58390_YAW, RICHARD_20120315

❑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 7 /.2
and the Coastal Resources Commission in an area of environmental concern pursuant to I SA NCAC
�+r []+Rules attached.
Applicant Name 3` f % Project Location: County
Address
City State ZIP
Phone # ( ) Fax # ( )
Authorized Agent
Affected ❑ Cw ❑ Ew ❑ PTA
AEC(s): ❑ OEA ❑ HHF ❑ IH
❑ PWS: ❑FC:
ORW: yes / no PNA yes / no,
❑ ES ❑ PTS
❑ USA ❑ N/A
Crit.Hab. yes / no
Street Address/ State Road/ Lot #(s)
Subdivision
City ZIP
Phone # ( ) River Basin
Adj. Wtr. Body (nat /man /unkn)
Closest Maj. Wtr. Body
e of Pro*ect/ Activity
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Agent or Applicant Printed Name
Permit Officer'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
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 complywith 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.
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)
Revised 08/09/06

LARRY G ARNOLD SR 2267
DBA LG ARNOLD DOCKS & SEAWALLS 66-112/531
PH. 252-241-2636
2779 MILL CREEK RD ®�
NEWPORT, NC 28570-6011 ' '^
, CI oA l%0
BRANCH BANKING AND TRUST COMPANY
1.800-BANK BBT BBT.com
NP
l:053101121,11:0005295798L5911'0 267 t

ADJACE• III RIPARIAN PROPERTY OER STATEMENT
(FORA,- �ti'11�ERl�IOORttYGFZLZNG"0ATLtF?i TOIISE
I hereby certify!! that I own property adjacent to s
c��rK (Name or Zperty Owner)
property located at 7
Lot, Block,. Road, etc.)
on , in , N.C.
(W aterbadsy Qwn aad/or Cou�t�•)
-ate has describe to me, as shown below, the development
. he is proposing at that location,
acid, I have no ob}ectio' s to his proposal. I understand that a piertmooring pilinQsboatIMboathouse
must be set backa mil !mum distance of fifteen feet (15) from my area of ripsrian access unless
uraived by me.
t o not I ish to waive t �...� ( tte setback r+egwrement.
I dg w4Ito waive that. setback rege�irerritnt,
------
DESCRTPTIf31' --•- ��� - -- --------------------
Ai\D1OR DRPbii:ING.OFPROPOSED DEVELOPMENT:
(Tay Ge fled *r L ndfuid } roposing4erel©plrentj
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NCDENR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
Beverlv Eaves Perdue, Governor James H. Gregson, Director Dee Freeman, Secretary
Date , _5 13 " P> /
Applicant Name
Mailing Address
I certify that I have authorized (agent) to act on my
behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to
install or construct
(activity)
at (location)
This certification is valid ttr
Signature
(dam
'kri:) QHvv-v`tOQ
wz�t� W
QaAlaDa-a
400 Commerce Avenue, Morehead City, North. Carolina 28557
Phone: [phone],,1 FAX`. 252-247-3330 \ Internet: www.nccoastalmanagement.net
An Equal Opportunity 1,A rmative Action Employer— 50% Recycled \ 10% Post Consumer Paper