53073_NELSON, PETE AND JUDY_20090108

T CAMA / D DREDGE & FILL / 15 1'13 C
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 15A NCAC � . 11no
[Rules attached.
r,
Applicant Name ji}" 11rlV 1 ��� ,i 1�,� Project Location: County 1 "0, %+
1 s
Address t Q� �n c Q tl C 1 Street Address/ State Road/ Lot #(s)
City State ZIP( t1
Phone # () n, - t Fax # (,) Subdivision ��, e it Lcr
,t
Authorized Agent City u, rwn 0 ZIP tt
CI CW ❑ EW PTA ESl PTS Phone # O River Basin i i o 2
Affected ElOEA ❑ HHF "D I ❑ UBA ❑ N/A
AEC(s): Adj. Wtr. Body n �, �Xy _(nat_�T n)
C PWS: ❑ FC:
ORW: yes / no PNA yes / no Crit.Hab. yes / no Closest Maj. Wtr. Bodyi
Type of Project/ Activity Jd-
Pier (dock) length
Platform(s)
Finger pier(s)
Groin length ��—'—
number
Bulkheaal Riprap length X
avg distance offshore_
max distance offshore if
Basin, channel
cubic yards_
Boat ramp
Boathouse/ Boatlift
Beach Bulldozi
Other
i
i
I
Shoreline Length �� S
SAV: not sure yes n—.--
I
Sandbags: not sure yes no ——
I
I
Moratorium: n/a yes n
Photos: yes n j
Waiver Attached: yes no
A building permit may be required by:
:
Notes/ Special Conditions
a --- a ctin f lrit—.
Agent o Applica Printed Name
,�._� ram► ' �-?'"�, � t'�'
Signature Please read compliance statement on back of permit
Application Fee(s) Check #
(Scale: ) T,"l )
See note on back regarding River Basin rules.
AA I
Perm -officer' Signature
f N S�
IssuingDath Elxpiration Date
CV61.J Y61�16i�P
Local Planninglurisdiction 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 the NC Division of
Water Quality. Contact the Division of Water Quality at the Washington Regional Offic 2-946-6481 r 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.
Raleigh, NC 27604
919-733-2293
Fax:[phone]
(Serves: Carteret, Craven, Onslow -above
New River Inlet- and Pamlico Counties)
Elizabeth Citv 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)
Wilmingaton 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

PCC Waterfront Construction Permit Application Process -
The.current edition of the Fairfield Harbour Waterfront Regulations and Guidelines is available at
http://tipyurl.com/yyg3b8
The following is a list of documents that must be submitted with the Waterfront Permit Application:
1. The "PCC Waterfront Construction Permit Application" form. This form_ must be signed by the Owner and
Contractor. Attach a copy of the contractor's Certificate of Insurance.
2. A detailed description and a "to -scale" drawing(s) showing complete scope of work. Description and
drawing to show removal of any existing structure(s) and installation of any new structure(s). Drawing(s) to
have all necessary dimensions, including but not limited to, property lines, riparian lines, bulkheads, docks,
tie poles, piers, walkways and shoreline.
A signed copy of the "Adjacent Riparian Property Owners Statement" form from each adjacent property
owner. A signed copy of the "Description and Drawing of Proposed Work" form is to be attached to the
"Adjacent Riparian Property Owners Statement" form.
4. If an "Adjacent Riparian Property Owners Statement" needs to be mailed to an adjacent property owner, then
use the "Certified Mail - Return Receipt Requested - Adjacent Riparian Property Owners Statement". A
copy of the "Description and Drawing of Proposed Work" form is to be attached to the "Certified Mail -
Return Receipt Requested - Adjacent Riparian Property Owners Statement" form.
If the "Certified Mail - Return Receipt Requested - Adjacent Riparian Property Owners Statement" is used,
then the following must be attached to the "PCC Waterfront Construction Permit Application":
a. A copy of the Certified Receipt from the post office signed by the adjacent property owner.
The original goes to CAMA if a CAMA permit is required.
b. A copy of the "Certified Mail - Return Receipt Requested - Adjacent Riparian Property
Owners Statement" form that was sent to the adjacent property owner.
C. A copy of the "Description and Drawing of Proposed Work" form that was sent to the
adjacent property owner.
A signed copy of the "Fairfield Harbour Waterfront Bulkhead Appearance Standards"
6. A signed copy of the "Permission to Use Adjacent Property" form (if applicable).
7. A signed copy of the CAMA permit (if required).
If a'CAMA permit is required, contact CAMA at [phone] to schedule an on -site inspection. Signed
copies of "Adjacent Riparian Property Owners Statement" form(s) and/or "Certified Mail - Return Receipt
Requested - Adjacent Riparian Property Owners Statement" form(s) must be obtained prior to CAMA's site
visit.
8. The final permit application package should be sent or hand delivered to the POA Office. Review and
approval of the permit application may require up to 30 days depending upon completeness and accuracy of
the submitted application information.
9. If there are questions regarding the permit application process please call the POA office for Waterfront
Committee contact person referral.

