53340_WAGNER, JAMES_20090225

EyCAMA / ❑ DREDGE & FILL
GENERAL PERMIT /7 Previous permit #
❑New ❑Modification ❑Complete Reissue 1:1 PartiaT Reissue Date previous permit issued
As autliorized 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
-�'"� ❑ Rules attached.
Applicant Name 3 !�l C. _ i� -� ( ! 1 Project Location: County
Address L Street Address/ State Road/ Lot #(s) �}
City t t j�t ' ! � ) - tare ( ZIP
Phone # r',x �" t - �:. # Subdivision
O (�- -�--- - ------ n
Authorized A ent ' ? ,( ! r j
t ) % f City_ ZIP g
I CW ❑ EW ❑ PTA -afS ❑ PTS Phone # ( ) _ River Bain vl {
Affected r, OEA ❑ HHF ❑ I ❑ UBA ❑ N/A t R 1
AEC(s): Adj. Wtr. Body_ f :�^�{/j( iL�, (nat an nk�n)
ORW: yes / no PNA yes / no Crit.Hab. yes / no ! t
Closest Maj. Wtr. Body
Type of Project/ Activity
Pier (dock) length
Platform(s)
Finger pier(s)
Groin length
number } 1
Bulkhead/ Riprap lengthy
avg distance offshore ,
max distance offshore�%
Basin, channel
cubic yards
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing
Other
Shoreline Length
SAV: not sure yes no
Sandbags: not sure yes no
Moratorium: n/a yes o
Photos: yes i`
Waiver Attached: yes ' no
A building permit may be required by:
Notes/ Special Conditions
Agent or Applicant Printed Name
m
Signaturg Please read compliance statdment on back of permit
Application Fee(s) Check #
(Scale:
I i I I
' ❑ See note on back regarding River Basin rules..
PermitOfficer' ignature
are � L^r•
!
�..✓
Iss ate r -"-
1 Expiration Date
Local Planning Jurisdiction
Rover File Name

I
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:
❑ 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
Mailing Address:
1638 Mail Service Center
Raleigh, NC 27699-1638
Location:
2728 Capital Blvd.
Raleigh, NC 27604
919-733-2293
Fax: [phone]
Morehead City Headquarters
400 Commerce Ave
Morehead City, NC 28557
252-808-2808/ 1-888-4RCOAST
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

F sawit
9FEB 2 4 2009
_ Morehead City M
Not l.al'oliila Eta i nee �i of Environment and ��utural Resources
(ai Coastal Mangs snt
Michael F Easley: Governor charier S, Jones, Diractor William G. Ross Jr., Secretary
Date
Applicant Nanie
Mailing Address
certify that I ha- e autIbOrizecl (agent) to act odd Iny
-- — - ra-^l,ts;iu� Ott �ANfA �eaa3aits��c�ssaay t� - — -- --
bek�aLf, IOr tlae--purp�s� eaa applyixa I.0 aaA� �, , b �,_ ---
install or construct (acti'dt-y)
at (location)_ g �C�z 1�
This certAa catio;<n is vai'd thru (elate)
,Signature
�2X��

1
T z , ..i
(FOR A PIER/UIY(___OVERED BOAT LVFI)
I hereby ceruty that' own property adjacent to
(4 e of rropertv O+rruer)
prcperry located a[__I S
(Lot, Block, Road, etc.)
on r'(1 YY� C L in.S G� �T , N.C.
(Waterbodv) (Town and/or County)
He has desc_ibd to me, as shown belo,,v, the development he. is proposin; at that
location, and, I have no obj�—_tions to his proposal. I understand that a pier/uncovered boat lit:
crust be set back a minimum distance or rimer❑ fe~t (IS') from my jarea or ripanan access unless
waived by me. 4
I do not wish to waive the setback requirement. h
PPP 9 d ?nno
I do wish to waive that setback requirement. - - --__
Moorehead City DCM
DESCR-=Oiti A-'N-D/OR DRAW—E G OF PROPOSED DFYELOP_IYM"NT:
(To be filled in by fndividucl proposin,; deve� pment)
------------ ------ -- --------------- -----------------------------_- --- - ----
Sig,^,ature
Print or Type Nane
Teiephone Numb(rr
Date: � - / -,-), ��

t _
WTO
,jfli.Ll�1 ^�l
'�ti i�,:���i�l��li
(FOR A PIER/UNCOVERED BOAT TIFI) FEB 2 4 2009
I hereby cert y that I own property adiactnt to }1��s Le DG
J / (,Ie of Property O Fner)
propem' lc'cated a( / �F' tz7vo c� n/
(Lot, Block, Road, etc.)
/i
on / C, Ai) 1<`' ' , u1 N. C.
(iY'aterbody) (To and/or) County)
He has desc_-ibed to me, as shown belov,-, the developrhent he. is proposing at tf at
location, and, I have no objections to his proposal. I understand Ihat a pier/uncovered boat lie
must be set back a minimum distance or firer❑ fit (I5') from my jarea or riparian access unless
waived by me.
I do cot wish to waive the setback re uirement.
I do wish to waive that setback requirement.
DESCRLP'ITO-i ;-N-D/OR DRAWT,4G OF PROPOSED DEVELOP?tiENTT:
(To be filled in by irzdividucl proposing devel 'Pment)
SICE,>--
��
Signature
,�--�-
I
�G
C,o L. i to
Print or Type Name
Telephone l umb(pr
�'_
Date: „Z " 1 v

v
fames A. Wagner
Betty B. Wagner
116 Beechwood Dr.
Ptne Knoll Shores, AT 28512
PAY TO TH4for
ORDER OF
1ci
o �Print signature Iln , ra t
® First citize g Y YPe and linework. First Citizens Bank
Bank
firstcitizeens. om
FOR 3
1:0 5 3 100 3001:00 13 17
3 29 706u6
K:
66-30/531
133
DATE 2 2,5',-65
logo on back. If not Present, do not c-
309 2
3062
$mod ��

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1
MONITORING & COMPLETION REPORT
[CAMA Major Development & State Dredge & Fill Permits]
PERMITTEE' S NAME: CJ S �V Y� PERMIT #
LOCATION: 1 Bee Ck wOJ D cy e FIELD REP.
PHONE: �- I�- 5 DATE REPORTEDLY COMPLETE:
DATE OF INSPECTION (0/
1) Do th easured dimensions of the development differ from those indicated in the permit and workplat?
YESN [circle one]. I
COMMENT: / VO
2) SEDIMENTATION & EROSION CONTROL: Has Permittee seeded, grassed, or otherwise stabilized all
disturbed areas? YES/NO [Rircle one]
COMMENT:
3) FUTURE MONITORING & ENFORCEMENT ACTION: Is further investigation or enforcement action
needed? YES �V[circle one].
COMMENT: Alo c000 � ---