55033_ROSS, TIM_20100225

L:1 CAMA El DREDG-A PILL
GENERAL PERMIT �drrevious permit #
L LI ]New ❑Moctification DComplete Reissue ElPartiall Reissue .'e 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
P Rules attached.
Applicant Name
Address
City
-it
State J,.j ZIP
Phone #( ti
Fax#
Authorized Agent
Affected D CW
El EW
El PTA )DES EJ PTS
AEC(s): i OEA
El HHF
El IH E1\Ul3A El N/A
El PWS:
0 FC:
ORW: yes / no
PNA
yes / no Crit.Hab. yes no
Project Location: County_
Street Address/ State Road/ Lot #(s)
Subdivision
City ZIP
Phone# '�-; (.-,:k k—,
River Basin
Adj. Wtr. Body (nat Jman unkn
Closest Maj. Wtr. Body
M Type of Project/ Activity ill P
(Scale:
Pier (dock) length__ LA 1
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
Shoreline Length
SAV: not sure yes no
Sandbags: not sure yes no
Moratorium: n/a yes no
Photos: yes no
Waiver Attached: yes 'no
A building permit may be required by:
Notes/ Special Conditions
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on back regarding River Basin rules.
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See note
Agent or Applicant Printed Name
Signature ** Please read compliance statement on back of permit ** -
Permit Officer's Signature
Issuing Date lExpPration ,ate
Application Fee(s)
Check #
Local Planning Jurisdiction Rover File Name

w
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
❑ Neuse River Basin Buffer Rules
❑ Other:
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.
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

1IM ROSS PAGE 01
&A
N DC ENR
North Carolina Department of Environment and Natural Resources
D141on of Coastal Management
Beverly Eavee Perdue, Governor Jame" H. Grsgson, Dbocw Dee Freeman, Seoretary
Date _ -�lr k7ifD
Name of Property Owner Applying for Permit:
T1/4iofhY 4, o�uT4 Ar'r, .easc
Mailing Address:
�a • � y7Gt7
I certify that I have authorized (agent) G R %$ rA O z/ L i ex S to act an my
behalf, for the purpose of applying for and obtaining all LAMA Permits necessary to
Install or construct (activity)
at (my property located at) A2 LJ S 7— ro v gr
This certification is valid thru (date)
Owner signature
VA
Date
400 Commerce Avenue, Morehead City, North Caroline 28557
Phone: 252.80&28081 FAX; 252-247-33301 Internet: www.ncooeatalmanagement.not
An Equal Oppodluniyy 1 Afmna ve Acton Emplger - W% Regcled 110% Poet Corwureer Paper

UZI IW 4U.LU C11: 00 zoZZ4(4doo i111 NA(at 02
XDJACENT RIPARIAN PROPERTY OWNER STA.TIIJI!UIN'T
1 hereby certify that I own property adjacent to - -- —r _ 1$
(Ntttnr of PropeM Owner)
projxtty located at4.—A J f.. r?t,..s
(Let, Dlocle, Road, etc.)
(M'aterbody) (Town endlor County) ----
.Applicant's phow #:-Lt I '.Yk$ lMalling Addrets:" • ' 0X
& AIC,
He has described to me. as shmm below, the development he is proposing at that loc2tic�rand. I
have no obieetions to iris proposal,
[ E'LRCRWTION AND/OR. DRAWING OF PROPOSED DE ELOYWNT:
` (To befiled in by property owner proposing de► a pment)
SA
ti
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to
vn owl S tV 0. C 4
(Information for Property Owner Applying (Riparian
snPropc nee Jnfurrastion)
fur Permit I
L' 0 - Lf7` 0 _Y
Mailing Address —
City"-tate/Zip
Telephone Number
0
Sign Date
G� CL4a
j+rn 90. s
Signature
Print or "ape }Name
7g7-+t, >5,'� >
Telephone Nuinher

u,rtu, i7- LVIU•= I:Dorwnzsz)v-j15v UUIVI No. 875) 'P, ueiee
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certlfy that I own property adjacent to s
awe of Property Owner)
property located atourd -
(Lot, Block, Road, etc,)
on C�AG�(Wter�body)
, in �' n G kin v I 1 S or r �_ , N.C.
J (Town and/or County)
Applicant's phone #: q! q 991IMalling Address; P- 0. BOX 4760
Cha'w/ NG 75/5
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 he filed in by properly owner proposing development)
H
p p Lk-
C
(Information for Property Owner Applying
for Permit)
P.O. &L L17 (a ---
Mailing Address
GA"el f�'/�• /NC a 7545
city/State/zip
914-9&8'r 9gl'7
Telephone Number
41140
Sign re Date
-�r-
J0m
(Riparian Property Owner Information)
Signature
A
Print or Type Name
2 2- 3 S-5 - 3 C (v �--
Telephone Number
z1 1 `�- /0
Date

ConnectGIS
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http://carteret.connectgis.com/Default/Default.aspx 2/24/2010

ConnectGIS Page 1 of 1
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Operating -NSB
McGinnis Point
P.O. Box 4455
Emerald Isle, NC 28594
252-354-6333
North State Bank
Raleiqh, NC 27609
PAY ****TWO HUNDRED DOLLARS AND 00/100 ***********
DATE AMOUNT
2/19/2010 $200.00
TO THE ORDER OF
NCDENR
1617 Mail Service Center
Raleigh, NC 27699-1617
General Permit
0001D29,10 g0S31123561: 120S&?D711'
1029
A.

7
Describe Belo v the 'HABITAT disturbances nor the application. All /aluas should match ?he name, and units of measursmert
round in your Habitat code sheet.
Habitat Name
DISTURS TYPE
Choose One
TOTAL Sq. Ft.
(Applied for.
Disturbance Total
includes any
anticipated
restoration or
temp impacts)
FINAL Sq. Ft.
(Anticipated final
disturbance.
Excludes any
restoration
and/or temp
im act amount)
TOTAL ;Feet
(Applied for.
Disturbance
total includes
any anticipated
restoration or
temp impacts)
FINAL Feet
(Anticipated final
disturbance.
Excludes any
restoration and/or
temp impact
amount)
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Dredge ❑ Fill ❑ Both ❑ Other ❑
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Dredge ❑ Fill ❑ Both ❑ Other ❑
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