54393_SCOTTI, RON_20090922

CAMA El DREDGE & FILL /)q
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�~m��^���~ PERMIT m �_ Previous permit#
iJNew LJMudi8otion LJ[omp|eteRei,,ua 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
`
Applicant Name_i__L,
Address LJ
City Wt�­O State ZIP 71/
OCW Oew El PTA Oea U�S
Affected�
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Project Location: County
Street Address/ State Road/ Lot #(s)
\ ,
Subdivision /\ -
Ci ZIP
Phone# River Basin
Adj. Wtr. Body
Closest Maj. Wtr. Body Ve
Issuingbate Expiration Date
\J e
Agent or Applicant Printed�n/
Signature Pleaie reA comp'liance statement on back of permit
ApplicxmmpeeW check#
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Agent or Applicant Printed�n/
Signature Pleaie reA comp'liance statement on back of permit
ApplicxmmpeeW check#
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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 ])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, certifythat 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 complywith 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/ 1-888-4RCOAST
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

APD-5AA
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NCDENR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
Michael F. Easley, Governor James H. Gregson, Director William G. Ross Jr., Secretary
Date 8 Z5 / 0
Applicant Name Qoy\ ✓Co l
Mailing Address 3 U 5 pev\�V\ S J � C�\ �) V-:
O'r, ev\ �,A . N C, 19 571
I certify that I have authorized (agent) /' 1�J'\v\'e to act on my
behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to
install or construct (activity) WcA\-v�3 YveSe-cJAAvov. \Vil\\
at (location)
This certification is valid thru (date)
Signature�'4�
400 Commerce Avenue, Morehead City, North Carolina 28557
Phone: [phone] \ FAX: [phone] \ Internet: www.nccoastalmanagement.net
An Equal Opportunity \ Affirmative Action Employer— 50% Recycled \ 10% Post Consumer Paper

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent toi PA-Ilb d4,&#AflVt1 SC0 +,'s
(Name of Property Owner)
property located at 3 1l s' YC= A11 `, Sy Z/;' D4jyL"r '
(Lot, Block, Road, etc.)
on 0 2 Ch �� /� �/� L L/<, , in �/Z!L—��'L , N.C.
(Waterbody) (Town and/or County)
Applicant's phone #•(9O r) C3 Y �c' c1 Mailing Address: �• !� �' 7� _
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:
_1To_befilled in by property owner proposing development)
Existing
Dock
Grassy
Bank
Sand
12 Feet
Property
(Information for Property Owner Applying
for Permit)
? 0. Lox 7 s
Mailing Address
City/State/Zip
Telephone Number
Lz ---cI6 L&�;- —
Signature Date
� Proposed RipRap
Embankment; football
size stone type B
d
a+
w
(Riparian Property Owner Information)
Signature
Print or Type Name
�'z z
Telephone Number
Date

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to.LPAib d-S1 4RO-. f(: ° I . 's
(Name of Property Owner)
property located at � � `S
(Lot, Block, Road, etc.)
on ®%Z h 4mjo 1.1eg- k , in (f-)2I L-ti fl- t , N.C.
(Waterbody) (Town and/or County)
Applicant's phone #: ��© S3 �(--'c 37Mailing Address: F 0- H ax 7 SY
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 bead in by Property owner proposing development)
Existing
12 Feet
Dock
10, Proposed RipRap
Property Embankment; football
size stone type B
Grassy
Sand emban_ nt
Bank
(Information for Property Owner Applying
for Permit)
R 0, l3 ox 7,§ 8'
Mailing Address
N Q -2
City/State/Zip
.'3 3 5
Telephone Number
Signature Date
71r Information)
C'
Signature
Print or Type Name
Telephone Number
Date

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