52124_NC LAND PARTNERS LLC & SMITH, DERICK_20080114

CJCAMA / ❑ DREDGE & FILL � , 5
GENERAL PERMIT Previous permit#
❑New El Modification El Complete Reissue El 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 I SA NCAC
Rules attached.
i
Applicant Name Project Location: County
Address Street Address/ State Road/ Lot #(s)
..> ,,.
City State ZIP -=-"
Phone # () Fax # ( ) Subdivision
Authorized Agent
Affected ❑ CW
AEC(s): ❑ OEA
❑ PWS:
ORW: yes / no
❑ EW ❑ PTA
❑ HHF ❑ IH
❑ FC:
PNA yes / no
City ZIP
❑ ES ❑ PTS Phone # ( ) River Basin
❑ UBA ❑ N/A
Adj. Wtr. Body (nat /man /unkn)
Crit.Hab. yes / no Closest Maj. Wtr. Body
Type of Project/ Activity
Pier (dock) length {P "� (Scale: —
�,
Platform(s) "' f r i
Finger pier(s) ' '
Groin length
number
Bulkhead/ Riprap length
avg distance offshore
max distance offshore
Basin, channel
cubic yards 4_
Boat ramp i
Boathouse/ Boatlift
iii
I
--
—
—
—
—=
i
Beach Bulldozing
Other
I
I
--
Shoreline Length
SAV: not sure yes no
Sandbags: not sure yes no
Moratorium: n/a yes no
Photos: yes no
Waiver Attached: yes no
A building permit may be required by:
Notes/ Special Conditions
xx ..
{
(�
L
{'
` '
r
❑ See note
on
back
regarding
River
Basin
rules.
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 Dat7174
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
❑ Neuse River Basin Buffer Rules
❑ Other:
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.
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

09/24/2007 11:34 2523555719 STACEY BYRUM PAGE 06/06
p.4
A
I hvtx be cerbfY that I own pro"' adtaoent to at
.1d
(Name of pvv!cty WWI=) 117
(Lot, block, road, etc-) C_7" _NC,
on d S i �r __7 � � andlor � Y)
(water body)
the develOPnNnt at the
'ate aWicant has descn to W as cook � exclu�dm$ tuft ads, be set
above location_ I �d the feet (& 5') frvaa my arra ofpaneorn aeceSs unless
back a mitnitmim► cSstancc offi�t�x►
waived by me.
/ the Inca as Wop°sed bat do nt wxsb to vmWe. the
no odJection To
-_--•�--^ I lie
setback requiTement
T have xso objecfi
to the project as FTOPasc4 and do wish to waive the (15')
setback tequimment
I objea to the pmjcat as Pr-
-jrnO1 Al /4� YA 4. ' G 03, pRop0" DEV�o�
o be filled in by indMdnat pmpvsillg developmcvt)
Print or type nano
Telephone number
st�nat�
Date

09/24/2007 11:34 2523555719
STACEY BYRUM
PAGE 04/06
p.3
Authorized ,Agent Consent Agreement
Cd�a �- tJ10-XEY_ hereby authorize Q_ r• Wary'tn.�- Sc^45,-J to act on
(Property Owner) (Authorized Agent)
my behalf in obtaining CAMA permits for the location listed below. This agency
authorization is limited to the specific activities described above.
Property Address:
Property Owner's Mailing Address:
Svt C

B. F. WARREN & SON, INC
PHONE [phone]
180 TAYLOR FARM RD.
BELHAVEN,NG 27810
x PAY
N TO THE
ORDER OF,
AFL
DATE
10242
66-258/531
8 ..
oy"a 5 - � I , ,� q L "
SbldhemHank
Belhaven/Bath, NC
FOR %!'� •� A-ra�Ja�O� t�
'la 10 21, 2112 i:053 10 2 SG, D:5 L 2 l 109E1,gn
:f
v

UNITED STATES POSTAL SERVICE
I II First -Class Mai?
Postage & Fees Paid
USPS
Permit No. G 10
• Sender: Please print your name, address, and ZIP+4 in this box •
B.F Warren & Sons, Inc.
180 Taylor Farm Rd.
Belhaven, NC 27810
■ Complete items 1, 2, and 3. Also complete
item 4 if Restricted Delivery is desired.
■ 'Print your name and address on the reverse
so that we can return the card to you.
■ Attach this card to the back of the mailpiece,
or on the front if space permits.
1. Article Addressed to:
[Li�Jn Gr ,-•
7
A. Received by (Please Print Clearly) B. Date of Delivery
1),1 rr--,/,�
C. Signature
X ❑ Agent
l ❑ Addressee
D. Is delivery address different from item 1 ? ❑ Yes
If YES, enter delivery address below: ❑ No
3. Service Type
ffif Certified Mail ❑ Express Mail
❑ Registered ❑ Return Receipt for Merchandise
❑ Insured Mail ❑ C.O.D.
4. Restricted Delivery? (Extra Fee)
2. Article Number (Copy from service label)
7003 1680 17004 8933 0448 'j9
PS Form 381 T, July 1999 Domestic Return Receipt
❑ Yes
102595-99-M-1789
I