53394_ROSE, BERT_20090401

77D"CAMAl ❑DREDGE & FILL
GENERAL PERMIT
Previous permit#
1JNew []Modification EComplete Reissue ❑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
i<Rules attached.
' Applicant Name_ � , �'�� ''
Project Location:
County „ c ,
Address" r`1 1 , ,_�. ' t i'�
Street Address/ State
Road/ Lot #(s)
j
City 3 State tq' n ZIP
Phone # () ,-- lfi Fax # ( _�� --- _
Subdivision
%
_- ..
_f
i r
ZIP
- si
Authorized Agent
y
0 CW ElEW ❑ PTA ElES ❑ PTS
Phone # ( )
River Basin
Affected
ElOEA HHF ❑ IH ❑ UBA El
❑AEC(s):
Adj. Wtr. Body
r i
- � ,- •' `
<i t:? . a.F y t z.:: y,
_
�nati/man /unkn)
Closest Maj. Wtr.
+
Body h`
1
ORW: yes / no PNA yes / no Crit.Hab. yes / no
Type of Project/ Activity
Pier (dock) length
yy
Platform(s)
Finger pier(s)
Groin length
number
Bulkhead/ Riprap length
avg distance offshore
max distance offshore
Basin, channel
cubic yards_
Boat ramp
Boathouse/ Boatlift%
Beach Bulldozing
Other
(Scale: 0 /)t )
i I
- F
i i i y•'
i
Shoreline Length
,1
SAV: not sure- yes no
Sandbags: not sure yes no r �`
Moratorium: n/a yes no i
Photos: yes +''no
Waiver Attached: yes no
A building permit may be required by:
Notes/ Special Conditions /i .] f s
Agent orApan rint Name /
Signature Please readcompliance ststatement onback ofpern�
Application Fee(s) Check#
r^ - -
i
See note on back regarding River Basin,rules.
Per ��tafficer' Signature r
F
Issu' Dat Expiration 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:
❑ 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 252-808-28L8/ 1-888ARCOAST
Location: Fax: [phone]
2728 Capital Blvd.
Raleigh, NC 27604
919-733-2293
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

1
MONITORING & COMPLETION REPORT
[CAMA Major Development & State Dredge & Fill Permits]
PERMITTEE'S NAME: ��� �l �US� PERMIT # �� 3
FIELD REP. � Gael
LOCATION: �Ar�
-� �1;fIC, � _
MONITORED BY
PHONE: 7g5l- IFJo)- DATE REPORTEDLY COMPLETE: `—
DATE OF INSPECTION d
1) Do themeasured dimensions of the development differ from those indicated in the permit and workplat?
YE O circle one]. AA i
COMMENT: C�•
2) SEDIMENTATION & EROSION CONTROL: Has Permittee seeded, grassed, or otherwise stabilized all
disturbed areas? YE [circl ne]
COMMENT:
3) FUTURE MO RING & ENFORCEMENT ACTION: Is further investigation or enforcement action
needed? YE NO circle one].
COMMENT:
-� ��S

0=l'29/ 2 A 0 9 2 31 : Cl6 2524448 88 BERTPOSE PAGE 01
08/14/2006 15:64 2527264092 INTRACOASTALMARINECO PAGE 01/02
North Carolina Department of env roam int and Natural Resources
Division of Coil Marhagement
M ichaef F. Lasky. GO,reM& Charles S. Jones, Rinectar vvllbm G. Ross Jr., SemMEq
Y I Fa�
Date �?
APR 1 2009
ling Add" ;
c
X certi (y that I have authorked (agmt) V` to as oa my
bebmif, for the purpose of applying for and obtaining 0 CAMA Permits necessary to
install or construct (activity)
at (location)
Tilis eerti£cation,}avalid
Signature
(d2te)
400 Commerce Avenue, Morehead City, Nort CaroMa 28557
Phone: 252-808.'2808l FAX, 252-247-3301 Intemet www.nemastaimanagwent.Wt
An Equal oppoMpf fr 1 AfiielOm Action em"r— m% %i cw \ l c % past Consumer Psr

Adjacent Riparian Property Owner Statement
(FOR A PIER/MOORING PILINGS/BOATLIVU BOATHOUSE)
I hereby certify that I own property adjacent to C V- 's
Nam f y (;
property located at
j b
Lot, block, toga, etc.Con lylyfoc)� C (fit ,in ,NC
wawbody Town an Vor county
He has described to me, as shown below, the development he is props ;ing at that location and I have
no obiections to his proposal.
I do not wish to waive the setback requirement.
_-LZ I do wish to waive the setback requirement__
APR � 2009
Description and/or Drawing of Proposed Development
(To be filled in by the individual proposing veto ent)
DT � (
iV2
,,1"
U I M
T3, , .S h 0 h f F i` p
Signature J
tTor type name ^— I
��-! 7;) 3
Telephone number
Date
-read City CCM

