53087_TALTON, JIM_20090309

❑CAIVIA DREDGE & FILL
GF�ENERAL PERMIT W�TPrevious permit #
11 New ElModification LJComplete Reissue El Partial Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environment and Natural Resourc)
and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC
E:1 Rules attached.
Applicant Name J Project Location: County
Address
City_
State ZIP
Phone #
Fax #
Authorized Agent
[71 CW
El EW 0 PTA ES El PTS
Affected
AEC(s): 0 OEA
El HHIF El 1H I—_ U BA El N/A
E PWS:
El FC:
ORW: yes / no
PNA yes / no Crit.Hab. yes no
Street Address/ State Road/ Lot #(s)
Subdivision
City j ZIP
Phone# I&L—tver Basin
Adj. Wtr. Body--_ (nat anjunkn)
Closest Maj. Wtr. Body
Type of Project/ Activity
(Scale:
Pier (dock) length
Platform(s)___. 77)
Finger pier(s)
Groin length
_4 NUI
number
Bulkhead/ Riprap length
avg distance offshore
max distance offshore
T_ Basin, channel k %T -
—Tj A 1
k A, 1 1
cubic yards
Boat ramp T
Boathouse/ Boatlift
Beach Bulldozing
Other
7
Shoreline Length
SAV: not sure yes no
Sandbags: not sure yes no
Moratorium: n/a yes n
0 Photos: yes no
Waiver Attached: yes no
A building permit may be required by: See note
Notes/ Special Conditions
River Basin rules.
on back regarding
n—
AM101pplicant Printed Name;
f
Signature "Please read compliance statement on back of permit"
Application Fee(s) Check #
77
PermitOfficer's Signature
Issuing Date Expiration Date /-
Local Planning 16piscirction Rov 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, certifythatthis 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 Citv 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

Amr7A
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
Name of Property Owner Applying for Permit:
{
Mailing Address:
j �►-� (L�;�-�.� (tea
I certify that I have authorized (agent) ��� to act on my
behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to
install or construct (activity)
at (my property located at)
2 10
This certification is valid thru (date)
erty Owner Signature
Date
400 Commerce Avenue, Morehead City, North Carolina 28557
Phone: [phone] FAX: [phone] Internet: www.nccoastaimanagement.net
An Equal Opportunity 1 Affirmative Action Employer — 50% Recycled l 10% Post Consumer Paper

MAP-2-2Oa9 1P:51P FROM:
03/02/2009
08:29 2527266079
CEANHARNEE
TO:12527266079
P. 1 ,
WAUL 01
AD4TACENT RYPARI.AN PROPERTY OWNER STATEMENT
(FOR A PIERMOOJWG PLEJNG"OATUFT.BOATHOUSE)
I hereby certify
that I own Property a4jacem to �
(Ntme of Property Own*r)
(LA $leek, Read, eft.)
on
f (Watcrbody) (Town asdlor County)
LDe has desctibod to me, as shown below, the development he is proposing at that location,
and, I 1 ptY4 no obj,ecdons to his ptvposW, I understand that a pier/mooring pilings/boatlift/baat6ousc
must Gb set hack a minimum distance of flftem feet (15) from my area of riparian access unless
waive j by me.
I do not wish to waive the setback requirement.
I 2g wish to waive that setback requirement.
f
I DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be Jilted in by IndWa vi proposing dne►lapww-it)
20 -r rn-t A 20 -f 2'�v �, x i o
Lord D 't?''111� Q
41"
(AppI"at Inforraxtioa) (Pi Pro er Ia
HaUi>g
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CYlyeSt Print or Type Naafw
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Tokepha mmbea Telephone Nwwber
2. -5S 09 c3. of c9

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/MOORING PILINGSBOATLIFTBOATHOUSE)
I hereby certify that I own property adjacent to 's
property located at
21on
(Lot, Block, Road, etc.)
(Name of Property Owner)
on in CQ.P��- h� , N.C.
(Waterbody) (Town 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.
I do not wish to waive the setback requirement.
I do wish to waive that setback requirement.
--------------------------------------------------------------------------------------------------
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
70�
�of6 D 2 S Q d L4O c.., "}ALL.
-Dc> c )�-
(Applicant Information)
Mailing Address
City/State/kip
22-3 t4 $
Telephone Number
2 2 S. o 9
Date
(Riparian Property Owner Information)
Signature
Print or Type Name
Telephone Number
2 25 6�
Date

MUD BUCKET DREDGING, INC. 3658
PH.252-241-1504 66-112/531
507 HEDRICK BLVD.
MOREHEAD CITY, NC 28557 q
DATE � • � � O /
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TO THE }s :7-6 Q,'
ORDER OF
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