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❑CAMA / ❑ DREDGE & FILL
ENERAL PERMIT
❑New ❑Modification ❑Complete Reissue ❑Partial Reissue
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
l0-0 7 /sx
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Previous per it #
Date previo s per
Applicant Name �r ✓e-F (if 2 Project Location: County
issued
I ,-
Address C i ()/• /06C Street Address/ State Road/ Lot #(s)
CiStateiIjf ZIP.),-7
481.7 1 c
Phone # ( ) ! ' V
L ��. (- Fax # ( )
Subdivision
-� %' �.34 J
City
ZIP. 1j C
Authorized Agent
V F� %►'t
(a�
❑ CW
❑12W 4EgTTA ❑ ES ❑ PTS
Phone # ( )
River Basinl-
Affected ❑ OEA
AEC(s):
❑ HHF ❑ IH ❑ UBA ❑ N/A
_t. ,
Adj. Wtr. Body ( '!. , r
i &t /man /unkn)
❑ PWS:
❑ FC:
[
Closest Maj. Wtr. Body
- '
ORW: yes / no
PNA yes / no Crit.Hab. 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
Basin, channel
cubic yards
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing
Other
Shoreline Length
(Scale: )
1
---�/_ -- -I
err
SAV: not sure yes no - _ — _
Sandbags: not sure yes
i
Moratorium: n/a yes
Photos: yes
Waiver Attached: yes no
A building permit may be required by: !J �r► ❑ See note on back regarding River Basin rules.
Notes/ Special Conditions (^�U0'J
or Applicant Printed Name
Signature ** Please read compliance statement on back of permit **
Permit Officer's Signature
Issuing Dater Expiration Date
Application Fee(s)
Check# Local Planning Jurisdiction
Rover File Name
ft
.j
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, certify that this 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 howto complywith 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:919-733-1495
Morehead City Headquarters
400 Commerce Ave
Morehead City, NC 28557
252-808-2808/ 1-888ARCOAST
Fax: 252-247-3330
(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:252-264-3723
(Serves: Camden, Chowan, Currituck,
Dare, Gates, Pasquotank and Perquimans
Counties)
Washington District
943 Washington Square Mall
Washington, NC 27889
252-946-6481
Fax: 252-948-0478
(Serves: Beaufort, Bertie, Hertford, Hyde,
Tyrrell and Washington Counties)
Wilmington District
127 Cardinal Drive Ext.
Wilmington, NC 28405-3845
910-796-7215
Fax: 910-395-3964
(Serves: Brunswick, New Hanover,
Onslow -below New River Inlet- and
Pender Counties)
Revised 08/09/06
t
` s
02,101/07 06:22pm P. 002
02./01!2007 09:41 2527266079 DEAh4BARPZ-S PAGE DI
I MJACRNT RIPARIAN PROPERTY OWNER STATTEMU.'a
I
/Z 0 k4-) _ b FiCTC
'y certify that I own property Adjaotnt iv DE ri�lt5's
1 (Name of t'roper•ly Owner?
p located at 0 5
�ll (Lot, Bloch, Road, etc,)
I I
Ms erbody) ('Town and/or County)
, 4;tt
descn, as sho%�rt,hetow, the development he is prpposing at Ihat location;
and, I e no`ohjections to his proposal,
L
...-___-•----•---------------------------------------------------- ------CRIPTIOV AND/OR DRAWING OF PROPOSED DEVELOPmrN'T
(To be filled in by individual propoSiag development) {
I FF
�6 pz
- LY1
r0/2 �I tjT .3.7" 3
L. 0 4 D G_ b; c `l'n'LQS
------------------------------------------ ------------------------------------------- -
I
,
Signature
Print or Type Name
Telephone flumhe:
Date: l -- t7
Z�z�z
AM
rJZ49 '41 'ia I :herel
propeidy iocatc
on �/ a
I. Wa
and, I ve n(
Y10 9 ,`�
CENT RIPARIAN PROPERTY OWNER STATEMENT
certify that I own property adjacent to 'S
(Name of Property Owner)
at r7 0 5 -Sqt2fS-&--T I
(Lot, Block, Road, etc.)
qcfs- V - i-n , C, �CT n &L N. C.
rbody) (Town and/or County)
n e as showP,below, the development he is prqposing at thitJocation;�
objections to his proposal.
---------------------- *-! .
IPTION AND/OR DRAWING OF PROPOSED. DEVELO
(To be filled in by individual proposing development) 40
V
IF-- ) %_4 /
11 /
Kar y-'N 0 \"-a < C :f-7 �-) 0 G� t? I' C Y* YL P5
-------------------------------- -----------------------------------------------------------
-
&rgnaiure
0
Print r Type Name
Telephone Number
Date:
--T
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
Michael F. Easley, Governor
Date ` i• 2 / . o
Applicant Name
Mailing Address
Charles S. Jones, Director William G. Ross Jr., Secretary
C . Z'i''51 G
O
I certify that I have authorized (agent) fC'n A L c k T ��6ci�,�'I to act on my
behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to
install or construct (activity) d:f;i-F- IJT"- �S '
at (location) F) �) 5 1-- r El '14"'EL
This certification is valid thru (date)
Signature
400 Commerce Avenue, Morehead City, North Carolina 28557
Phone: 252-808-28081 FAX: 252-247-33301 Internet: www.nccoastalmanagement.net
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