56322_WILLIAMS, RONALD_20100908

11 CAMA / El DREDGE & FILL
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GENERAL PERMIT
Previous permit #
El New El -Modification OComplete Reissue
0 Partial Reissue C 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
E] Rules attached.
Applicant Name
Project Location: County
Address
Street Address/ State Road/ Lot #(s)
City State ZIP
Phone # Fax # O
Subdivision
Authorized Agent
City ZIP
El Cw [J EW [I PTA L. ES D PTS
Affected
Phone# River Basin
El OEA El HIHIF D 1H LJ UBA El N/A
AEC(s):
Adj. Wtr. BodyLna /man /unkn
El PWS: El FC:
ORW: yes / no PNA yes / no Crit.Hab.
yes no Closest Maj. Wtr. Body
IME No
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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 Expiration Date
4-Y
Local Planningjurisdictio.. 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 ❑ 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 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

A�
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
Beverly Eaves Perdue, Governor James H. Gregson, Director Dee Freeman, Secretary
Date
Name of Property Owner Applying for Permit:
Mailing Address:
I certify that I have authorized (agent) V . NCSCAq A Y I n C,00-6i , 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)
This certification is valid thru (date)
Property Owner Signature
'Z/e�
Date
400 Commerce Avenue, Morehead City, North Carolina 28557
Phone: [phone] FAX: [phone] Intem t www.nccoastaimanagement.net
An Equal Opportunity 1 Afflmm ve Action Employer — 50% Recycled 110% Post consumer Paper

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ADJACENT RIPARIAN PROPERTY OWNER STAT IdENT
I hereby certify that I own property adjacent to ' ' / / � ,� '" 's
7 (Name off perfy er)
property located at
(Loot, Block, Road., etc.)
on ��o 5"� .ky",�e , in Z' N.C.
(Waterbody) Trown and/or County)
Applicant's phone #: -) s Mairmg Address: j, D
He has described to me, as shown below, the development he is proposing at that location, and, I
have no objections to his proposal.
DESCRI iON AND/OR DRA`6V NG OF PROPOSED DEVELOPMENT:
(To be fr W hi by propffly owner p v pig &vdq"Mft4
J-
(information for Property Owner Applying
for Permit)
Mailing Address
City/State/Zip
Telephone Number
Signature
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5el, �,-
( Property Owner h&r=Wm)
Signature
L
Print or Type Name
Telephone Number
0
Date

ADJACENT RIPARIAN PROPERTY OVMER STATEAVM
PCI hereby certify thatI own property adjacent to.l h/ //1,tw 2sS
-� (Name of Property Owner)
property located at l
P / ?4
(Lot, Block, Road, etc-)4k"e
1/ // ce , N.C.
(Wady) (Tows an(vor County)
Applicant's phone #: 7 <� Z *ailing Address: /D CJ<
He has described to me, as shown below, the development he is proposing at that location, and, I
have no objections to his proposal.
DESCRtMON AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by propeny owoar p rg develapment)
/ g / /,ry 1-;= /
(information for Property Owner Applying (Riga ian Propeirty Owner htfiwmadion)
for Permit)
Mailing Address
City/State/Zip
Telephone Number
Signature _ Dare
Signature
Prim or Type Name
481-CY-21
Telephone Number
Date

B PRESCOTT MARINE CONSTRUCTION
PO BOX 874 252-249-0149
ORIENTAL, NC 28571
PAY 1
TO THE
ORDER OF
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DATE
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Applicant: Ronald Williams
Date: September 8, 2010
General Permit #: 56322C
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 ®
338
338
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