55334_SIDES, BRUNER_20100415

El CAMA / 0 DREDGE & FILL
GENERAL PERMIT Previous permit #
EINew ElModification EICOMD[ete Reissue L:]Partia*essue Date DreviOUS Dermit 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
E3,Rules attached.
Applicant Name i Project Location: County_
e7
Address Street Address/ State Road/ Lot #(s) CA (A �e_ 0ee t,
City Stateft." ZIP
Phone #( _Fax #
Authorized Agent C-'/)-/
Affected El CW E EW EJ PTA El ES D PTS
AEC(s): Ll OEA D HHF [-] 1H Ll UBA El N/A
D Pws: EJ FC:
ORW: yes / no PNA yes / no Crit.Hab. yes / no
Subdivision 'ck V
City I. C ZIP
" i '
Phone # River Basin 'VI -44�� C
Adj. Wtr. Body (natJman unkn)
Closest Maj. Wtr. Body
I -
Type of Project/ Activity i--
rt^/
.-
T1
/-'
V
(Scale:
/
Pier (dock) length
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 11
Shoreline Length
SAV: not sureyes 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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rules.
4'
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on back
regarding
River
Basin
❑See note
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Agent or Applicant Printed Name 7
Pe 'to ATIgntture
/
Signature Please read compliance statement on back of permit lsspingDate Explr4tion D t
L-4
77
Application Fee(s) Check # Local Planninijurisdiction 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
landowners).
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 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 North Carolina Department of Environment and Natural Resources
Division of Coastal Management
Michael F. Easley, Governor Charles S. Jones, Director William G. Ross Jr., Secretary
Applicant Name
Mailing Address
I certify that I have authorized (agent) ' C -B to act on my
behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to
install or construct (activity)
at (location)
This certific'on is vapid thru (date)
Signature
i" \
400 Commerce Avenue, Morehead City, North Carolina 28557
Phone; 252-808-2808 \ FAX: [phone] \ Internet: www.nrcoastalmanagement.net
An Equal Opportunity \ Affirmative Action Employer — 50% Recycled \ 10% Post consumer Paper

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIERIMOORING PILINGSBOATLIFTBOATHOUSE)
I hereby certify that I own property adjacent to L 1- U` ir1 e-r Si d f� 's
(Name of Property Owner)
property located at
(Lot, B1oclWRoad, etc.)
on T-C W , in �� o DdRc.
(Waterbody) (Town and/or Cohn )
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)
k Lk'
Signature
•TN,4 L L �
Print or Type Name
252-3q3-6062_
Telephone Number
Date: 2 3 4 a 0/ v

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/MOORING PILINGSBOATLIFTBOATHOUSE)
I hereby certify that I own property adjacent to '6f wnec
(Name of Property Owner)
property located at
(Lot, Block, goad, etc.)
on �— �� , in e. LA-) ov- 0 C" y' �e-r-2 , N.C.
(Waterbody) own and/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.
DESCRII'TION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
G'1
Date:
Signature
Print or Type Name
Telephone Number

NC Division of Coastai Mg. Habitat Impact Computer Sheet
Applicant: Bruner Sides
Date: April 15, 2010
General Permit #: 55334C
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
OW
Dredge ❑ Fill ❑ Both ❑ Other ❑x
316
316
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 ❑
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4
DENNIS & SONS MARINE CONSTRUCTION, LLC
109 SEAHORSE DRIVE
INBEAUFORT, NC 28516
OFFICE: 252-504-6329
PAY
TO THE
ORDER OF
BB&T-BRANCH BANKING & TRUST COMPANY
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1-112/531 1556
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AUTHORIZED SIGNA UFE
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