49804_GORE, KENT & LISA_20070723

0 CAMA / ❑ DREDGE & FILL �f
GENERAL PERMIT Previous permit#
ENew ❑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
❑ Rules attached.
Applicant Name z
a:
Address
City i '►. _', _State ZIP
Phone # (_ ? ,_ Fax # ( )
Authorized Agent,r�
Affected CW © E7 PTA ❑ ES ❑ PTS
AEC(s): 11 OEA ❑ HHF O IH ❑ UBA ❑ N/A
❑ PWs: ❑FC:
ORW: yes / no PNA yes / no Crit.Hab. yes / no
Type of Project/ Activity
Project Location: County
Street Address/ State Road/ Lot #(s)
City zip
Phone # (`) River Basin
Adj. Wtr. Body (nat /man /unkn)
Closest Maj. Wtr. Body 4. -
(Scale: )
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
`r
Beach Bulldozing
Other
All —
Shoreline Length
SAV. not sure yes no
Sandbags: not sure yes no
Moratorium: n/a yes no
Photos: yes no
Waiver Attached: yes w.
b,
A building permit may be required by: ❑ See note on back regarding River Basin rules.
Notes/ Special Conditions
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 Date
4-
Local Planning Jurisdiction Rover Fife 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, 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 how to 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:[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

NCDIIEw�
North Carolina Department of Environment and Natural Resources
Division of (coastal Management
Michael F. Easley, Goverra Charles S. Jones, Director William G. Ross Jr., Secretary
Date - 3 -
(; 'ii�1
Applicant Name °� i� tS C� i�2'ti'�€ ity
Mailing Addressy�o2 ��JY�bCIQ
f
I certify thatI have authorized (agent). e to act on my
behalf, for the purpose of applying for and -obtaining all LAMA Permits necessary to
installor construct (activity)
at (location) - . b c �c,✓�� z�J �, _
This certifi
Signature
400 Commerce Avenue, Morehead City, North Carolina 28557
Phnnc- -9R,`J_7d7'ATAn \ InfPmPt• www nnr_nacf2Imnnnn,=monf naf

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(FOR A PIERIMOORING PILINGSIBOATLIIi TIBOATHO USE)
I hereby certify that I own property adjacent to cw) -
(Name of Property Owner or Applica t)
Mailing address if different from location address ��a 3�\� >
(town, state and zip)
1V
phone numbers you can be reached at-
property located at 5a. W-'" CDLL&
(Lot, Block, Road, etc.) l f
on , in 1't.TCo N.C.
aterbotly) (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 pilings/boatlift/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.
J I do wish to waive that setback requirement. �`?
initials l- .i
I l i
------------------------
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPME)+ y, ()CM
(To be filled in by individual proposing development)
1 '2- 4
o � 4
0 _ v v v \ \
-------------------- -----------------
Signature
P �T�i�Cl
Print or Type Name
Telephone Number
11- ?- 'l 111-,r7

I hereby certify that I own property adjacent to &4-411'sa_ C-cu-Q,
(Name of Property Owner or Applicant)
Mailing address if different from location address . S'Q
C)3 G�klo� a(,/-+
,
(town, state and zip)
phone numbers you can be reached at 1 3
property located at LU
(Lot,
Road, etc.)
on in CilcLc4c-e+� N.C.
(*aterbody) (Town and/or County)
Block,
He has
to me, as shown below, the development he is proposing at that location,
and, I have no objections
proposal. I understand that a pier/mooring pilings/boatlift/boathouse
must be set back a
distance of fifteen feet (15) from my area of ripar*an access unless
waived by me.
5.1
I do not wish to waive the setback requirement.
initials
I do wish to waive that setback requirement.
initials Mre .00/
c)
------------------------------------- ---------------------------------------------
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOP
(To he
described
to -his
minimum
filled in by individual proposing development)
a 111. ft
(FOR A PIER/MOORING PILINGSIB OA TLIFTIB OA TITIO USE)
'ZI
--------- -------------- ------------------------------------------------- ---- - -- --- -- --- ---------------
Signature
Print or Type Name
Telephone Number

MUD BUCKET DREDGING, INC.
PH, 252-241-1504
507 HEDRICK BLVD.
MOREHEAD CITY, NC 28557
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66-112/531
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