58337_ROMANOVICH, KATHLEEN_20110815

❑ CAMA / ❑ DREDGE & FILL
GENERAL PERMIT
❑NeN ❑Modification El Complete Reissue ❑Partial Reissue
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
Applicant Name
Address(
City : o rc. State zip
Phone # ( ) Fax # ( )
Authorized Agent ,rt s
Affected ❑ CW ❑ EW ❑ PTA ❑ ES ❑ PTS
AEC(s): ❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A
❑ PWS: ❑ FC:
ORW: yes / no PNA yes / no: Crit.Hab. yes / no
Previous permit #
Date previous permit issued
71 Rules attached.
Project Location: County
Street Address/ State Road/ Lot #(s)
Subdivision
City. zip
Phone # ( )57_ �Z'� 2! River Basin
Adj. Wtr. Body A-rw �V (oat /man /unkn)
Closest Maj. Wtr. Bodyy ti j
Type of Project/ Activity © r
� (Scale: � ff 7 Z 0 � )
i A Y. i,. 2.1 i�
II
Finger pier(s)
i■■■■■■■�w■■■■■■■■■■■w■■■■■■■■■�■■■i■■�■■■
■■■■■■■■■■■■■■■■■■■■■■■■■e■■■■■■■■■■■■■■
Groin length
number
Bulkhead/ Riprap length_
avg distance offshore
max distance offshore_
Basin, channel
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■■■■■■■■■■■�a�■■■■■■■wr��a
■■■■�
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cubic yards
Boat ramp
Boathouse/ Boatlift
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■1:;!�■■■■■■■■■■■■
Beach Bulldozing_
OtherSAV:
■■■■■■■■■■■■■■■■■■■■■■■■■[�!YWi■■■■■■■■■■■
■■■■■■■■■■■■■■■■■■■■■■■■■!■■■■■■■■■■■■fljl
Shoreline Length
not sure yes .
Sandbags:mmmm■■■■■m■mmmmmmmm®mmm■1lmo[I■■■■■■■■■■
hot
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11
A building permit may be required by: 0 G t o ❑ See note on back regarding River Basin rules.
Notes/ Special Conditions J 4 r rt-r r ^ r
i
Agent or Applicant Printed Name
Signature ** Please read compliance statement on back of permit **
Application Fee(s) Check #
Permit Officer's Signature
Issuing Date , ; Expiration Date
� !ra}Gt1 S hGi'4
Local Planningf urisdiction Rover File Name

AP
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
❑ Neuse River Basin Buffer Rules
❑ Other:
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/ 1-888-4RCOAST
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)
Revised 08/09/06

SHORELINE PIERS & BOAT LIFTS, INC. 1266
DBA SHORELINE MARINE CONSTRUCTION
580 PEARSON CIR 252-393-7934 �'�� /. f
341
NEWPORT, NC 28570 `I 66-30/
DATE 1
PAY
TO THE •` $ CR
ORDER OF
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First Citizens
Bank
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"UG-10-2011 06:51 AM SHORELINE MARINE CONST. 1+252+393+7934 P.01
Shoreline
Marine Construction, Inc.
580 PEARSON CIRCLE
NEWPORT, NC 28570 NCLicense # 62746LS-Marine
mobile [phone]
office / fax [phone]
email: abrooksi fw.rr.com
FAX COVER SHEET
DATE: F - l o p
FAX # 247-
3 5Y O
FROM: 45rk
# PAGES SENT
(including this cover) gflmdli✓i C, 1 DO C4<

P.02
AUG-10-2011 06:52 AM SHORELINE MARINE CONST. 1+252+393+7934
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AGENT AUTHORIZATION FORM
Name of Property Owner Applying for Permit: an 0 l/a 4e^ Rvmmrravl ed
Mailing Address:
60(o Oat,-&" r P t-i - RJ
w an
I certify that I have authorized (agent) --454 I.CV &014� 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) a4 IR��,,
SAVartS►CASrp NC, -
This certification is valid thru (date) /,9
Property Owner Signature Date

F+UG-11 -2011 br :53 r1M :H[IRELIHE r•1ARIHE CLAN'-:T. 1+25z-*-Z93 =_4 P.04
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DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIOWWAIVER FORM
Name of Property Owner: ]-� ct -� W e P
Address of Property, t ' ' . t)�
(Lot or Street k Street or Road, City & County
Applicant phone#: C - 25 7 Mailing Address: (D CD� to
I hereby certify that I own property adjacent to the above referenced property, The individual
applying for this permit has described to me as shown on the attached drawingwthe development
they are proposing. A s r, -ipn or drawing, with ZM§rtsions, must ba Myi ided with this letter.
f I have no objections to this proposal. I have objections to this proposal.
you have objections to what Is being proposed, you must naft the Division of Coastal Manapwment
(DCM) In writing within 10 days of receipt of this nonce. Contact Information for DCM officers is
available at www.nccoastaimangmentnoticontect-dcm.htm or by calling 1-8884RCOASr. No
response is considered Me same as no objecdon N you have been notftd by Certified Mall.
II I N I I.li iiu
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boathouse, or lift must be set back a
minimum distance of 15' from my area of riparian access unless waived by me. (If you wish to
waive the setback, you gust Initial the appropriate blank below.)
I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(Property Owner Information)
S*ature
Print or Type Name
Mailing Add4ss
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cityisrare2lp
C I I ,
Telephone Number
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(Riparian Property Owner Information)
Print or Type Name
P D BpI( 71 Z)
Mailing Add ss
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cv state
03-2
Telephone Number
-7- ,2g5 - l /
Dare Date

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77°8'15'W
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77°7'48"W
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Vicinity of Hwy. 24 Bridge
Swansboro, NC
The coordinates listed below Map Date : 20 June 2005
are in 1983 North Carolina
State Plane Feet Photography Date, September 2003
Points for reference
80ft. Setback
Navigation Channel
N
0 200 400 800 1 Us Army corps
of er,
77°7'48' W 7707'21 "W Feet �'. 1W igwn D wia ��
Point
X
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344299.01
n° 5
1 2561145.80
340604.36

N/F
Judith Christopher
\ DB 1263, Pg 911
\ N/F \
\ Jan Romanovich \
\ MB 62, Pg 12
\ �N
N/F
Brian J. Scott \
DB 519, Pg. 373 \
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Note: This Map Is Not Intended For Recording!
I, CHARLES A. RAWIS, PROFESSIONAL
LAND SURVEYOR do hereby certify
that I have surveyed the property
as shown hereon in accordance
with THE STANDARDS OF PRACTICE
FOR LAND SURVEYING IN NORTH
CAROLINA.
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Ashlev Brooks Marine
Boundary Information From MB 62, Pg 12, Onslow
Co. Registry
AIWW R/W & Setback Information Taken From USACE Datum
606 Barbour Point Road
Swansboro
Onslow County, North Carolina
Charles A. Rawls
CAR
and Associates
PLANNING
1117 HAMMOCK BEACH RD., P.O. BOX 1126
MAPPING
SWANSBORO, N.C. 28584
TELEPHONE: [phone] FAX: [phone]
SURVEYING