Adjacent Riparian Property Owne • Statement
(FOR A PIER/MOORING PILINGS/BOATLIFTI 10ANHOUSE)
I hereby certify that I own property adjacent to.
property located at
Lot, Mock, ro4 etc.
Oft ct in & NC
b- it C,�� U C
adWbody Town w Ow cauEty
He has described to me, as shown below, the development he is props ;in@ at that location and I have
nc�objections to his proposal-
�\\`� I do not wish to waive the setback requirement.
waive the setback uimawnt '
_ l do wish to way re4 !a P R i 2009
DoseiroomxOtUor Drawieg of Proposed DeveWpnent
(To be filled in by the individual proposing � el
51 MI&M-mm
I�' % s� 0 k e �"Nr--f'
Signature ;;}}
y r'ihLfi �� f W 44
Print or type name
,1,.5-j_� -,-5, L-4-A17
Telephone number
'j
Date
-A City IDCn4

gq':5 �oreIi,u f
106 A. LC� e 5��
Havc/oc
a
APR 2009
,t, acne
31- �/ /0 1

Pay to the
Order ofG
INTRACOASTAL MARINE CONSTRUCTION
1512 SCOTT'S LANDING
MOREHEAD CITY, NC 28557
BRANCH BANKING AND TRUST COMPANY
1-800-BANK BBT BST.COM
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Date / ( — 0
FOR
IL'0000 2 1 23LI■ 1:053 1011 211:0005 198349943LL'
2123
66-112/531
seas„„
� Deleil[ on
Back.

This Buffer Authorization is not considered approved until the DWQ has received both
this signed form AND the project map.
Submit the requested information to:
Division of Water Quality
Attn: Surface Water/Buffer Program
943 Washington Square Mail
Washington, NC 27889
By your signature below you agree to be held responsible for meeting ALL of the above listed
conditions and verify that all information is complete and accurate. Please be aware, violations
of the above -listed conditions are subject to civil penalty assessment of up to twenty-five
thousand dollars ($25,000.00) per violation per day.
Applicant/Agent's Signature
CAMA General Permit Number:
North Carolina Division of Water Quality
943 Washington Square Mall
Washington, NC 27889
✓�33q�C
Internet: www ncwatergualitv.org
Phone: [phone]
FAX [phone]
An Equal Opportunity/Affirmative Action Employer — 50% Recycled/10% Post Consumer Paper
Date
NorthCarolina
,Vaturallry

North Carolina Department of Environment and Natural Resources
Coieen H. Sullins, Director
Chuck Wakild, Deputy Director
BUFFER AUTHORIZATION CERTIFICATE FOR PIER ACCESS
A riparian buffer authorization is regUired for an approved access way through the Tar -Pamlico
& Neuse River Riparian buffer per Division of Water Quality (DWQ) regulations 15A NCAC
02B.0233 & .0259.
Activities covered by your Coastal Area Management Act (CAMA) permit are deemed to have
a Buffer Authorization from the DWQ as long as the project can meet ALL of the conditions
listed below. If ALL of the avoidance and minimization guidelines listed below cannot be met, a
separate buffer authorization request must be submitted using a Pre -Construction Notification
(PCN) application to DWQ at the address below.
A PCN application may be obtained on the DWQ site http://h2o.enr.state.nc,us/wetlands.htm1.
Any questions regarding this process should be directed to the wetland/buffer staff of the DWQ
in the Washington Regional Office at 252-946-6481, or the 401 Oversight Unit in the Raleigh
Central Office at 919-733-6893.
A written authorization from DWQ MUST be received prior to any construction activities in the
riparian buffer, including land clearing. Failure to secure a Buffer Authorization prior to
construction &/or land clearing shall subject the property owner & the party (contractor)
performing the construction &/or land clearing to a civil penalty of up to $25,000 per day per
violation.
❑ Pier access must cross the riparian buffer perpendicularly (which is defined as between
75 and 105 degrees). The alignment should also be located to minimize the removal of
woody vegetation to the greatest extent practicable.
❑ Walkway/access shall be made of pervious materials like open -slatted wood, mulch, or
grass. The use of impervious materials like concrete, pavers, or gravel will require a
PCN review and a separate Buffer Authorization. A request for an impervious walkway
shall include a justification of need.
❑ The width of the access is limited to six (6) feet or less. A width of greater than 6 feet
wide shall require a PCN review and a separate Buffer Authorization. A request for an
access greater than 6 feet shall include a justification of need.
❑ Please submit a project map of your property indicating the location of the pier and any
requested walkway/access.
North Carolina Division of Water Quality Internet: www ncwatergualitv.org One
943 Washington Square Mall Phone: [phone] NorthCarolina
Washington, NC 27889 FAX [phone] Naturallff
An Equal Opportunity/Affirmative Action Employer- 50% Recycled/10% Post Consumer Paper