58831_PEELE, RICK_20110915

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❑CAMA / '--] DREDGE & FILLS n� 81131c
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 Pee Ip. Project Location: County
Address i a C C-fN Dino 3 TN • Street Address/ State Road/ Lot #(s)
City- —__---_---___ State .�Jr- zip 2-m "A f it
Phone # (_ ) Fax # ( ) Subdivision
Authorized Agent } { C26k'�r City E vr.p r cj(� i 3 ( ZIP KS�y
Affected ❑ CW ❑ EW I] PTA [DES ❑ PTS Phone # (25') t tjV � > 12 River Basin i.-31?^ d
❑OEA CHHF ❑IH ❑UBA ❑N/A 1
AEC s : Adj. Wtr. Bod RS d nat /m/
O ❑ PWS: ❑FC: I y r .: )n..
ORW: yes / no PNA yes / not Crit.Hab. yes / no Closest Maj. Wtr. Body
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NEVIREWMEwE
or Applicant Printed Name
Signature ** Please read compliance statement on back of permit **
Permit Officer's Signature )
4
hi�JE ij
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 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, certifythat 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/ 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

EF-FPS-" 011 05.45 PM SHORELIHE MARINE LAINS•T. 1+ 52+393+i934
P . 0 1
AGENT AUTHORIZATION FORM
Date q— 3 ''r
Name of Property App ying for Permit:
7(- d— -7-e
Mailing Address:
Cam/ �a k-,
I certify that I have authorized (agent) � � �%v'� � to act on my
behalf, for the purpose of applying forand obtaining
6" install or construct (activity) 144 at 0
at (my property located at)
CAMA Permits necessary to
This certification is valid thru (date) ! 30, U
Property Owner Signature Date

j ■ Complete items 1, 2, and 3. Also complete
j item 4 if Restricted Delivery is desired.
■ Print your name and address on the reverse
so that we can return the card to you.
■ Attach this card to the back of the mailpiece,
or on the front if space permits.
1. Article Addressed to:
Phi 1, Co%IX -I^
P �
131 Wes-f tilp,,, 5 —,
6�a►'Aer , kG �'-15'xj
2. Article I
(Transfe
PS Form
A. Signature
X
B. Received by ( Printed Name)
D. Is delivery address different from item 1?
If YES, enter delivery address below:
Yes
No
3. Se Ice Type
Certified Mail
❑ Express Mail
❑ Registered
❑ Return Receipt for Merchandise
❑ Insured Mail
❑ C.O.D.
l'
4. Restricted Delivery? (Extra Fee) ❑ Yes
weo95-02-M-1540 I

UNITED STAT�Sr9i!AVittJ-wtN)GIa-'- 1 HIIIL 1 :,s
• Sender: Please print your name, address, and ZIP+4 in -This box •
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09/15/2011 01:20 9198297539 LS3Pi'E:0NE'Y PAGE 02'/02
09/07/2011 04:32 9198297539 LS3P/3l9hiEY PAGE 01;'01
SEP-07-2011 ®a:47 FM MHORRI..XNE MAPINE CONST. 1+252+8q3+7-�54
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CERTIFIELI MAJL - RETURN RECEIPT REQUESTED
I hereby cenity that I ow Property adjacent to —lR! Gl4� P.-ge/-(--
t0
P, Qfi
1 �P Sol 01 S � (Name of Proporty Owner) �-�1 n �
RrQperly lor�ted gE
on 80 E � ddre", L+a% Black, Road, o c.T �s �
!wabY? Ptyfr~ and/or County} �o
.AwnfA Narm F: -5k/'C Cyr U Mulfing A�dora+� d PPq f:; I/
Agerres phone x, 14WOor,+- ALL 5 70
—r,.
H e/She has desWbed tome as shown below the developrl Ord 46MM9 ig PM=Ing at that 1"fon,
and I hoe no objWions to the proposal,
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(MNIvNdt�11 PMPOS V ,d6v*A0Pt*"* m9ft flu In d6vedPdon below or attach a x1to drawftga
+rYOU OM h'.M Ab who rA a PAWXWed you RuAwnatffy the QIv 0f Cof Co3.r Alwngemw
(00" In MOW Wftn 10 days of nrc"t of Ok rrofk.'4. C~ btfop"Wfon for DC* o"kee is
avallabro at wwwn hrlMaRgQtb6,t,#gt"tea�-+al MNuR Of br cs I-NO.4RCIAST.. No
pmf or
&*,nor
Name
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09/��Ir''?611 4�4: 919 :9 5:;� L=73P/SONE'r PAGE 011"01
SEP-67-2011 97;47, PM SHORELINE MAPINE COHST_ 1+252+393+79 ti4
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CERTIFIED MAIL - RETURN RECEIPT REQUESTED
a
I hereby certify that I own property adjacent to el G P Is
propetty (Mama of PropOrty Owner)
s ) It S� s�-�— L� �e
dress, Lot, Block, Road, etc.}
on
(Weterbody) (CiltylTown andlor county)
Agent's Name #: 4 6f'PPK5— Malfing Address, 0�Q �Sv� f�i��GAgent's phone #; `- Z &T�' 32lZ _ 1ehL��P- ,� 7 M L—
He/She has described to me as shown below the developmeni!he/she is proposing st #hat locatlan
and I have no objections to the proposal,
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(lndlv/dutal propeyalPW daval+aptttorri mtr$t 0In defedpilon below or attach a sle
FX/S N1 P, ),
Pr6COd
P.lai
tfyou have vNectl m to what is 6eln8 propced you must »only the Dlvleton Of Comm Menagemant
(DC*Q in writing wllhfn 10 tfeys of rmcv/pt of this notke. Confect inferte,tttan fdr DCM ofrlcea is t
avMsWa at www nccoash6rlerrgerrrerltnlw mbc efcnt.htm or by calNng 1.ass-4RC0AST. No
nmmsg is consld wW 04 ae no o H You have been rto~ py Ceditd AW1,
Owner
v oeurnv �_ v
Print or Type Name
7M ' ng Address
�rc4 , NC o2-7J R. 3
Telephone Number
Date
(Riparlan roperty Owner Information)
Siprratura ".—'
Print or Type Name
%
Ma ft Address
crry�staterz�
Telephone Number
Date