112/531
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Pay to the L)
Order of
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BRANCH BANKING AND TRUST COMPANY
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FOR
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NC®ENR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
Beverly Eaves Perdue, Governor James H. Gregson, Director Dee Freeman, Secrelary
Date t-f 6'- l -Z
Applicant lame WD_h--we; cj, rt/,
Mailing Address Z42 454-14e:m
T k�NOe-4 h C Egg 1 „y� z �51 z
I certify that I have authorized (agent) M v-p b e-t-szU ►ems to act on my
behalf, for the purpose of applying for and obtaining all LAMA Permits necessary to
install or construct (activity)
at (location) Z 42 `'�
This certification is valid thru (date)
Signature
400 Commerce Avenue, Morehead City, North Carolina 28557
Phone: [phone] t FAX: [phone] t Internet: www,nccoastalmanagement.net
An Equal Opportunity 1 Affirmative Action Employer - 50% Recycled 110% Post Consumer Paper

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/MOORING PILI_VGSIBOATLIFTIBOATHO USE)
I hereby certify that I own property adjacent to ��%t �.�� �� 1III rn5:n!q is
(Name of Property Owner)
property located at 2 `{ -L 79-4 h T04D
(Lot, Block, Road, etc.)
(Waterbody)
-ZSZ
Applicant's phone #:
,, -to 12.4
in W-S
(Town and/or County)
N.C.
Mailing Address:
S1-izrz-
He has described to nie, as shown below, the development he is proposing at that location, and, 1
have no objections to his proposal. I understand that a pier/mooring pilings / boat:lift / boathouse
must be set back a minimum distance of fifteen. feet (IT) 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 not wish to waive
„ham I do wish to waive that setback requirement.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
i
---------------------------------------------------------
(Information for Property Owner Applying
for Permit)
w6w,r Li 1 111 A rr
Mailing Address
City/State/Zip
Te ephone Number
Signature Date
(Riparian Property Owner Information)
Signature
Print or T pe Name
%;-L)��12 �3�3
—` Telephone Number
Date

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/1VIOORING PILI-NGSIBOATLIFTBOATHOUSE)
I hereby certify that I own property adjacent toUa-/z,-iiG U) I1)4 +ro 4;.> ►✓ is
(Name of Property Owner)
property located at .Zq Z TA-4 h ?--s.v 7
(Lot, Block, Road, etc.)
on in 7 ,5 , N.C.
(Waterbody) (Town and/or County)
Applicant's phone #:
V52- Z40 I Z4�
Mailing Address: Z S8 14ty T41" P. D
He has described to me, as shown below, the development he is proposing at that location, and, I
have no objections to his proposal. I understand that a pier/mooring pilings / boatlift / boathouse
must be set back a minimum distance of fifteen feet (IT) 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 not wish to waive
I do wish to waive that setback requirement.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
--------------------------------------------------------
(Information for Property Owner Applying
for Permit)4
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2" � tJ �J J I 11l r� o r1
Mailing Address
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City/State/Zip Z �L
2-5Z Z-10 124#
lephone Num r _
+nature
/ y Date
(Riparian Property Owner Information)
ignature
Print or Type Name
do?3
Telephone Number
Date