59747_SLOAN, LARNY_20120315

C•CAMA / C- DREDGE & FILL
GENERAL PERMIT
❑New ❑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__-__ - A t to ZIP
Phone # () _ Fax # O
Authorized Agent
Affected Cl CW -i 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
attached.
Project Location. County
Street Address/ State Road/ Lot #(s)
Subdivision
City ZIP W_
Phone # O River Basin i { f _ fI` l�
Adj. Wtr. Body (nat /man /unkn)
Closest Maj. Wtr. Body
Type of Project/ Activity
(Scale: iI r V.
)
Pier (dock) length
Platform(s) j
Finger pier(s) ;
Groin length
number
Bulkhead/ Riprap length
avg distance offshore
max distance offshore—`
Basin, channel
cubic yards
Boat ramp
Boathouse/ Boatlift
1
a
yr
x
ix
Beach Bulldozing
Other
i
Shoreline Length
SAV: not sure yes no
Sandbags: not sure yes no i
Moratorium: n/a yes no
Photos: yes no
Waiver Attached: yes no
A building permit may be required by:
Notes/ Special Conditions
I
I
❑ See
note
on
back
regarding
River
Basin
rules.
Agent or Applicant Printed Name
Signature ** Please read compliance statement on back of permit **
i )
Dom_ m7r1/ �' •
_ J 1
Iss in Date tx ir�tfb to
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, 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/ 1-888-4RCOAST
Location:
Fax: [phone]
2728 Capital Blvd.
(Serves: Carteret, Craven, Onslow -above
Raleigh, NC 27604
New River (nlet- and Pamlico Counties)
919-733-2293
Fax:[phone]
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

TURNER MARINE CONSTRUCTION
P.O. BOX 1885
MOREHEAD CITY. NC 28557
PAY
TO THE
ORDER OF
1017
66-112/531
DATE
U as
66
DOLLARS
I
BRANCH BANKING AND TRUST COMPANY
1-800-BANK BST BBT.com
FOR L SC.� l7✓ — l/v M+
11'0000 10 1 ?o IIM 5 3 LO 1 l 2 0:000 5 LD 3 1 L 304 20
p

ppricant:
Date:
5q17q'-C-
Describe below the HABITAT disturbances for the application
found in your Habitat code sheet.
j2shlatcAll 1 values , an n" measurement
Habitat Name
DISTURB TYPE
Choose Ore
TOTAL Sq. Ft.
(Applied for.
Disturbance total
includes any
anticipated
restoration or
tern impacts)
FINAL Sq. Ft.
(Anticipated final
disturbance.
Excludes any
restoration
and/or temp
impact amount)
TOTAL Feet
(Applied for.
DisturLance
total includes
any anticipated
restoration or
temp impacts)
TFNAL Feet
pated final
ance.
Excludes any
restoration and/or
temp impacl
amount
- 1 �(�C)�7—
redge ❑ 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 Cl Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
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I
North Carohlria Depa rnent of Environment and 11"Iatura! Resources
iDo,v�sjoij e4 Coast -al Management
Michael F. Easley, Governor Chwies S. Jones, Diractor William G. Ross Jr., Secreti,ry
Date /-31)—/ �—
Applicant }Maine
Maating Address [ 'J
l certify that I have axatilhorized (agent:)
to act on any
behalf, for the Purl?ose cia applying for and obtaining all CANIA Permits necessary to
install or construct 61cOYRY)at (location)�13 qa
This certification. is ual:id film u (date)��—
Signatur

■■ab 09 12 03:42p Diesel Equipment Company 336 272 3189 p.1
■
ADJACENT R][7 ARLk PROI?Ejt'j k� OWNER SI' ATE�ENT
Lbick f-J 's
�(%cre)y certify that I own property ad�aeenl' o
(Name of Property Owner)
property Ioccacd at
(Lat, Blade, Road, etc.)
Oil
(Waterl�ody) (�'nwn aod/ r County)
jg $l� p kvi[ailing Address;—�5
Applicant . phone 4�T N C-
L
He has described to -me, as shown below, the development he is proposing at that location, and, 1
have no objections to his proposal.
-----------------------------------------------------------------------------------
NRwjr4OF VROPOSED DEVELOFXENT:
DSCZiPTXONt
(To be filled in Gv property nwfzer proposing develaprnenf)
U' P .
ion `
(Cn arm21iO for property Owner ApplYi
tbz permit) S �,
NjaiUng .Address
C ityl p
Telephone Number
_M-S L c D
Signature
()Riparian Property Owner Into
AV,
s.g��tur�
Print or Type Name
Telephone Number
Date
Received Time Feb, 9. 4:20)FM

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to.i-Ag ( SL 84)tJ is
(Name of Property Owner)
property located at % a3 ���'"�1� 5
(Lot, Block, Road, etc.)
on Chi C�—MI c* , in �� fiI4T �, C�}KIX�A�zI , N.C.
(Waterbody) (T2yn -�ind/or County)
��� ��`� -63�% Mailing Address: la3 Bb� l-' -S
Applicant's phon g
PET—b "T1 - 3 ,=N 1
He has described to me, as shown below, the development he is proposing at that location, and, I
have no objections to his proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by property owner proposing development)
P� Pa 5T=, D
----- -----------------------------------------------------------=---------1- ------------------
-----tProperyOwner Applying Property - fie Information)(-i-n-f-o-
for Permit) IE5AST � � �-
Mailing Address
City/State/Zip
Telephone Number
Signature Date
Print or Type Name
!-�77S!%
Telephone Number
Date