60333_ROBERTS, JOHN_20120703

1CAMA / J DREDGE & FILL
'"
W � NO.
60333
GENERAL PERMIT
Previous permit #
❑New LlModification ❑Complete Reissue LIPartial 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
Applicant Name
Project Location:
❑ Rules attached.
County
,
Address '�
Street Address/ State Road/ Lot #(s)
City i i�!''��� State t, t�.0 .ZIP
-
Phone # O ifs t _ Fax # (')
Subdivision
Authorized Agent ~�► I
City_ j H �,
r f
t" �t C iL (._ + ZIP
CW �'].EW TA ' 0 ES ElPTS
Phone # (_
!� I River Basin
Affected
AEC s : OEA ElHHF ❑ IH ❑ UBA El N/A
()
___)
Ad'. Wtr. Bod
I y
'~% ' •'�
� !� ��
at
(n/man /unkn)
- PWS: ❑ FC:
Closest Ma'. Wtr. Body{
I
ORW: yes / no PNA yes / no Crit.Hab. yes / no
Type of Project/ Activity
Pier (dock) length
Platform(s)
Finger piers)
Groin length
number
Bulkhead/ Riprap length_
avg distance offshore
max distance offshore
Basin, channel
-- a--- -1
cubic yards' k �,
r
Boat ramp
Boathouse/ Boatlift�5��
Beach Bulldozing
Other-3I-----
r
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
Signature ** Please read compliance statement on back of permit
Application Fee(s) Check #
(Scale:
See note on back regarding River Basin rules. I
Permit Officer's Signature
Issuing Date Expiration Date
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, 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:
El 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/ 1-888ARCOAST
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)

Aaplicant: ;Ih� ��"���
��ate: 1
I y �&X'UtC4"D
a11
Describe below the HABITAT disturbances for the application. All values should match the name, and units of measurement
found in your Habitat code sheet.
DISTURB TYPE
Habitat Name 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 amou
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
redge ❑ Fill ❑ Both ❑ Other
Dredge ❑ Fill ❑ Both ❑ Other ❑
bredge ❑ 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 ❑
,1. 0 X
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a
N',C. DiVISION OF COASTAL MANAGEMENT
t
Name of Property Owner Applying for Permit:
,vlailinc, Address:
?%
44) I certify that I have, authorized (a0ent)to act oil 11IN
behalf. for the purpose of applying for and obtaining allCAA Permits necessam to
install or construct (activio!) [3o o14— L t 44-s
at (my property located at) t
This certification is valid thru (date)
Owner Signature
Y —12 3 - /,?—
Date

iZ
CE-RTII~IED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
AOjACENT RIPARIAN PROPERTY J,,r--NEt= NOT IFICATION.NVAIVER FORM
-dress of ,Jr,oc, "y,
iail ino .-`.t%iess: /V %J //1 lKco, r%l figf
,',+ Certify, that 1 own propem., adpcent to the above referenced prCce ;Y, T^L individual
" i0( this .�ti'i ^lit has ''Scribed to me as showy i on the a: ached drawing the deveiolor ent
YJ, are p'000sirtg. ,A description n cr drawing, with dimensior.1s. must be provide with'! this
hu, ;t> *his proposal.
Uni »
_._. €' aections to
If you have objections to what is being proposed. you must notify the Divis,`on of Coastal Management
(DCPA) in writing ;within 10 days of receipt of this notice. Contact information for DCM offices is
available at wvvrv.nccoastaimangement.neticontect_dcm.htm or by calling 1-888-4RCCAST. No
response is considered the same as no objection if you have be-n notified by Certified Mail
WAIVER SECTION
::naersta'nc- that a pier, doci,. '1-Oc"inn pilings, breakwater, boai^use, or lift must be set b2_-K a
m iwt�€m d=stance of ? 5' from my area of ripanar access urn ess waived by me, ,;i= you wish to
aive the setback you must initial the appropriate b?ank be ow
do ;�,is;; to waive the 9 set; ack recuirement
.�.` do not wish to waive the 15 setback req Direr tort
Property Owner information)
%v 3GCE
t: 'C M VJmber
(Riparian Property Owner information)
tit Ile sl& r,
� �,/ C4 r'.�.-%ems � ;,► .
la;{1r)i Addr2Ss
"" ian4—/Z;�
Teieohore N,, mbOr

CERTIFIED MAIL • RETURN RECEIPT REQUESTED
MVISICN OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PMCtPERTY OM NER NOTIFICATIONMAIVER FORM.
Name cf PrCperhy Cwr`:e irliq ,,
o' Propel —I y:
Lot or St -eel ii. Street ❑, i' oa,-!. .. `V & Col.S-'Ilv,)
Appiicantpone#: � �7 l Maiiing address:
"ereby certify that l own progeny ad acem to the above referenced property. The individual
applying for this permit has described to me as shown on the attached drawing_the development
'hey are proposing. A description or drawinq. w& dimensions. must be orovided With this letter.
Ilae no olliection's to this Proposal. I hal e ot7iections to thi-S prono4l.
If you have objections 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_neticontact_dcm.htn; or by calling 1-888-4RC©AST. .No
response is considered the same as no objection if you have been notified by Certified Mail.
WAIVER SECTION
understand that a pier. dock. mocring pilings, breakwater. boathouse. or lift must be set back a
minimum distance of i5 from my area of riparian access unless waived by me. (If you ravish to
waive the setback. you must initial the appropriate blank below.)
l do wish to waive the 15' setback requirement.
l / I do not wish to waive the 15' setback requirement.
(Property Owner Information)
I.
11av
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P!-Int or Type Name
lo� dieza") t VA Iia&% d
" si .rnr Address
CityStatel ip
. ?/ V ?
ei)t?ene Mitr?ber
an P'Fgperty Owne laformation)
Print or 1 ype Name
�ff'' 7.
Mailing Address
Ci`;.'SSa.'s�in
Telephone Putimbe.-
,tfe

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SHORELINE PIERS & BOAT LIFTS, INC.
DBA SHORELINE MARINE CONSTRUCTION
580 PEARSON GIR 252-393-7934
NEWPORT, NC 28570 DATE 7-3
PAY
TO THE
ORDER OF
$
clfd
R S
First Citizens
Bank
FOR P. cod ?
L"I ,
110000178111 I:0531003001:0034123089020
1478 ..............
66-30/53�
34