58342_STEVENSON, JOHNNY_20110818

2
❑ CAMA / ❑DREDGE &FILL
r.
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 15A NCAC ? 1.40C'
_ © Rules attached.
Applicant Name kE 0 IN ,I Project Location: County
Address
City d V-J 04N y ero State t + . zip 7—.
Phone # (7 i r) r ") Fax # (__)
Authorized Agent
Affected ❑ CW U EW ❑ PTA ❑ ES ❑ PTS
AEC(s): ❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A
❑ PWS: ❑ FC:
ORW: �_ye�s / no PNA yes / no Crit.Hab. yes / no
Street Address/ State Road/ Lot #(s)
Subdivision
City t 1 % 4e zip t SSW
Phone# (a`!L- 3212 RiverBasin NIN�,;r 6�.,
Adj. Wtr. BodyV-,n %if �1C�.1+.� nae./man /unkn)
Closest Maj. Wtr. Body 0;j 30 -r
Type of Project/ Activity
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Agent or Applicant Printed Name f ems'
Signature ** Please read compliance statement on back of permit **
Application Fee(s) Check #
Permit Officer's Signature
> 1 s � `' ­ , - /JZ
Issuing Date 1 Expiration Date
if
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
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)
Revised 08/09/06

SHORELINE PIERS & BOAT LIFTS, INC.
DBA SHORELINE MARINE CONSTRUCTION
5130 P
NEWPORT, NC 28570
66-30/531
DATE
�,I q'-1 341
OF
! / DOLLARS 0
MFirst Citizens
Bank _ NP
-3142 *.jq39
u`00L27011'l:053L00300j:0034L2 _

N.C. DIVISION OF COASTAL MANAGEMENT
AGENT AUTHORIZATION FORM
Date —7" 2 1 — ) I
Name of Property Owner Applying for Permit:
btl�N S��s�
Mailing Address:
v I RwtD
I certify that I have authorized (agent) .S J"e �fv �'`S 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) �� oZ So�tN� �2111
ism n1 C-- ?F5� �f
This cert�cation is valid thru (date) / 0 — 3 / — l /
roperty Owner Signature Date

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AUG-11-201t 05:12 PM SHORELINE MARINE CONST. +252+393t7934 P.0!
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM
M
Name of Prooetty Owner' j o Girl f 'C ✓`C/1 S0�
Adoress of Property: 7 +'-
(Lot or AlNaat 0 S"W or Road, City 3 County)
x
Applicant phorNt el�l1 ' �/S� i 5 �� Mailing Adc!•ess:
I hereby certify that I OWP prope y adjacent to the above referenced property. Ttie tndivrdaat
applying for this pent has desertbed to me as snown on the attached crew:ng tra deve;ap'nent
they are proposing mtjv be provided with this I""
X I have nc, ubjectttions to this proposal. _ _ i have to thi; prvprnsal.
H you have objectfons to what is being pralosqa(. you must noay the f MJv on of Casstat Msnepemvnt
(pCAf) in wrMng wf hin 10 days of tacmpt ut this nonce. Contact infonration for DCM offices is
avallabk at www_r)cco"tafmdngwr+arrt.nstcontect_dcm-Mm Or by CalAng 1.889-4P OAST Mo
res naQ ►s CQnstt1e/�9Q t1w satrw as r7o objection H you have been natfiT�d 6Certtftod Malt.
WAIVER SECTION
understand v w a pier dock, moonn9 pilir•gs, GreaKwater. bcathouse, or 1(ft trust be Set Lack 9
rnlnimum distance of 1 its' from rry area of npwian access unless walvec by me (`f you wish to
waive tt�e setback, you t inItIll the appropnete blank Wow )
t do w►sh to waive the 15' setback requifemen'..
do not wish to waive the 15' setback requirement.
O-CnS.C;'^
PM or TW ramv
Q
c�v4n ro i_ltl � 2�'S�' I
ft - 4045- i55S
TNmphons Number
(RIPWisnp Infof►"1 *n)
f' L. -e J o'e
Print or type AWW
5 S3 0 S N.
Ra1�. NC �76J2
Telephate Number

CERTIFIED MAIL - RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Property Owner:
Address of Property:
� Applicant phone #:
Any 4'te✓-eA3o.1
/ ,;L .SO L4^d D r r
(Lot or Street #, Street or Road, City & County)
ar7 zerel_
Mailing Address: 7 ,? / �JE6-r 7'l2>E L✓ ��
SwR/)s�ro , IV C-- 2 r5F4
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 drawing_the development
they are proposing. A description or drawing, with dimensions, must be provided with this letter.
I have no objections to this proposal. I have objections to this proposal.
/f 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.net/contact_dcm.htm or by calling 1-888-4RCOAST. No
response is considered the same as no objection if you have been notified by Certified Mail.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boathouse, or lift must be set back a
minimum distance of 15' from m area of riparian access unless waived by me. (If you wish to
i waive the setbac ou must initial a appropriate blank below.)
1 I►I / %� _ I do wish to waive the 15' setback requirement.
a I do not wish to waive the 15' setback requirement.
r rty Owner formation) (Riparian Property Owner Information)
Signature c Signature
JO AV J�v�il5nr\ Moll\ J o kn 5 b /\-
Print or Type Name Print or Type Name
791 W eS r-17 (Al-,,er 0 4 b b D Oa L, Dad 7`far r
Mailing Address Mailing `A��dress
SwR',4sbar� �� IF5�� 6,(.OISba-o � t✓ a753`f -
City/State/Zip City/State/Zip
Telephone Number Telepho e Number
) //__ & X/
Date Date
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