54104_TOSTO, TOM_20090721

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CAMA / DREDGE & FILL
GENERAL PERMIT
❑New [-]Modification ❑Complete Reissue ❑Partial Reissue
As authorized by the State of North Carolina, Department of Environment and NaturafZources
and the Coastal Resources Commission in an area of environmental concern pursuant to I SA NCAC
Previous permit #
Date previous permit issued
❑ Rules attached.
Applicant Name
Project Location: County
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yes / no
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Agent or Applicant Printed Name
PermitOfficer's Signature
Signature ** Please read compliance statement on back of permit ** Issuing Date
Expiration Date
Rover File Name
Application Fee(s) Check# Local Planning Jurisdiction

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 ❑ Other:
�IQeuse 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

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
Date .Iv 2) 2-C)bg
Applicant Name ''�aPA Tay T �
Mailing Address v2 oZ �7 l G f /Zoy
C- .2- So
I certify that I have authorized (agent)` ; �S giw ne CM to act on my
behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to
install or construct (activity) („k yJ) 'DC�CV— ,
at (location) cR 5 l T`�kn IZOCIA 'R'EQA_�d r�
This certification is valid thru (date) A-uwug—.50 Z6y�
Signature
400 Commerce Avenue, Morehead City, North Carolina 28557
Phone: [phone] FAX: [phone] Internet: www.nccoastaimanagement.net
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ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/MOORING PILINGSIBOATLIFTBOATHOUSE)
I hereby certify that I own property adjacent to :1 ✓ / 0 5%0 is
(Name of Property Owner)
property located at p� J� O S l a �?b�gi Z)
(Lot, Block, Road, etc.)
on in 0EHcJ f-o(Z l 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. (If you wish to waive the setback, you must initial the appropriate blank
below.)
o�
I do not wish to waive
I do wish to waive that setback requirement.
------------------------------------------------------------------------------------------------
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To beflled in by individual proposing development)
Da-K �o Llf- g�,eT
Signature
Print or Type Name
3 � - /. -z-9- 4fS9
Telephone Number
Date: l - �?,o— D e L—_

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/MOORING PILINGSBOATLIFTBOATHOUSE)
I hereby certify that I own property adjacent to TO M To STo is
(Name of Property Owner)
property located at c; !1 -ro s -ra Re-.f D
(Lot, Block, Road, etc.)
on G A J('e1e in S'E'4 (J Fc-.-. R 1 , 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. (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)
)Do -CAI
A&AZ
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c F-I zK
Print or fype Name
Telephone Number
Date: l

DENNIS & SONS MARINE CONSTRUCTION, LLC 1-112/531 1449
109 SEAHORSE DRIVE
BEAUFORT, NC 28516 DATE Z1
OFFICE: 252-504-6329
PAY ` a
TO THE '� ! { �K' sn 'e I 1
ORDER OF
BB&T-BRANCH BANKING & TRUST COMPANY
MEMO��� O `D� - 5Lf/0
11100 L44911' 40531011211:
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Security features
ailed.
2 IDelails on back.
AUTHORIZED 0UR
000 5 2 9 4 1913 7110

North Carolina Department of Environment and Natural Resources
Coieen H. Sullins, Director
Chuck wakild, Deputy Director
BUFFER AUTHORIZATION CERTIFICATE FOR PIER ACCESS
A riparian buffer authorization is regUired for an approved access way through the Tar -Pamlico
& Neuse River Riparian buffer per Division of Water Quality (DWQ) regulations 15A NCAC
02B.0233 & .0259.
Activities covered by your Coastal Area Management Act (LAMA) permit are deemed to have
a Buffer Authorization from the DWQ as long as the project can meet ALL of the conditions
listed below. If ALL of the avoidance and minimization guidelines listed below cannot be met, a
separate buffer authorization request must be submitted using a Pre -Construction Notification
(PCN) application to DWQ at the address below.
A PCN application may be obtained on the DWQ site http://h2o.enr.state.nc.us/wetlands.html,
Any questions regarding this process should be directed to the wetland/buffer staff of the DWQ
in the Washington Regional Office at 252-946-6481, or the 401 Oversight Unit in the Raleigh
Central Office at 919-733-6893.
A written authorization from DWQ MUST be received prior to any construction activities in the
riparian buffer, including land clearing. Failure to secure a Buffer Authorization prior to
construction &/or land clearing shall subject the property owner & the party (contractor)
performing the construction &/or land clearing to a civil penalty of up to $25,000 per day per
violation.
❑ Pier access must cross the riparian buffer perpendicularly (which is defined as between
75 and 105 degrees). The alignment should also be located to minimize the removal of
woody vegetation to the greatest extent practicable.
❑ Walkway/access shall be made of pervious materials like open -slatted wood, mulch, or
grass. The use of impervious materials like concrete, pavers, or gravel will require a
PCN review and a separate Buffer Authorization. A request for an impervious walkway
shall include a justification of need.
❑ The width of the access is limited to six (6) feet or less. A width of greater than 6 feet
wide shall require a PCN review and a separate Buffer Authorization. A request for an
access greater than 6 feet shall include a justification of need.
❑ Please submit a project map of your property indicating the location of the pier and any
requested walkway/access.
North Carolina Division of Water Quality Internet: www.ncwaterquality.org One 1
943 Washington Square Mall Phone: [phone] NorthCarolina
Washington, NC 27889 FAX [phone] Naturalli
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This Suffer Authorization is not considered .approved until the DWQ has received both
this signed form AND the project map.
Submit the requested information to:
Division of Water Quality
Attn: Surface Water/Buffer Program
943 Washington Square Mall
Washington, NC 27889
By your signature below you agree to be held responsible for meeting ALL of the above listed
conditions and verify that all information is complete and accurate. Please be aware, violations
of the above -listed conditions are subject to civil penalty assessment of up to twenty-five
thousand dollars ($25,000.00) per violation per day.
Applicant/Agent's Signature
CAMA General Permit Number:
North Carolina Division of Water Quality
943 Washington Square Mall
Washington, NC 27889
Internet www.ncwatcraualitv.orQ
Phone: [phone]
FAX [phone]
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Date
NorthCaroina
Ndtmrallbl

MONITORING & COMPLETION REPORT
[CAMA Major Development & State Dredge & Fill Permits]
�/
PERMITTEE'S NAME: Q PERMIT #
LOCATION:
FIELD REP. b C
&C, u R MONITORED BY C
zz
PHONE: - (.0 J DATE REPORTEDLY COMPLETE:
DATE OF INSPECTION / O
I[ i
2)
Do nNircle
sured dimensions of the development differ from those indicated in the permit and workplat?
YE one].
SEDIMENTATIO SION CONTROL: Has Permittee seeded, grassed, or otherwise stabilized all
disturbed areas. E [circle one] T
3) FUTURE MONJXORINQ & ENFORCEMENT ACTION: Is further investigation or enforcement action
needed? YES [circle one].
COMMENT: ('dm- -� _ 1 P I �� 4 ►��'`�—