PCC Waterfront Construction Permit Application
Property Owner:
Section Number: �_ Lot Number: �� •' % • -
��Owners Name:
Address: !,�r��
Telephone Number:
E-mail Address:
Contractor:
CompanyName:
Contact Person:
Address:
Telephone Number-
E-mail Address:
Dredging: Attach a copy of the "Description and Drawing of Proposed Work" form indicating area to
be dredged, depths of dredging, cubic yardage of dredged materials, how the dredged
materials will be removed from the site and where the dredged materials will be disposed.
Docks: Attach a copy of the "Description and Drawing of Proposed Work" form.
Maximum dock distance to the bulkhead or shoreline: feet/inches
Dock distance from Riparian Line (facing water from land): Left Side feet/inches
Right Side feet/inches
Maximum distance from tie pole to bulkhead or shoreline: feet/inches
Tie pole distance from Riparian Line (facing water from. land): Left side feet/inches
Right Side feet/inches
Dock platform: Width feet/inches, Length feet/inches
Walkway/Pier: Width feet/inches, Length feet/inches
Dock piling diameter inches Tie pole diameter inches
Floating dock Yes, No
Page 1 of 2

Bulkheads: Attach a copy of the "Description and Drawing of Proposed Work" form.
Repair to existing bulkhead Yes, No
Removal and reconstruction of existing bulkhead ✓' Yes, No
Length of bulkhead to be repaired or replaced feetlinches
Existing concrete cap and/or cement bulkhead removed ✓ Yes, No
Backfill required vo Yes, No
v
Length of bulkhead behind a walkway or dock: feetlinches
A Certificate of Completion is required upon completion of work- An inspection will he made to verify that the
completed work complies with the scope of work identified on the "Description and Drawing of Proposed Work"
form, the "Fairfield Harbour Waterfront Guidelines and Regulations" and approved changes to the work (if
any). Upon completion of work the Owner or Contractor is to contact the PCC Waterfront Committee to schedule
this inspection.
The Contractor is to carry liability insurance with a minimum $1,000,000.00 coverage. Attach to this application a
copy of the Contractor's Certificate of Insurance.
I understand that I am responsible for any damage to an adjacent lot caused by construction activity. I agree to repair
restore any damage to its original condition to the satisfaction of the owner of the adjacent property.
I certify that the "Fairfield Harbour Waterfront Guidelines and Regulations" will be adhered to on this project
and that any deviation to the "Fairfield Harbour Waterfront Guidelines and Regulations" requires review and
approval from the Property Control Committee and the PCC Waterfront Committee.
I also certify that the wood to be used on this project complies with Tables D-2 and D-4 in Appendix D of the
"Fairfield Harbour Waterfront Guidelines and Regulations".
Property Owner's Signature ,��
Contractor's Signature
Page 2 of 2
Date - / L'�� /0
Date 91) A)- 19 7

Fairfield Harbour Waterfront Bulkhead Appearance Standards
Repair and maintenance of a refaced, wooden bulkhead requires that the property owner adhere to appearance
standards set by the Fairfield Harbour Property Control Committee. These standards require a bulkhead to remain in
its original alignment and that any added vertical posts be equally spaced and plumb. Materials and design
requirements are specified in the Fairfield Harbour Waterfront Regulations and Guidelines. The current edition of
the Fairfield Harbour Waterfront Regulations and Guidelines is available at http://tinvurl.com/yvg3b8
Minor repairs, such as tieback rod replacement, may mitigate more serious problems from developing in the future.
Broken tieback rods will result in bulging bulkhead walls and bowed walers. In severe cases the corrective repair of
this problem requires the removal of the concrete cap, removal of the original bulkhead and installation of a new
bulkhead in order to bring the bulkhead back into alignment.
Removal of the concrete cap is considered a major bulkhead repair by the POA and requires the addition of new 6" x
6" vertical posts, new tieback rods and new deadmen installed between all existing vertical posts to additional
support and bracing of the existing bulkhead. The maximum spacing (center to center) of all vertical posts on a
repaired existing bulkhead (new and existing) is 5'-4". The concrete cap that is removed from the original bulkhead
is usually buried on -site .
Even though the removal of the existing concrete cap, addition of new 6"x6" vertical posts with new tieback rods and
new deadmen between existing vertical posts does not require a CAMA permit, it does require a "PCC Waterfront
Construction Permit"
The following bulkhead appearance standards must be met upon completion of the repair:
1. The existing wooden bulkhead must be brought back to its original alignment and position as when first
constructed in front of the original concrete bulkhead. On any straight sections, the repaired bulkhead must
be realigned in a straight line. Construction standard: +/- I" as measured from fronts of new and existing
vertical posts along entire length of wall.
2. New vertical posts are to be plumb. Construction standard: +/- 3/4" in 4'-0" as measured on sides of new
posts.
3. New vertical posts must be centered between existing vertical posts. Construction standard: +/- 2" as
measured between existing vertical posts.
4. New 2"x6" cap board must be installed in a straight line for the entire length of the bulkhead. Construction
standard: +/- 3/4" as measured from front of new cap board along entire length of wall.
The physical condition of a bulkhead cannot always be accurately assessed prior to the start of repair work- Repair of
some vertical tongue & groove boards, addition of backfa replacement of some existing vertical posts, tieback rods
and deadmen, or complete reconstruction of some bulkhead sections may be required. The property owner's
discovery of such conditions when affecting repairs does not relieve the property owner from adherence to these
appearance standards or from the necessity to obtain additional construction permits from the PCC or from CAMA.
Property Own
Signature��
{� r�/) i
Print Name U �� = � �' i'' e� (", E' i a' jfi _
Contractor.
Signature Gam`
Print Name
Date Jai Date hn1) , 1 9 , 7t

