55341_ROBUCK PROPERTIES, LLC._20100428

D CAMA / 1:1 DREDGE & FILL
GEI`ll#=-RAL PERMIT Previous permit #
_F]Nevv Ell'Yodification DComplete 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
0 Rules attached.
Applicant Name I\ k bt Project Location: County
I Address 0 0 1 X, Street Address/ State Road/ Lot #(s)
le V .
-4 e
City
i C"I State Zip
Phone # Fax #
Authorized Agent
Affected 0 Cw , 'q.'E'W ,X-PTA D ES 0 PTS
AEC(s): El OEA El HHF El IH El UBA El N/A
El PWS: 0 FC:
ORW: yes / no PNA yes / no Crit.Hab. yes no
Subdivision
City ZIP
Phone # O River Basin
C.
Adj. Wtr. Body (nat unkn)
Closest Maj. Wtr. Body
Type of Project/ Activity 6!XCII V-,Tf 10/) 0 1 e-Y .5> r
(Scale:
Pier (dock) length
Platfo
Finge
Groin
Bulk
Basin
Boat
Boat
Beac
Othe
Shor
SAV
Sanc
Mor
Phot
Wai)
A bL
rm(s)
head/
II
-AIL
r pier(s)_
length
_C _1CN
V
I cl� I
number
Riprap length
avg distance offshore
max distance offshore
,channel
7—
N,
N_
cubic yards
ramp
house/ Boatlift
------
h Bulldozing
r
L I —
AJ
Act
Q4 V. 1),
aline Length --I
no
not sure yes n
es 0
nags: not sure yes no i
es no es n s
torium: n/a yes n
:)S: yes n
L4
er Attached: yes no L
ilding nermit may be renuired bv:
7_
L
_4#L
K nol
I
Skr�pt�
F-1
See
note
on back regarding
River Basin rules.
Al � _e� —
Notes/ Special Conditions i fO
Agent or Applicant -Printed" N:fme
S* at e *,,*Please read compliance statement on back of P'gKmit**
Application Fee(s) Check #
(0
Issuing E irat D
Local Planning Juriscliction 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/ 1-888ARCOAST
Location:
Fax: [phone]
2728 Capital Blvd.
(Serves: Carteret, Craven, Onslow -above
Raleigh, NC 27604
New River Inlet- and Pamlico Counties)
919-733-2293
Fax:[phone]
Elizabeth Citv 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

NCDENR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
Beverly Eaves Perdue, Governor James H. Gregson, Director Dee Freeman, Secretary
Date �Z—.120 ,2CJ/D
- Name of Property Owner Applying for Permit:
Mailing Address:
I certify that I have authorized (agent) 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),Z
This certification is valid thru (date) //
Property Owner Si?,ature Date
400 Commerce Avenue, Morehead City, North Carolina 28557
Phone: [phone] \ FAX: [phone] \ Internet: www.nccoastalmanagement.net
An Equal Opportunity 1 Affirmative Action Employer — 50% Recycled 110% Post Consumer Paper

Apr 21 10 01:20p
1
ADJACENT RT,P.ARTAN PROPERTY OWNFR STAUMENT
I hereby certify that 1 own property ac ftmt to � �1��I� 1��Pr7'�J�f !�z c 's
(Nmne of Ptoperty Owae))
property Iotxted at
toad, etc.)
p.2
i
on in
(Waterbody) ('gown axed/or County) ,/�
A.ppli umt's phone #:1O-- tW Mailing Address; �i
vy
fle has described to me, as shown below, the development ha is proposing at that (ocaton, and, I
have no ob}ectiuw to his proposal.
... ti..---.-..+--------------- —--- --- _—----- ......... Y-------...A_•--__rr___�r+_�..-.-_r-.."n.,.YMww.V _II
DESCRIPTION AND/OR DRAWING OF PROPOSED WEV ELOPMNT.,
(TO be fel"in by property 0wirer proporfng d¢vdopr)tent)
or
!./� �I
..__.----------- .....................- --- - (information for Property Owner Applying (RipANaa Property Owner InformAdon)
for Permit)
1�24 Lr-
alal x V
Mailing Address Signature
11711,11
City/5t eTzip Tint or Type Noma
Telephon
�a oz�✓D
r atUtre V Data
919-,36 - 2 ? s' G /� t"z „7w ?- 5qf-
`l'elephone Number
y T���n10
Date

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
LG�
I hereby certify that I own property, adjacent to � izzef JJ� /p�aZ-611-1�,S 's
nn (Name of Property Owner)
property located at��
(Lot, Block, Road, etc.) /
on�i�nlDh lj2 �� , in l/�!�1�Q �/ �%b�-� T , N.C.
(Waterbody) (Town and/or County) Applicant's phone#: 9/9- e122-ZLF Mailing Address: 4i'IZ/ayf-ex/
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)
4�e4 45xj �� �,
(Information for Property Owner Applying
for Permit)
/,? /
Mailing Address Q
City/St e/Zip
Teleph ne Number
///� �-X/ Z-1-
ignature Date
(Riparian Property Owner Information)
Signature
Print or Type Name
gig- � 71- r -?6 /
Telephone Number
Date

NC Division of Coastal Mgt. Habitat Impact Computer Sheet
Applicant! F obuck Properties, LLC
Date: April 28, 2010
General Permit #: 55341 C
Describe below the HABITAT disturbances for the application. All values should match the name, and units of measurement
found in your Habitat code sheet.
TOTAL Sq. Ft.
FINAL Sq. Ft.
TOTAL Feet
FINAL Feet
(Applied for.
(Anticipated final
(Applied for.
(Anticipated final
DISTURB TYPE
Disturbance total
disturbance.
Disturbance
disturbance.
Habitat Name
Choose One
includes any
Excludes any
total includes
Excludes any
anticipated
restoration
any anticipated
restoration and/or
restoration or
and/or temp
restoration or
temp impact
temp impacts)
impact amount
temp impacts
amount
SB
Dredge 0 Fill ❑ Both ❑ Other ❑
300
300
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 ❑
252-808-2808 :: 1-888-4RCOAST :: www.nccoastaimanagement.net revised.02/03/10

PAY_
TO
THE
ORDER
OF
ROBUCK HOMES TRIANGLE, LLC
P.O. BOX 17102
RALEIGH, NG 27619
[phone]
3148
"NO WAI-O 66-112-531
RTH�LI"NA
0
PATE
TE8
DOLLARS $ 2CC). '
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II■ i:05310 L L 2 L1:0005 19745806411