52666_SALOUN, ARIADNE_20090108

❑CAMA / I� DREDGE & FILL --61 I /54�
• GENERAL PERMIT, Previous permit#
❑,,t4ew ❑Modification CComplete Reissue ❑Paeissuel Date previous permit issued
As,iuthorized 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
-©-Rules attached.
Applicant Name
I_
,'.,; I ; + .
Project Location: County
Address
4`,�r�
_ i i ', ':
Street Address/ State Road/ Lot #(s)_
City
r r
State ZIP
Phone # (i)
Fax # O "
Subdivision
Authorized Agent
City---,--- ZIP
Affected ❑ CW
❑ EW
❑ PTA ❑ ES ❑ PTS
Phone # ( ) River Basin
AEC(s): ❑ OEA
❑ HHF
❑ IH f l UBA ❑ N/A
Adj. Wtr. Body (nat /man /unkn)
❑ PWS:
❑ FC:
ORW: yes / no
PNA
yes / no Crit.Hab. yes / no
Closest Maj. Wtr. Body
Type of Project/ Activity
Pier (dock) length
Platf
Finge
Groin
Bulk
Basin
Boat
Boat
Beac
Othe
Shore
SAV:
Sand
Mora
Phot
Waiv
(Scale: 6'' i t(L � )
orm(s) — — — -- - -- -
it -H
r pier(s) L r---
length
number
head/ Riprap length / r _
avg distance offshore
max distance offshore
channel �I _ I --
cubic yards
ramp --
house/ Boatlift
�.rn
h Bulldozing_t
r �-
-; -
XI
line Length ----------
not sure yes no
G
bags: not sure es no _ - t ^ i
g Y 1
r -;
torium: n/a yes no
os: yes no
i
er Attached: yes no - - ---- - --- - - -
A building permit may be required by:
Notes/ Special Conditions
Agent or Applicant Printed Name
Signature Please read compliance statement on back of permit
Application Fee(s) Check #
See note on back regarding River Basin rules.
PerMitOfficer's Signature
Issuing Date xpiratio Dat
17
Local Planning Jurisdiction //�/ Rover File Name
A building permit may be required by:
Notes/ Special Conditions
Agent or Applicant Printed Name
Signature Please read compliance statement on back of permit
Application Fee(s) Check #
See note on back regarding River Basin rules.
PerMitOfficer's Signature
Issuing Date xpiratio Dat
17
Local Planning Jurisdiction //�/ Rover File Name

It
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:
L 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/ 1-888-4RCOAST
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)
Revised 08/09/06

MONITORING & COMPLETION REPORT
[LAMA Major Development & State Dredge & Fill Permits]
PERMITTEE' S NAME: S"IouaPERMIT # �
LOCATION: 9 p �f�l (� ' �� FIELD REP.
MONITORED BY b
PHONE: �6 liJ -10 DATE REPORTEDLY COMPLETE: DATE OF OF INSPECTION
1) Do th easured dimensions of the development differ from those indicated in the permit and workplat?
YE /NO` circle one].
COMMENT: fio CD
2)
3)
SEDIMENTATION & E OSION CONTROL: Has Permittee seeded, grassed, or otherwise stabilized all
disturbed areas? YES j[circle one]
FUTURE MO ORING & ENFORCEMENT ACTION: Is further investigation or enforcement action
needed? YE,S NO [circle one]_

North Carolina Department of Environment and Natural Resources
F Division of Coastal Management
Michael F. Easley, Governor Charles S. Jones, Director William G. Ross Jr., Secretary
Date 1 C)CMhPY
DEC 2 3 Z008
Applicant Name �� 1 GuairuL %tI-6(Ln
b y�� �S Morehead City. DCM
Mailing Address _ i �1Y11 n 5�
I certify that I have authorized (agent) 'Ali'Alil I 10 I r-R(5 to act on my,
f1A� r,'1 ort5�f�i.Cc ion `C
behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to
install or construct (activity) I LLj 4 Nkl k he(yl
at (location) q y 0 Sort Lcl 111 1 Y� ka hay-4- - / C ::: - 76
This certification is valid thru (date) 3 it
Signature ` � 4aLg-C'?--j
400 Commerce Avenue, Morehead City, North Carolina 28557
Phone: [phone] FAX: [phone] Intemet www.nccoastalmanagement.net
An Equal Opportunity 1 Affirmative Action Employer — 50% Recyded 110% Post Consumer Paper

t—
------------------------------------------------ -----------------------------------
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIERIMOOR17VG PILIIVGSBOATLIFTBOATHOUSE)
I hereby certify that I own property adjacent to LL Q A16ufo 's
(Name of Property OnogolgftTj
property located at 91
on jcW
(Waterbody)
8 Sea,6a;6 r-I' -
(Lot, Block, Road, etc.)
in rk J ehead Q DC
own ah&or County
He has described to me, as shown below, the development he is proposing at that location, and, I
have no objections to his proposal. I understand that a pier/mooring pilings / boatlift / boathouse
must be set back a minimum distance of fifteen feet (15') from my area of riparian access unless
waived by me. (If you wish to waive the setback, you must initial the appropriate blank
below.)
�_ I do not wish to waive
I do wish to waive that setback requirement.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
ln5i-ull 105`
�-
TV IV
MorevIeaca Cmy bcm
rim
Signature
S"'4A) n lz�q M , ou I-( ! �(-
Print or Type Name
Telephone Number
Date:

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIERIMOORIIVG PIL17VGSBOATLIFTBOATHOUSE)
I hereby certify that I own property adjacent to P-6-10aTU a�
(Name of Property
� l
property located at q L OG eCc C'�GLI s�r' (l/� DEC 2 3 2008
(Lot, Block, Road, etc.) Morehead City DCM
on l G V J , in eWD�Cdj4fft.7-) , N.C.
(Waterbody) own an or County)
He has described to me, as shown below, the development he is proposing at that location, and, I
have no objections to his proposal. I understand that a pier/mooring pilings / boatlift / boathouse
must be set back a minimum distance of fifteen feet (15') from my area of riparian access unless
waived by me. (If you wish to waive the setback, you must initial the appropriate blank
below.)
I do not wish to waive
I do wish to waive that setback requirement.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
Install 10s' '� (yam l>1CCf06P-
yaw'
Morehead City UC;M
_ U 6Signature
Q
Print or Ty Name
�1";- 1'�9
/ Telephone Number
Date: / � s Q U (�

DENNIS & SONS MARINE CONSTRUCTION LLC
109 SEAHORSE DRIVE` '
BEAUFORT, NC 28516
OFFICE: 252-504-6329
PAY
TO THE
ORDER OF
JL
1-112/531
1366
DATEqzL-lt '
BB&T-BRANCH BANKING & TRUST COMPANY DOLLARS
Security
cludedfeatures
g� � �elails on back.
MEMO � jjG 0 to IJPXIYL- i-�
4 11�
1: 0 5 3 10 1 1 2 1 1: 0 0 0 5 2 9 4 4 19 AUTHORIZED SIGNATURE — Alp
- -- - - -
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