Description and Drawing of Proposed Work
Property Owner:
Section Number: -7 Lot Number.
Owners Name:
Address:
Telephone Number:
E-mail Address:
Contractor:
Company Name:
Contact Person: e, leq
F
Address: cz- i o A,,,c
Telephone Number: :2 62D
E-mail Address:
Detailed description of proposed work:
"To -scale" drawing of proposed work:
?7

Adjacent Riparian Property Owner's Statement
Adjacent Riparian Property Owner:
Section Number: _ _ Lot Number: , 3
Name: M r�
Address: I d IL l c3"fJiLr
Telephone Number: 6� 3 4 %2 9 ?-)
E-mail Address:
I hereby certify that I own the property adjacent to:
Section Number. l Lot Number: 3
Owners Name: �j% o� (/� f� 1 _/ f t �% S
Address: Y b 1 ae c?Jv
Telephone Number: ,-,�
E-mail Address:
The individual applying for this permit has described to me the scope of work as shown on the attached copy of the
"Description and Drawing of Proposed Work" form and have no objections to the proposed work- I understand that
docks, pilings, tie poles or any other marine structure must be set back a minimum of fifteen feet (IY-0") from my
riparian line unless waived by me.
i I do not wish to waive the setback requirement.
I do wish to waive the setback requirement.
Adjacent Rip,
Signa
PIr i-
Date /2�0

Description and Drawing of Proposed Work
Property Owner:
-7 ?M/
Section Number: Lot Number. -
Owners -Name:
Address:
Telephone Number:
E-mail Address:
Contractor:
Company Name:
Contact Person:
Address: j 10 A
Telephone Number.
E-mail Address:
Detailed description of proposed work:
x4=,1,e
-To-scaW' drawing of proposed work:
[?/ ), 03 N -
9

Adjacent Riparian Property Owner's Statement
Adjacent Riparian Property Owner:
Section Number: _ Lot Number: J
Name: (U D 11 %v 1 CC (-
Address: ! fl St`1(�IU C 6-R1t r
Telephone Number
E-mail Address:
I hereby certify that I own the property adjacent to:
Section Number. Lot Number.
Owners Name: .J (a Q 1111- Iv L 6-
Address: y C 7 U &-,')
Telephone Number: 1/�1 �" 7, 11 ?
E-mail Address: LAct T 014 , m er
The individual applying for this permit has described to me the scope of work as shown on the attached copy of the
"Description and Drawing of Proposed Work" form and have no objections to the proposed work. I understand that
docks, pilings, tie poles or any other marine structure must be set back a minimum of fifteen feet (15'-0') from my
riparian line unless waived by me.
/< I do not wish to waive the setback requirement.
I do wish to waive the setback requirement
Adjacent Riparian Property Owner:
Signature -I'j4
Print Name -0e-
1) cc C �(r
Date
f

Description and Drawing of Proposed Work
Property Owner:
Section Number: Lot Number -
Owners -Name:
Address:
Telephone Number. a
Z-lxg!,5-�z
E-mail Address:
Contractor:
Company Name:
Contact Person:
1eq
Address: o -60
Telephone Number.
E-mail AddTess-.
Detailed description of proposed work:
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"To -scale" drawing of proposed work-
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For
1:224L72186I:
PETER R. NELSON
JUDITH F. NELSON
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GUARDIANS SAFETY YELLOW OIWYE

