56327_TEDDER, THOMAS_20100827

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CAMA / ❑ ►' DREDGE & FILL — a_krA j
GENERAL PERMIT Previous permit #
New ❑Modification ❑Complete Reissue ❑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 I SA NCAC
O Rules attached.
Applicant Name i Project Location: County
Address__
City State ZIP
Phone # ( ) Fax # O
Authorized Agent
Affected ❑ CW ❑ EW ❑ PTA ❑ ES ❑ PTS
AEC(s): ❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A
❑ PWS: ❑ FC:
ORW: yes / no PNA yes / no Crit.Hab. yes / no
Street Address/ State Road/ Lot #(s)
Subdivision
City
ZIP
Phone # (`) River Basin
Adj. Wtr. Body (_nat man /unkn)
Closest Maj. Wtr. Body
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Agent or Applicant Printed Name
Signature ** Please read compliance statement on back of permit **
Application Fee(s) Check #
Permit Officer's Signature
Issuing Date r Expiration "Date
�! 1 f
Local Planning) urisdiction 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
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/ 1-888-4RCOAST
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

:�UG.23.2010 3'02PM DUMC IMMUNOLOGY NO.666 P.1/1
NCDEHR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
Beverly Eaves Perdue, Gvvm= James R Grown, Director Dee Fmem n, Secretary
Date P L
Nme of Property Owner Appblng for Perms
e#e
Mailing Address:
LL
I certify that I Gave $uMorized (agent} J `£' � 11��f .�tf'1��' to nct on my
behalf, for the parpose Of applying for and obtaining an CAMA Permits necessary to
install or construct (activity) _()_ ._l�I C' V I _
At (my property located At) < Pit ' �. {
This eertffication is valid thra (date) •.� r 0/ (P
400 Commerce Avenue, Morehead City, North Carorma 28557
Phone: 25$$08.28081 FAX 252-247.M t Internet www.nccoastalmanagement.rW
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ADJACENT RIPARUN PROPERTY OWNER STATEIVl m
I hereby certify that I own ply a&jacw to
�j AM (�I �''�
(Name of Property ()waer)
property located at
Bbx*, Road, etc.)
on IUkJfAi� aU- , is C.L�C : t �/C (� CC% . N.C.
(W y) t (Town or cmaty)
Applicant's phone #:6N' IPg-7 9( Address: )
I;Lam�
He has descnbed to me, as shown below, the development he is proposng at dw location, and, I
have no objectors to his proposal.
w
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Unformation for property Owner Apply 046rim property OwIm � )
for Permit)
Mailing Address
Signature
t,YtyibtaWztp
Telephone Number
Signature Dale
Print or Type Name
Ted Number
Dme
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ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that l own property a*cent to
(Naive of Property Owner)
property located at
BhWk Read, eft.)
on _M /K v Co. . N.C.
(ce' '9) (Tower amwer Ce"ty)
App's pMm
He has descn`bed to me, as shown below, the developmmt he is proposng at that location, and, I
have no objections to his pmposa1.
l `►� 1' iAtli!
- YkS
P,of'� y
(hWormation fur Property Owiw Applying
for Pawk)
Mailing Address
CitY/ip
- Telephone Number
Siguatare Date
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4Vr�
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Signature
Print or Type Name
7 S2 9 o24G�
T Number
Bate
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B PRESCOTT MARINE CONSTRUCTION
PO BOX 874 252-249-0149
ORIENTAL, NC 28571
PAY
TO THE
ORDER OF
2095
DATE LJ 66-30/531
472
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First Citizens
Bank
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ANC Division of Coastal Mgt. Flab,- --.7:
Applicant: Thomas Tedder
Date: August 27, 2010
General Permit #: 56327C
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
HG
Dredge ❑ Fill ❑ Both ® Other ❑
200
40
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