60379_SMITH, KEVIN_20120913

O CAMA / —. DREDGE & FILL N No. 60379
�• GENERAL PERMIT Previous permit#
DNew ❑Modification El 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 15A NCAC
❑ Rules attached.
Applicant Name Project Location: County
Address Street Address/ State Road/ Lot #(s)
City
Phone # (,)_
Authorized Agent
E cW
Affected
AEC(s):
❑ OEA
O PWS:
ORW:
yes / no
State ZIP
Fax # (_)
❑ EW 'I PTA D ES C PTS
11 HHF D IH UBA N/A
-i FC:
PNA yes / no Crit.Hab. yes / no
Type of Project/ Activity
Pier (dock) length
Platform(s)
Finger pier(s)
Groin length
number
tI ,
Bulkhead/ Riprap length
avg distance offshore
max distance offshore 1
Basin, channel
cubic yards_
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing
Other
Shoreline Length lin +
SAV: not sure yes
no —
Sandbags: not sure yes
no
Moratorium: n/a yes
no
Photos: yes
no
Waiver Attached: yes
I
no
A buildingpermit
P may be required Y 9
b Y:
Notes/ Special Conditions
Agent or Applicant Printed Name
Signature ** Please read compliance statement on back of permit
Application Fee(s) Check #
Subdivision_
i
ZIP
Phone # ( )_- _ River Basin
Adj. Wtr. Body --
Closest Maj. Wtr. Body
(Scale:
_._ See note on back regarding River Basin rules.
Permit Officer's Signature
Issuing Date txpiration 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 complywith 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)

.. .J ,,;Q'� '.: •. .:. if .; .. .. . . i � �. J _ .e
APPl;cant:
1\
Date: .
W?7 V
Describe below the HABITAT disturbances for the application. All values should match the name, and units of measurement
tound in your Habitat code sheet.
Habitat Name
DISTURB TYPE
Choose One
TOTAL Sq. Ft.
(Applied for.
Disturbance total
includes any
anticipated
restoration or
ternimpacts)
FINAL Sq. Ft.
(Anticipated final
disturbance.
Excludes any
restoration
and/or temp
impact amount)
TOTAL Feet
(Applied for.
Disturbance
total includes
any anticipated
restoration or
ternimpacts)
FINAL Feet
(Anticipated final
disturbance.
Excludes any
restoration and/or
temp impact
amount
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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 ❑
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N.C. DIVISION OF COASTAL MANAGEMENT
AGENT AUTHORRIIZATION FORM
Data 7- I -/ ;',L
Name of Property Owner Applying for Permit:
-KmmT
Mailing Address:
30L �-'-
q,*-fdy t Li - N :�7k3
I certify that I have authorized (agent) Rb6&E woruw to act on my
behalf, for the purpose of applying for and obtaining allCAAM,�A Permits necessary to
install or construct (activity) 5�� � .J,(- `bo-C. - a% cr- C� /1 � ,
at (my property located at) ;Ly S%%*>tfi> Zj', f4TLP41 t'ic, acAA
This certification is valid thru (date) /.2 -:31-- / -.;k—
Property Owner Signature
Date
R ,CEMD
AUG 13 Z01Z
DCM_^qgB CITY

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent toSrf I T' f�' 's
(Name of Property Owner)
property located at J.-A L4 -ta> —,
(Lot, BIock, Road, etc.)
on MAO pn4U� C-A;hl�(� , in 4—FL-P13T1C. 7$572� Q-Pt77N.C.
(Waterbody) ('I'ow�xid/or County)
Applicant's phon(rs'z 3a$'•�Sd Mailing Address :3�� `� 5,brftrAf ki Q-`T'
G Nd1�-L � G �-53-q
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)
c R6-3 0
�Tft D S,,� Uje L RECEIVED
LT
.V�K i>0C.11�
---------------------------- ----------------------------------------- -----------------
---------------------------
tr
ormation for Property Owner Applying
Permit)
Mailing Address
City/State/Zip
Telephone Number
Signature Date
(Riparian Property OwIe nformation)
Signature
-NW Lt. +T
Print or Type Name
Telephone Number
Date

ADJACENT RTPARTAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to.KOPmiT: Smryj 4 's
(Name of Property Owner)
property located at 1 :4 9 -5z�,04t�, :R, t y—
(Lot, Block, Road, etc.)
on MCOIE C--Q►* L- , iI1- ' A) C � cl-� C� ( N.C.
(Waterbody) (Town and/or Count)
Applicant's phon( I�t1\Mailing Address�a����cT
!fie 77?34
He has described to me, as shown below, the development he is proposing at that location, and, I
have no objections to his proposal.
------------------------------------------------- 7-----------------------------------------------------------------
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by property owner proposing development)
RECEAVTD'
AUG 13 2012-
JE�,D L DCM-MHD CITY
Cte-
L) 06
'J aIM
- - --------- - - - - - ---------------------_-------------- -
-- - 7c: :
rmation for Pr rty Owner Applying fl�$ian Property Owner rmation)
for Permit) 7&4t5-rW6
- r
Mailing /Address % ignature
i State/Zip Print or Type Name
-3 o
Telephone Num r
Date

TURNER MARINE CONSTRUCTION
P.O. BOX 1885
MOREHEAD CITY, NC 28557
DATE
:'AY
FO THE C b -2 DRDER OF Li
jlz� DOLLARS
BRANCH BANKING AND TRUST COMPANY
1 -800-BANK BBT BBT.com
FOR \71i-t-
116000012GSiii ':0531Dll211:0005l031L30t,2ll'
1265
66-112/531
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