50120_PATE, ANNE_20080206

❑CAMA / ❑ DREDGE & FILL X. 12
�. GENERAL PERMIT Previou ' ermit# _
❑New ❑Modification ❑Com lete Reissue ❑Partial Zsue Date previous permit issued
P P
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___
State ZIP
Phone # O
Fax #
Authorized Agent
Affected ❑ CW
❑ EW ❑ PTA ❑ ES ❑ FITS
AEC(s): ❑ OEA
❑ HHF ❑ IH ❑ UBA ❑ N/A
❑ PWs:
❑ FC:
ORW: yes / no
PNA yes / no Crit.Hab. yes / no
Project Location: County
Street Address/ State Road/ Lot #(s)
Subdivision
City ZIP
Phone # () River Basin
Adj. Wtr. Body Lat /man /unkn)
Closest Maj. Wtr. Body
Type of Project/ Activity
Pier (dock) length
Platform(s)
Finger pier(s)
(Scale:
Groin length
number
Bulkhead/ Riprap length
avg distance offshore
I
max distance offshore
Basin, channel
cubic yards
Boat ramp
Boathouse/ BoatliftI
Beach Bulldozing
Other
?
r
i
It
4-
L
I
_
Shoreline Length
SAV: not sure yes no '
Sandbags: not sure yes no
Moratorium: n/a yes no -
Photos: yes no i
I
Waiver Attached: yes no
A building permit may be required by: ' ( r
Notes/ Special Conditions
❑ See note on back regarding River Basin rules.
(1P-r
Agent or Applicant Printed Name
Signature Please read compliance statement on back of permit"
Application Fee(s) Check #
Permit Officer's Signature
Issuing Date
Local Planning Jurisdiction
Expiration Date
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
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

q1/10/2008 11:14 FAX [phone]
� 004/005
'ADJACENT RIPARIAN PROPERTY OWNER STATEMENT FOR CAMA
MINOR PERMITS
I hereby certify that I own property adjacent to H11V11-V)-E:- s
(Name of Property owner)
7)
property located at
(Address, Lot, Block, Road, etc.)
on 1%1
(Waterbody) in �A 1 (Town and/or -County) N.C.
He has described to me as shown below, the development he is proposing at that location, and, I have no
objections to his proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(To be filled in by individual proposing development)
ej, Rg(l RVED
,]AN 2 3 2008
Morehead City DCM
Signature
Print or Type Ne
Telephone Number
Date:

O1/10/2008 11:14 FAX [phone] PATE DAWSON COMPANY 1&02/005
{
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT FOR
MINOR PEPUMITS
I hereby certify that I own property adjacent to
(Name of Property Owner)
property located at
(Address, Lot, Block, Road, etc.) 'eg&
on _ f . t } , N.C.
(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.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(To be filled in by individual proposing development)
Signature
Print or Type Name
l 5v--Z "- 6
Telephone Number
Date: 1 7 --vy

O1/10/2008 11:14 FAX [phone] PATE DAWSON COMPANY 10003/005

eJbn 2S 08 08: 25a The Howeri's 2527262244 p- 2
NCDEN�
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
10:1-1hael F. Easley, Governor James H. Gregson, Director W"Jarr, G. Ross Jr_, Secre!atyA
Date-✓�
1 00
. :
Lctw
JAN 2 9 2008
rehead-City DCM
Applicaut.Natne a%'l Cry<� `=�',,t^✓�= iiF�,'s.� rf�. L...
Mailing Address
7J
7 5,3
I certify that have authorized (agent)l.OW-oi. S"'C'_S ZSZ- 7io act on my
behalf, for the purpose of applying for and obtaining all CANIA Permits necessary to
install or construct (activity) l\ _ h z w
/� 17-1 i pJ� Sac oS o� (�.
at (location) �[n?�/a.r \p0 "rr A('_n 0-Y)r.r- D_ rk— _ 1 '-
This certification is valid th`ru (date)
Signature
u
400 Commerce Avenue, Morehead City, North Carolina 28557
Phone: [phone] FAX: [phone] Internet: ww:v.nccoastaJmanagement.net
Ar Eti ual Opportvrity 1 A11'JrnatiVe Action Er-oloyer - 50;;iecfc:ed 1 io% Post co-iscr, er Pdoer

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CAROLINA SHORES
1607 SANDERLING DR 252-726-2244
MOREHEAD CITY, NC 28557
1094
DATE - %-p 66-30/531
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