53632_WITT, PEGGY_20090512

a�A / t� DREDGE & FILL �''oM
EL 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 15A NCAC
❑ Rules attached.
Applicant Name
Address
City
StateZIP
Phone # ( )
Fax # ( )
Authorized Agent
❑ CW
❑ EW ❑ PTA ❑ ES ❑ PTS
Affected
Affecte -] OEA
❑ HHF ❑ IH ❑ UBA ❑ N/A
❑ PWS:
Li FC:
ORW: yes / no
PNA yes / no Crit.Hab. yes / no
Project Location: County
Street Address/ State Road/ Lot #(s)
Subdivision
City
Phone # ( )
Adj. Wtr. Body —_
Closest Maj. Wtr. Body
ZIP
River Basin
(nat /man /unkn)
Type of Project/ Activity
(Scale:
)
Pier (dock) I gth
Platf
Finger
Groi
Bulk
head/ Riprap length
channel
cubic yards
ramp
house/ Boatlift
h Bulldozing
r
eline Length
not sure yes no
bags: not sure yes no
atorium: n/a yes no
os: yes no
1 4-- —
I
n length
number
-- I
� -�
avg distance offshore _ _ -
max distance offshore
s'
�I i
I
---- - - — — — i�
�
-
i`
Agent or Applicant Printed Name
Signature ** Please read compliance statement on back of permit
Application Fee(s) Check #
PermitOfficer's Signature
Issuing Date Expiration Date
l
Local PlanriingJurisdiction Rover File Name
i`
Agent or Applicant Printed Name
Signature ** Please read compliance statement on back of permit
Application Fee(s) Check #
PermitOfficer's Signature
Issuing Date Expiration Date
l
Local PlanriingJurisdiction 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, certifythatthis project is consistentwith 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/ 1-888ARCOAST
Fax: [phone]
(Serves: Carteret, Craven, Onslow -above
New River Inlet- and Pamlico Counties)
Elizabeth Citv 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

017r / R O�CCT-
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Nor �`o �cRc�

CERTIFIED MAM - RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER
FORM , �, `4 f
Name of individual applying for the permit: �eA� 4 \ , -4
Address of property: 1- 4 C-f l ' Na GV7) Vel
(Lot or street#, street or road)
Gmf' ,- NC
r.11
I hereby certify that I own property adjacent to the above referenced property. 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 proposed, please write the Division of Coastal
Management, 400 Commerce Ave., Morehead City, NC 28557 or call [phone]
within 10 days of receipt of the notice. No response is considered the same as no
objection if you have been notified 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.)
I do wish to waive the 15' setback requirement
do not wish to waive the 15' setback requirement
�� � S
Signature
ate
eCfSSi�
Print Name
elephone number with area code

NCDENR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
Michael F. Easley, Govemor James H. Gregson, Director William G. Ross Jr., secretary
Date
Applicant Name
Mailing Address
I certify that I have authorized (agent to act on my
behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to
install or construct (activity)
at (location) A9)�' �
This certification is valid thru`(date-) Q
Signature / , V , �'l/ z l
400 Commerce Avenue, Morehead City, North Carolina 28557
Phone: [phone] FAX: [phone] Intemet: www.necoastalmanagement.net
An Equal Opportunity 1 Affirmative Action Employer— 50% Recycled 110% Post Consumer Paper
s

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/MOORING PILINGSBOATLIFTBOATHOUSE)
Pe-f 4.,), -17
,S
I hereby certify that I own property adjacent to
l 7 (Name of Property Owner)\
property located at
(Lot, Block, Road, etc.)
on / 1� `-f,�,,P yin f��°-2� N.C.
(Waterbody) own 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.
I do not wish to waive the setback requirement.
I do wish to waive that setback requirement.
---- -------------------
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
(Applicant Information)
Mailing Address
City/State/Zip
Telephone Number
Date
(Riparian Property Owner Information)
Signa6re
L�
rent or Type Name
_ � :� !I - 0 9 A -
Telephone Number
��o -
Date

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIERIMOORING PILINGSBOATLIFTBOATHOUSE)
`�'
I hereby certify that I own property adjacent to � OA ' is
(Name of Property Owner)
property located at
(Lot, Block, Road, etc.)
N.C.
on in
(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.
�- I do not wish to waive the setback requirement.
I do wish to waive that setback requirement.
-----------------
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
hJ�d 1`,6^Ni
P; t6 0 1 �'/a z J�
(Applicant Information)
f .7 4 N > C-
Mailing Address
City/State/Zip
).-5-z-2 y-3 G / f
Telephone Number
Date'
*(Riparianoperty Owner ormation)D Ci
Print or Type Name
Telephone Number
D=" a t , Q Csa9
Date

BOBBY CAHOON
MARINE CONSTRUCTION AND LAND DEVELOPMENT
WACHOVIA BANK, NA
BAYBORO, NC 28515
K_
6744
DBA BOBBY CAHOON CONSTRUCTION, INC. 66-21/530 � Wo
6003 NEUSE RD.
GRANTSBORO, NC 28529
PH [phone]
PAY TO THE
=^ ORDER OF
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DOLLARS 8
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11000 E 7 4 4ii' I:O S 3000 2 L 91: 20000 L 7 68 48 28,10
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