49761_DANIELS, J.M._20070719

❑CAMA / ❑ DREDGE & FILL
r• �
GENERAL PERMIT Previous permit#
❑New ❑Modification ❑Complete Reissue El Partial Reissue Date previous permit is— s
As authorized by the State of North Carolina, Department of Environment and Natural Resources 1
and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC
❑ Rules attached.
Applicant Name ; Project Location: County
Address Street Address/ State Road/ Lot #(s) r �;
City State ZIP
Phone # Fax # O
Authorized Agent
❑ CW ❑ EW ❑ PTA
Affected
ElOEA ❑ HHF ❑ IH
AEC(s):
❑ PWS: ❑FC:
ORW:
yes / no PNA yes / no
Type of Project/ Activity
Pier (dock) length
Platform(s)
Finger pier(s)
Groin length
number
Bulkhead/ Riprap length
avg distance offshore
max distance offshore
i
Basin, channel
cubic yards
Boat ramp
Boathouse/ Boatlift
f
Beach Bulldozing
Other
Shoreline Length
SAM not sure yes no
Sandbags: not sure yes no
❑ ES ❑ PTS
❑ UBA ❑ N/A
Crit.Hab. yes / no
Subdivision
City ZIP
Phone # ( ) River Basin
Adj. Wtr. Body (nat /man /unkn)
Closest Maj. Wtr. Body
j
Moratorium: n/a yes no X
Photos: yes no
Waiver Attached: yes ' no ----� --- --------- e� �f-+
A building permit may be required by: ❑ See note on back regarding River Basin rules.
Notes/ Special Conditions
(Scale: )
a
Agent or Applicant Printed Name
Signature Please read compliance statement on back of permit
Application Fee(s) Check #
Permit Officer's Signature
f
Issuing Date Expiration Date,'
a
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 [)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,thatthis 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 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

Al)JA(a;N'1' ltll'�11t1/1i��1'lcui'l,x i 1011 ALI,. ,) t ,A t r, ll,:� t
(FOR A PIER/MOORING PILINGSIBOATI,1FT1110A7"11UU,S1;)
I hereby certify that I own property adjacent torn•
(Name of Property Owner or Applicant)
'
Mailing address if different from location address (- -- �d-1 ,
(town, state and zip) �� �!��� �r 9-Y 0-2 L� 1 A-1 4-o ry
phone numbers you can be reached a
property located at _ f J 2 Q- 6 o2-,'4.aig
(Lot, Block, Road, etc.)
on Rc)5 c.a Sa„ ,,, p ` callo L , in 1L , 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. I understand that a pier/mooring pilingslboatlift/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.
initials
-------------------------------------------------------------------------------------------------------------------
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPINIENT:
(To be filled in by individual proposing development)
�6
0 1 /
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----'J
- ----------- -- ------------- �-----------
-
------------------
,A'--. - - V- -- ----- - ----------------------
Signature 0 �
Print or Type Name
Telephone Numbe
/�/d7
Date:
WE
www.nmmtatmanagement.netfPennits/ADJACENTRIPARIAN PROPERTYO WNERSTATEMENT. pdf

ADJACENT RIPARIAN PROPERTY OWNER
STATEMENT FOR CAMA MINOR PERMITS
I hereby certify that I own property adjacent t VJ A tv 1 4 L, -s
k' (Name of Property Owner)
property located at
it
l�
ft to w"6 Address, BbckRoad etc. )
" on in `f I Jt K . o f � t'� y N.C.
Ora (yyabwbody) (Town and/or County)
He has described to me as shown in the attached application and project drawing(s), the development
he is proposing at that location, and, I have no objections to his proposal.
4A-7 'S Eri- ; K �-
Sgnature o q
Print or Type Name
Uzi t,) 2- o - 1 -1
Telephone Number
(Nnu—ls- L rayl D Date
L , -� 4-
* 1 u to oJ<'c.
) 2 1. 45' �-�"`
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May 07 07 08:32a JM Daniels Construction 913 553 0417 p.l
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
Michael F. Easley, GOVEff1Q(
Charles S. Jones, Director William G. Ress Jr., Secretary
f)atc 6
Applicant Name IT
Mailing Address a S
to act on my
1 certify that l Have authorized (agent) tJ
behalf, for the purpose of applying for and obtaining all CANNA Permits necessary to
install or construct (activity)
at (location)
This certification is Valid thru (date)
i
Signature
400 Commerce AveRue, htcrehead City, North Carolina 28557
Phone: [phone] FAX 2F2-247-33301 intemet: www.nccoastalmanagement.net
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MUD BUCKET DREDGING, INC.
PH. 252-241-1504
507 HEDRICK BLVD.
MOREHEAD CITY, NC 28557
PAY
TO THE
ORDER OF
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400
2379
66-112/531
BRANCH 02201
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