59719_WILLIS, TIM_20120214

CAMA / -_ DREDGE & FILL
GiENERAL PERMIT
! iNevv ❑Modification -]Complete Reissue El Partial Reissue
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
Applicant Name
► , .ve
t% , E s
Address
City J n
State +� (, ZIP 15
Phone # 7`IG}—� Sti7� Fax # ()
Authorized Agent
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Affected —" CW
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N PTA n ES a PTS
AEC(s): O OEA
❑ HHF
❑ IH ❑ USA ❑ N/A
❑ PWS:
FC:
ORW: tyes / no
PNA
yes / no Crit.Hab. yes / no
Previous permit #
Date previous permit issued
Rules attached.
Project Location: County
N-9171.9c
Street Address/ State Road/ Lot #(s)
Subdivision
City c� hc ;,4, C ZIP
Phone # Riv r Basin
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or Applicant Printed Name
Signature ** Please read compliance statement on back of permit
Application Fee(s) Check #
Permit Officer's Signature
Issuing Date pitation.Date
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 (910-796-72 l 5) 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
Fax: [phone]
Location:
2728 Capital Blvd.
(Serves: Carteret, Craven, Onslow -above
New River Inlet- and Pamlico Counties)
Raleigh, NC 27604
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 5518
507 HEDRICK BLVD
MOREHEAD CITY NC 28557-3045 66-112/531
Date
Pad to the CZ— $order of
Dolfars
(�
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BRANCH BANKING AND TRUST COMPANY
1-800-BANK BBT BBT.c0m
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nm
FOR
u'0000 5 5 W30 +:0 5 3 10 1 1 2 11:000 5 29 3 2 L8 34 111'

N.C. DIVISION OF COASTAL MANAGEMENT
AGENT AUTHORIZATION FORM
Date
Name of Property Owner Applying for Permit:
-AA--
Mailing Address:
/60 b'r CONOT
I certify that I have authorized (agent4._�� • ^&W4� to act on my
behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to
install or construct (activity) P4W /A* "�f/E1Vl i�� �ALI/
at (my property located at) �a s1l ��1� RD / AG
This certification-is-yalid Oru (date)
11410dl 7-
Owner SiLyadture ' Date

Jan 01- 2012 7:49PM Wills Fax/Scanner 9198489712
page 1
ADJACENT RIPAA N PROPERTY OWNER STATEMENT
I hereby ctrtify that I own property adjacent to 6 16 s
(Name of Property Owner)
property located at —'; 25 �]�%� C1T'��
(Lot, Block, Road, etc.)
on c5
..� , N.C.
(Wa erbWy) (Town and/or County)
He has described to me as shown below, the development he is proposing at that location,
and,1 have no objections to his proposal.
DESCRIPTION ANWOR DRAWING OF PROPOSED DEVELOPMCNT
(ro be filled in by individualproposing development)
�A(64WMLW
(Applici mt Information)
MO /%LW CdAkz
Mailing Address
-949& we ff
Ity/C�staee/zp
., 4 -- I7
Tef one Nu ber
IAI 3��,Ffi4
64�RWW-
/Zo Cu�tc �i9�t95 Lt�
(Riparian Property Information)
A -=::
Sighoure
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Print or 7ype Name
-2/�- �4-1- &
Telephone Number
Date - - -

Tim Willis Marshallburg property
Star Chruch Rd.
Marshallburg, NC
Maintenance Dredging
I 140' ►-
Bulkhead & Dock
j�• —113'
00
1
O _ _
Bulkhead & Docks
- Treated Lumber
- Treated Pilings
- PVC Sheet Pile
- Galvanized nails
& tie back rod
f
A: 3470.0 Sq.Ft. x 2.5 Ft./(27 Cu.Yd./Cu.Ft.) = 321.3 Cu.Yd.
B: 11605.5 Sq.Ft. x 1.5Ft / (27 Cu.Yd./Cu.Ft.) = 644.75 Cu.Yd.
Total = 966.05 Cu.Yd. Contact: Tim Willis
Note: area calculated from CAD drawing 1004 Denfield Ct.
Raleigh, NC 27615
919-848-7808
[e-mail]

Jan 01. 2012 7:49W W ID9 Fax/Scanner 9198488712
P" 2
ADJACENT RIPARUN PROPERTY OWNER STATEMENT
I hereby certify that I overt property adjacent to _ _ !�/Y1 l�d�/�l.'f 8
(Name of Property Owner)
property located at z 7 S�K t..1T� ll 4-im—LD
(Lot, Bloc/Ijc, Road,,, etc.)
on 1541WI
in
ANA
(Wa erbody) (Twn send/or County)
He has described to me as shown below, the development he is proposing at that location,
and,1 bave no ebjecdons to his proposal.
DESCRUTION AND/OR DRAWING OF PROPOSED OLVELfIP1VILNT
(To be filled in by individualproposing oposing development)
Ao�alztLK�
A/
(Applicant Information)
Nailing Addrm
, f/G d /k
rtylstatelzip
I Wi- 11/4
Telapho" Number
/-
�W—V—A z
hate
10A 1,V re7e4��Al -*A-JZ-) &OhOWU6�--
faro Cu/rc
tF
T
�4
(Riparian Property Owner Information)
Si re
Prins; ypr ame r
r'elephow Number
_ h/ -%,41 A 1 L.
Date

1
Tim Willis Marshallburg property
Star Chruch Rd.
Marshallburg, NC
Maintenance Dredging
- 140' ►'
1
0
CO
Bulkhead & Dock
Bulkhead & Docks
- Treated Lumber
- Treated Pilings
- PVC Sheet Pile
- Galvanized nails
& tie back rod
A: 3470.0 Sq.Ft. x 2.5 Ft./(27 Cu.Yd./Cu.Ft.) = 321.3 Cu.Yd.
B: 11605.5 Sq.Ft. x 1.5Ft / (27 Cu.Yd./Cu.Ft.) = 644.75 Cu.Yd.
Total = 966.05 Cu.Yd. Contact: Tim Willis
Note: area calculated from CAD drawing 1004 Denfield Ct.
Raleigh, NC 27615
919-848-7808
[e-mail]