54193_PADGETT, DOUG_20080806

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MA/ DREDGE&FILL } NBRAL PERMIT ' Previous permit# L,
❑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
D Rules attached.
Applicant Name Project Location: County
Address,..'. Street Address/ State Road/ Lot #(s)
City_ —-- . ------------State
Phone # ( ) iz Fax # (_
Authorized Agent
❑ CW ❑ EW El PTA ❑ ES
Affected
AEC(s):
❑ OEA ❑ HHF ❑ IH ❑ UB
ElPWS: ElFC:
ORW:
yes / no PNA yes / no
ZIP
Subdivision
City ZIP
❑ PTS Phone # () River Basin
A ❑ N/A
Adj. Wtr. Body _ (nat /man /unkn)
Crit.Hab. yes / no Closest Maj. Wtr. Body J,
Type of Project/ Activity
Pier (dock) length �- 1�j �;r- __-
(Scale:
Platform(s)
Finger piers) - ^_
I
Groin length
number
Bulkhead/ Riprap length
avg distance offshore
max distance offshore
Basin, channel
cubic yards
Boat ramp
Boathouse/ Boa It ift
Beach Bulldozing
Other
_It
S
j
_
T1
I
i
I
_
--
_
—
--_—
i
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I
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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: �! n� �rw
Notes/ Special Conditions
_
(
- —
—
"!c
'
❑ See note on back regarding River Basin rules.
g g
Agent or Applicant Printed Name
Signature ** Please read compliance statement on back of permit"
Application Fee(s) Check#
PermitOfficer's Signature
Issuing Date
1
Expiration Date
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, certifythatthis 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

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•
40 NCDENR
AUG 4 j009 rth Carolina Department of Environment and Natural Resources
Division of Coastal Management
�/� 6:,
amyMichael F. Easley, Governor Charles S. Jones, Director William G. Ross Jr., Secretary
MWLw d— c
Date 7- �j / — iq �'I
Applicant Name DOC4 P42 J cl -e��
Mailing Address J. h n L.
AfC ZrS?
I certify that I have authorized (agent) k!j.9% 0 ley to act on my
behalf, for the purpose of applying for and obtaining all CAAMA/P'eerrmits necessary to
install or construct (activity) do G(� cr4 � T /( `f�1 ,
at (location) /bJ-6An L -
This certification is valid thriL4"el /3/-0
400 Commerce Avenue, Morehead City, North Carolina 28557
Phone: [phone] \ FAX: [phone] \ Internet: www.nccoastalmanagement.net
An Equal Opportunity \ Affirmative Action Employer — 50% Recycled \ 10% Post Consumer Paper

ADJACNT RIPARIAN PROPERTY OWNER STATEMENT
,, � G 4 (FOR A PIERIMOORING PILINGSBOATLIFTBTHQU�)
I hereby certify that I own property adjacent to 14, 's
e o Prop rty caner)
property located at y (��N J V /, S •
(Lot, Block, Road, etc.)
on �. C&1 , in ��lZ�$z"Vyo , N.C.
(Waterbody) (Town and/or County)
Applicant's phone #: ��3" �— Mailing Address: 80,< 2W
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.
L- 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)
--------------------------------------------------------
(Information for Property Owner Applying
for Permit)
Mailing Address
=c�o•�vl � P
City/State/Zip
Tele hone Number
770 _ZM
Signature Date
C: � 7e- k-Yo
(Riparian_ lyrnperty Owner Infgrmatiq
Signature
Print or Type Name
Telephone Number
Date

lk(C;
110hil I
WrOJACENT RIPARIAN PROPERTY OWNER STATEMENT
AU G 4 2N (FOR A PIERIMOORING PILINGSBOATLIFTBOATHOUSE)
°
I hereby certify that I own property adjacent to .-1 ,1 rJ
orehead City D CM (Name of Property Owner) I
j property located at
J
(Lot, Block, Road, etc.)
� onin h��F�� icy N.C.
(Waterbody) (Town and/or County)
Applicant's phone #:9,V-3y2,-5-`/2'0 Mailing Address:? -7-3y �s�T �✓
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.)
V 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)
(Information for Property Owner Applying (Riparian Property Owner Information)
Print or Type Name
Y/V .sa6
Telephone //umber
2�7�2//a9