55352_TOM THUMB SEAFOOD, INC. & CAROON, M.N._20100518

❑CAMA / ❑ DREDGE & FILL 4 _ _ /) )AK 155152 C
IVERAL PERMIT V-11 Previous permit #
dtNew ❑Modification ❑Complete Reissue ❑Partial Reissue 6 Date previous permit issued
As authorized by the State of North Carolina, Department of Environment and Natural Resources —7
and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC '
r ' _ _ sla f;` ❑ Rules attached.
Applicant Name n i ol lei' e- , --d-41 _ • Project Location: County
Address �l ! (Q� Qr Street Address/ State Road/ Lot #(s)
City 'f t (} {1�,y I State.�� ZIP!?
Phone # ( �'�t�?-' (35Y7 Fax # (�� Subdivision
Authorized Agent
(A 0
City
ZIP
�
ElCW
❑ EW
,kPTA El ES ElPTS
Phone # (_ )
River Basin !6' usi'�
Affected ❑ OEA
AEC(s):
❑ HHF
❑ IH ❑ UBA ❑ N/A
,f „ ,#�
Adj. Wtr. Body �) fi. t_:�,
/
( L - _ dria /man /unkn)
❑ PWS:
❑ FC:
ORW: yes / no
PNA
yes /. no,.-, Crit.Hab. yes / no
Closest Maj. Wtr. Body
Type of Project/ Activi?i fC'.(1(t` �4 �C'/ +^•} 1P�� "{f:
r
Pier (dock) length
Platform(s)
Finger pier(s)
Groin length — -'
number
Bulkhead/ Riprap length
avg distance offshore
II
max distance offshore —_
�X' r
Basin, channeJI ; t —
cubic yards
Boat ramp
;I
Boathouse/ Boatlift I i
Beach Bulldozing
Other
Shoreline Length
SAV: not sure yes no -__—
Sandbags: not sure yes
Moratorium: n/a yes
Photos: yes qn
Waiver Attached: yes
A building permit may be required by:
Notes/ Special Conditions
Agent or Applicant Printed Name P er 0
(Scale: ��'% �00 )
Cc- n a �-'�--
��r r6q
See note on back regarding River Basin rules.
Signature ** Please read compliance statement on back of permit Issuing Datd r Expiration Date
. "A -
ApplicationFee(s) Check# Local Planning Jurisdiction 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, 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 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

To:
From:
Re: Authorization Letter
I uthorize
e,0 to act as my agent for the sole purpose of
obtaining/signii g permits to perform work at
Sincerely,
Signature's
Print Name/-/,,4

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/MOORING PILINGSIBOATLIFTIBOATHOUSE)
I hereby certify that I own property adjacent to 1p\6 -( n's
(Name of Prop rertty Owner)
property located at
(Lot, Block, P.,oad, etc.)
on ��'��-��� , in AN.C.
(Waterbody) (town' and/ r County)
Applicant's phone #: �.5`a' S �'Mailing Address:
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 i dividual proposing development)
�cor�
-------------- ---- ---------------------------------------
(Information for Property Owner Applying (Riparian Property Owner Information)
fnr Permitl
Telephone Number
Signature
Date
Signature
Print or Type Name
Telephone Number
Date

+�� i xi' Axau IY1. LxiL — K i UkCN RECEY ' REQUESTED
DIVISION OF COASTAL - I_4N AGED ENI
ADJACENT RIPARI.A- PROPERTY aVy:�IR \GTIFICATION-n AIiTER
FORM
Name of individual aPpl.vinb for permit:
Address of r0 ert
• . (:at or street 11, sttt:et or Gad)
(City & CODUW)
I hereby certify that I own property adjacent to the above refemaced pkoperty. The
individual applying for this permit has described to me (as shown on the attached
drawing) the development they are proposing. A description or drawing, with
dimensions, should be provided with this letter.
I have no Objections to this proposal.
If you have Objections to what is being,propose4 please write the Division of Coastal
Management, 400 Commerce Ave., Morehead Cih', NC 28557 or Gall [phone]
within'10 days of receipt of this notice. No response is considered the same as no
objection if you have been notified by Certified Uad.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boathouse, iift or sandbags
must be set back a Minimum distance of 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.)
signature
- I do Wish to waive the 15' setback requa rement.
- I do nai wish to waive the 15, setback requircment.
5"1C-10
Date
,J /° t� Ly
'tint Nam
Telephone Number ;Vita .1.:ttst Cndt

.a &A' iL' " jr'Lz3"— % + A UM-4 AZL25i .,a JL J'(hV V Jt�►J,� a Jam/
DIVISION OF COASTAL NUM AGENM-NI
ADJACENT RIPA:EtIA.N PROPERTY a'4i+ti,ER NOTIFICATIONlWAAIR
FORT!
Name of individual applying for permit:
Address of property:_ bnb���
ti
(!ot or utxt q, strut or road)
(City k County)
I hereby certify that I own property adjacent to the above referenced prroperty. The
individual applying for tYtis permit has described to me (as shown on the attached
drawing) the development they are proposing. A description or drawing, with
dimensions, should be. provided with this letter.
I have no objections to this prgposal.
If yvu have objections to what is being proposed; please write the Division of Coastal
Management, Opp Commerce Ave., Morehead City, NC 28557 or call (25.2) 808-2848
within IU days of receipt of this notice. No response is considered the same as no
objection V you have been noticed by Certified Mail.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boathouse, lift or sandbags
must be set back a minimum distance of 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)
T do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
Teephou Number WI�Area Code ^
t 0rt"!,Nl an;.if rr44Ir11 rt•-.4ri
r t~c
TO �Jt�d NOOJdO 7 VGNI-1 808TGVZZSZ TE :E0 000Z/TE/50

- - Usecu i.ry nlia--ed do cum e mt. -Se e ba ckfor _dc.t a-;Is:p
TOM THUMB SEAFOOD INC. 12530
'
609 NORTH ST. .'titi ,i ;�,• , .
ORIENTAL, NC 28571
J 66-30/531
L / ��fp 472'
DATE 7�i�
11 PAY
THE ORDER
ORDER O� �
DOLLARS 8
0
�.
FIRST CITIZENS 47Y
D /� l*illI OriaMal zans Bank &Trust Comparry
jjru �i� OriarHal N.C.
4✓)
�
www.firstcitizens.com
stcittcitizens.com V
�1'3
-
ii'0 L 2 5 30i1' L003 00�:0�4 ?l 2000 28 20

NC Division of Coastal Mgt. Habig.:..;
Applicant: Tom Thumb Seafood, Inc. c/o M. N. Caroon
Date: May 18, 2010
General Permit #: 55352C
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 ❑
9,236
9,236
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
252-808-2808 :: 1-888-4RCOAST :: www.necoastalmanagement.net revised:02/03/10