58109_OLIVER, DAVID_20110810

CAMA / ❑ DREDGE & FILL
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 I SA NCAC
❑ Rules attached.
Applicant Name
Address
City
State ZIP
Phone # ( )
Fax #
Authorized Agent
Affected ❑ CW
❑ EW ❑ PTA ❑ ES ❑ PTS
AEC(s): ❑ DEA
❑ HHF ❑ IH ❑ UBA ❑ N/A
❑ PWS:
❑ FC:
CIRW: yes / no
PNA yes / no Crit.Hab. yes / no
Project Location: County
Street Address/ State Road/ Lot #(s)
Subdivision
CityZIP
Phone # ( ) River Basin
Adj. Wtr. Body (nat /man /unkn)
Closest Maj. Wtr. Body
Type of Project/ Activity
Pier (dock) length
Platform(s)
Finger piers)
(Scale: )
Groin length
number
Bulkhead/ Riprap length
avg distance offshore
max distance offshore
Basin, channel
cubic yards
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing
Other
--
IV
I
i
--
--
-
-
j
I
I
Shoreline Length
SAV: not sure yes no
I I _
Sandbags: not sure yes no
Moratorium: n/a yes no j
Photos: yes no f
Waiver Attached: yes no r {
A building permit may be required by: ❑ See note on back regarding River Basin rules.
Notes/ Special Conditions
Agent or Applicant Printed Name
Signature "Please read compliance statement on back of permit"
Permit Officer's Signature
Issuing Date
Expiration Date
Application Fee(s) Check# 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 I) 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 (910-796-7215) 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/ I-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

Jul 26 11 09:32a Baskervill
252-249-3537 PI
N.C. DIVISION OF COASTAL MANAGEMENT
AGENT AUTHORIZATION FORM
Date G
Name of Property Owner Applying for Permit:
-pig" I f i� 0 Ve-2
Mailing Address:
I certify that I have authorized (agent) C31? V l L to act on my
behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to
install or construct (activity)
at (my property located at) 1 /e�i✓ wj dS D^
f/
This certification is valid thru (date)
Property Owner Signature Date

DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION FORM
CERTIFIED MAIL - RETURN RECEIPT REQUESTED
I hereby certify that I own property adjacent to DYy a ©(l tiff' 2 's
(Name of Property Owner)
T
property located at J /�PJ�� l.�oI,,
(Address, Lot, Block, Road, etc`.) �
on T—A PNf �� Jt(Z- in I iR�V4 rjt "0(5 N.C.
(Waterbody) (City/Town and/or County)
Agent's Name #: Bob Rho d1 ,e Rv I I Mailing Address: 3 ! q .3eA,--d f L%R,z dL
Agent's phone #�a��� 1 U C dG % ��lt h �� ;).x 5- 10
He/She has described to me as shown below the development he/she is proposing at that location,
and I have no objections to the proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(Individual proposing development must fill in description below or attach a site drawing)
l��13
.I/_ _
-J L-"— �A
155 011?
() I Jr£-
If you have objectio s 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.nccoastalmangement.net/contact dcm.htm or by calling 1-888-4RCOAST. No
response is considered the same as no objection if you have been notified by Certified Mail.
(Pro erty Own onration (Ri P erty Owner Information)
&.�
Signature Signature
rZ-
Print or Type Name Print or Type Namel
Mailing Address
/
1 �QR.j)City/State/Zip
Telephone Number
-2 bl///
Date
--527 7""k L'��s
Mailing Address
/tk,./ --&-, ,UC_ ZV.SZ2
City/State2ip
Telephone Nu�ber
,/� / (,
Dat

DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION FORM
CERTIFIED MAIL - RETURN RECEIPT REQUESTED
I hereby certify that I own property adjacent to ppyy ,o tt 01 ( V t 17, 's
. (Name of Property Owner)
property located at VJ-.1 C ✓111k k Ve-
(Address, Lot, Block, Road, etc.)
on Re id1 II 0- in kt'V/00 S N.C.
(Waterbody) (City/Town and/or County)
Agent's Name #: 30 , -8.,)5 Q� v+ ( Mailing Address: 3� y p�.�-r>(y CRC"z%t
Agent's phone #5a) 5 t - 5�� y ! a,nr h�� ,�✓ a�5i
He/She has described to me as shown below the development he/she is proposing at that location,
and I have no objections to the proposal.
---------------------------------------------------------------------------------------------------------------------
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(Individual proposing development must fill in description below or attach a site drawing)
I rQp,,t" KJ'VZA-
' - — 1�R,��c�'•1c� � free. �
(Ve.n e)ei6f.
TAV l ar
If you have obf ections to what is being proposbd, you must notify theiNvision of Coastal Manbgement
(DCM) in writing within 10 days of receipt of this notice. Contact information for DCM offices is
available at www.nccoastalmangement.net/contact dcm.htm or by calling 1-888-4RCOAST. No
response is considered the same as no objection if you have been notified by Certified Mail.
(Pr Owner ford )
Si nature
Dov,t'A 01 l v* a --
Print or Type Name
S-74 - %���� W0,45 Jar
M/a�iling Address
be
City/State2ip
Te phone Number
Date
(Riparian Property Owner Information)
Signa ure
Print or Type Name
Mailing Address
0\) --� I., �-7 C- a,1g.
City/State2ip
ZSZ' 6-10-900 61
Telephone Number
"I �
Date

CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM
Name of Individual applying for Permit: Dr) i. , d U (A'
Address of Property: — 52 I
%e,.ti
(Lot or Street #, Street or Road, City & County)
I he y certify that I own property adjacent to the above referenced property. The individual
appI 'n for this permit has described to me as shown on the attached drawing the development
they a proposing. A description or drawing, with dimensions, should be provided with this letter.
X I. have no objections to this proposal.
if you na"bjections to what is being proposed, please write the Division of Coastal
Management, 400 Commerce Avenue, Morehead City, NC, 28557 or call [phone] within
10 days of receipt of this notice. No response is considered the same as no objection if you
'have been notified by Certified Mail.
WAIVER SECTION
I unde tand that a pier, dock, mooring pilings, breakwater, boathouse, boatlift or sandbags must
be set b ck a minimum distance of 15' from my area of riparian access unless waived by me. (If
you w'sh t aive the setback, you must initial the appropriate blank below.)
x I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(Applicant Information)
Mailing Address
City/State/Zip
Telephone Number
Date
( i arian Property O Information)
7
Print or Type Name
Telephone Number
Date
- 'I._-� ` \

NC Division of Coastal Mgt. Habitat Impact Computer Sheet
Applicant: Michael Howard
Date: August 10, 2011
General Permit #: 58108C
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
SB
Dredge ❑ Fill ® Both ❑ Other ❑
3,120
208
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