JAN-03-2007 03:39 AM FHPOA �p 2526352154 P. 1
J HN-IJU-EZ09 16: 08 Fr' om: DCM MHDCTY ," 57� V 7 7 � 3, 0 Tn : 96352154
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Michael F. , Gowmor
wlioni G- Ross Jr,BecrAtaryNorCarNlnl Depaft ent of Enviroftment and Natural ResDurew
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Colean H. Sullins, DIMMor
Chuck WAN, Deputy Director
BUFFER AUTHORIZATiON CERTIFICATE FOR SHORELINE STABILIZATION
A riparian buffer authorization is required for shoreline stabilization activities within the Tor -
Pamlico & Neuse River basins per Division of Water Quality (DWO) regulations 15A NCAC
0213:0233 & .0259,
Activities covered by your Coastal Area Management Act (LAMA) permit are deemed to have
a Buffer Authorization from the DWO only N the project can meet AL-4 of the conditions listed
below, If" the avoidance and minimlzation guidelines described below cannot be met, a
separate buffer authorization request must be submitted using a pre -Construction Notification
(PCN) appll04tion to DWO at the address below, A PCN application may be obtained on the
DWQ web site b=t J/h2p,enr.atate.nc•us etlande himl,
Questions regarding this process should be directed to wetlandlbuffer stgfff of the DWO in the
Washington Regional Office at 252-946-6481, or the 401 Oversight Unit in the Raleigh Central
Office at 919-733-0893.
A written authorization from DWQ MUST be received prior to any construction activltles in the
riparian buffer, Including land clearing, Failure to secure a Buffer Authorization prior to
construction &for land clearing shall subject the property owner & the party (contractor)
performing the construction BWor land Clearing to a civil penalty of up to $25,000 per day per
violation.
w Minimize removal of woody vegetation in Zone 1 to what MU6T be removed for the
Installation of the shoreline stabilization project, Zone 1 begins at -the most landward of
either the Walters edge or the coastal wetland line and ,extends 30 feat landward.
Unnecessary clearing is a violation of the dparlan buffer rules and may result in a civil
penalty assessment of up to $25,000 per day per violation.
0 The property owner Is responsible for site restoration of woody vegetation, Pre-projoct
site conditions MUST be re-established_ A site that was wooded prior to this
shoreline stabilization project MUIT be restored with native hardwood trees at a stern
density of 320 trees per acre. Hardwood restoration must be completed by the first
subsequent planting season (November 1 through March 30).
❑ Disturbance in Zone 2 of the riparian buffer, which begins at the landward edge of Zone
1 and extends 20 feet Is restricted to uses listed under 15A NCAC 213 .0233(4)(b) & (8),
and 15A NCAC 28.0259(4)(b) & (6), Clearing and grading of Zone 21s allowed provided
that it is re -vegetated Immediately and Zone 1 Is not Compromised, which includes
maintaining diffused flow of storm water runoff through Zone 1.
Worth Cnollaa Diviaim bf Waw Quality Irdomet MMM,nowttMuafity ore
943 Wabingmn S4uerV Mall Phone, 252446.6491 Np� CaVoa
Wayhingtaa, NC 27899 PAX 252-946-9215 �1 f��Ae1011Oppor41n1iy1,4tfirmaMAldanEmployer-50%Rwydedrl0%PantWa rnerPaper sL

JAN-03-2007 03�39 AM FHPOA
JPW02-2009 16:09 From:DCM MHDCTY
2526352154 P. 2
To:96M2154 Paoe:2-2
Q For vertical shoreline stabilization projects (bulkhead) only; sites where wave overwash
Is expected to be severe, the first ten (10) feet landward from the structure may be
maintained as a stable lawn in order to provide for structural stability. This certificate
condition is intended to apply only to projects adjacent to larger water bodies where the
conditions may routinely produce severe overwash.
a Construction corridors are allowed for shoreline stabiiizataon projects, but they must be
satisfactorily restored, see the first condition of this authorization.
u When restoration Is required Please suhmlt a project map of your property Indicating the
area to be restored, and a restoration plan. The DWQ website (Helpful links),
2c 1 t s ri n ff i may be helpful in the
preparation of the restoratlon plan.
This Suffer Authorization Is not considered approved until the DWQ has received both
this signed form &Q the project map.
Submit the requested information to:
Division of Water Quality
Attn: Surface Water/Buffer program
943 Washington Square Mail
Washington, NO 27889
By your signature below you agree to be held responsible for meeting Aim, of the above listed
conditions and verify that all information Is complete and accurate. Only the property owner is
responsible for the second condition. please be aware, violations of the above-ilsted o0nditions
are subject to civil penalty assessment of up to twenty-five thousand dollars ($25,000) per
violation per day.
J"i
Agent's Si*nature ' Date
CAMA General Permit Dumber; � 3 a � , C
North Carolina Division of Water Qwl[{y In1AMe6 rr_w y4UdU
943 Wwh[ftUWn Square msii Ph=: 252-W,6481 ne
WwhiaPxi� NC MR FAX 2$2-MQ15 N Caro "na
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