60143_OREILLY, CHRIS_20120405

l CAMA / ❑ DREDGE & FILL C' N0. 60143
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.
A pp I'i ac nt Ki ' P L C
i
Address
City
State ZIP
Phone # ()
Fax # ( )
Authorized Agentk._
s y
,; CW
Affected
ElEW ❑ PTA ❑ ES ElPTS
AEC(s): D OEA
❑ HHF ❑ IH ElUBA ❑ N/A
❑ PWS:
❑FC:
ORW: yes / no
PNA yes / no Crit.Hab. yes / no
Type of Project/ Activity
Pier (dock) length
Finger pier(s)
Groin length
number
Bulkhead/ Riprap length
avg distance offshore
max distance offshore
Basin, channel
cubic yards
Boat ramp
Boathous B tliff
�t^r
Beach Bulldozing
Other____ _
Shoreline Length
SAV: not sure yes no
Sandbags: not sure yes no
Moratorium: n/a yes no .
Photos: yes no
Waiver Attached: yes no
A building permit may be required by:
Notes/ Special Conditions
Agent or Applicant Printed Name
roiect ocation: ounty
Street Address/ State Road/ Lot #(s)
Subdivision ---
City -. ZIP
Phone # ( ) River Basin
Adj. Wtr. Body__ (nat /man /unkn
Closest Maj. Wtr. Body
(Scale: )
See note on back regarding Kiver basin rules.
Permit Officer's Signature
Signature ** Please read compliance statement on back of permit" Issuing Date
Application Fee(s)
Check # Local PlanningJurisdiction
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, 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
Mailing Address:
1638 Mail Service Center
Raleigh, NC 27699-1638
Location:
2728 Capital Blvd.
Raleigh, NC 27604
919-733-2293
Fax:[phone]
Morehead City Headquarters
400 Commerce Ave
Morehead City, NC 28557
252-808-2808/ I-888-4RCOAST
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)

Hogue Banks Marine Construction, Inc.
111 D Turner's Dairy Rd
Morehead City, NC 28557
[phone]
WACHOVIA BANK, NA
66-21/530
4/5/2D12
U
m
PAY TO ORDER OF E 10
NCDENR $ **200.00 "
0
Two Hundred and
DOLLARS
NCDENR - --
PO 7 �.. FT13' A1 4 �P� 7 c1 .. U
7
E
I Q
000,3 38 2112 l:0 5 3000 2 L9i: 20000 248 3 L40 20

Actr licant:
Date:
Describe below the HABITAT disturbances for the application. All values should match t4nam, units asurement
found in your Habitat code sheet.
Habitat Name DISTURB TYPE
Choose One
TOTAL Sq. Ft.
(Applied for.
Disturbance total
includes any
anticipated
restoration or
Lemfl impacts
FINAL Sq. Ft.
(Anticipated final
disturbance.
Excludes any
restoration
and/or temp
irQacyamounjj
TOTAL Feet
(Applied for,
Disturbance
total includes
any anticipated
restoration or
tern im acts
FINAL Feet
(Anticipated final
disturbance.
Excludes any
restoration and/or
temp impact
ount
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 ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
'�r.2•c�i.G73.?'.3:�:� �..:u3c-r7uUA'ai ,. ��rsir:�r.;�cr_:,��,•:a�:�:,aa.aaa,.�r:^..�v,4_n:at ._.:•T::..,t. »>�n�i;•.�,�

ADJA.CENV'T RIPARIAN PROPERTY OWN -ER STATEMENT
(FOR A p1EgAf00RI1VG PILINGS/BOATLXFT/BOA?W0USE} J
- Y is
I hereby certify that I ou�n property adjacent to C
(Name of Proper Owner) ,
property located at 1—Qr C✓ 1 - - _
(Lot, Block, Road, etc.)
V �. &e6�'
•R'' ©,�; N.C.
on 1e J a f ► lv , in
(Waterbody) (Town and/or
Applicant's phone #• ;! � � /Mailing Address: j v_5 -1,7
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 I boatlift / boathouse
must be set back a minimum distance of fifteen feet (151 from my area of riparian
naccess
unless
waived by me. (If you wish to waive the setback, you must initial the appropriate
below.)
A�. 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)
--------------
L> ,
�fe�
r
lilt
----�-____---------
-- a Pro y Owner I ormation)
(information for Property Owner Applying (Rip
for Permit)
Mailing Address
P ik�1 `t�
Ciiy1slawizip
n ion 'U[7 ber
%% ignlature
r
P-
Prim vt 1 yj)le 2�at�ir
zs Z -1_-30
9 ` Qt_
Telephone Number
Dai
Date

N.C. DIVISION OF COASTAL MANAGEMENT
AGENT AUTHORIZATION FORM
Date L./a.'�ct l Z
RECEIVED
Name of Property Owners Applying for Permit:
vc �1A 9 2012
Mailing Address: DCM-^/fHp CITY
I certify that I have authorized (agent) �a5"'u'1 I UK t,Sd (LC ! l(m to act on my
behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to
install or construct (activity) 0Q�prir- *-Effze--,�Ij er ,
at (my property located at) So�7 �LaT3 I l E��/Q �( �{►r�✓
This certification is valid thru (date)
re
red,'/(
Date

ADJACENT RIPART:Ai.t" ti PROPERTY OWNER STATEMENT
(FOR A PIER/MOORTNG PILINGSIBOATLIFTIBOATHOUSE)
v
1 heietry certify thtttl Oft propertyadjacent Meb €" s
n f -
(Name of PropertyOwner) t
property located at L(,-T 22. `Cxyt,f
(� '(Lot, Block, Road, etc,)
on in
(Waterbody) (Town and/or C ty)
�s rp
Applicant's phone #: ,al- �i` 60 /Mailing Address:
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 pierlmooring pilings / boattift / boathouse
must be set back a minimum distance of fifteen feet (1 S) from my area of riparian access unless
waived by me. (If you wish to waive the setback, you must initial the appropriate blank
below.)
/ .BAR 1 9 2012
ti/ I do not wish to waive
I do wish to waive that setback requirement.
CITY
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be,illed in by individual proposing development)
/A
evvtir a,C�T441(t
(Information for Property Owner Applying (Riparian
for Permit)
A Pier
-----------------------------------
er Information)
Mailing Address
oc
Citylsfatelzip I Print or Type Nairn:
i� Date
Z S L - 6 S-9 - Cd cf,C
Telephone Number
Date

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIEMWORING PILINGSIBOATLIFTIBOATHOUSE)
r
I hereby certify that I own property adjacent to 's
(Name of Proper Owner)
property located at LaT 3 �5�Q►yy/l �1 101 t �avlh.e�
(Lot, Block, Road, etc.)
on in N.C.
(Waterbody) (Town and/or C ty)
Applicant's phone #: 66 /Maiiing Address: /v
�rss�
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 (15) 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 befilled in by individual proposk tlevelopme
�l �q,,_ • • �' ur4 AWroX gd.
->ft aT To €X�p
(Information for Property Owner Applying
for Permit) Q/ n
er
; / 1.1
RjoC Oe- i� ►v►
(Riparian Property Owner Information)
Mailing Address ignature
(% ft fl(, 01 �� c-C
City/siateizip I
/•//', /)J Pi int///�/fTT�yr�pe Name
Telephone Number
Date

Ch"6,cr-eIIIIG1�I--'o-f"

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T
PX- C E VV E D
MAR 2 9 2012
DCM-MED CITY