48460_GRAY, MICHAEL_20070416

ill
E tiCAMA / ❑ DREDGE & FILL
GENERAL PERMIT Previous permit#
❑New ❑Modification El 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 Project Location: County c
Address Street Address/ State Road/ Lot #(s)� •.,
City
State ZIP
Phone # ( ) ! '1 7' j `1(
Fax # ( )
Authorized Agent
r, 4 A
❑ CW ❑ EW
❑ PTA ❑ ES ❑ PTS
Affected
AEC(s): ElOEA ElHHF
❑ IH ❑ UBA ElN/A
❑ PWS:
❑ FC:
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
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:
Notes/ Special Conditions
r
Agent or Applicant Printed Name
Signature Please read compliance statement on back of permit
Sub(
City
ZIP
Phone # () River Basin ^'�
Adj. Wtr. Body nat/lman /unkn)
Closest Maj. Wtr. Body
(Scale: )
i
❑ See note on back regarding River Basin rules.
PPgrmitOfficer's Signature
C)
Issuing Date Expiration Date
Local Planning Jurisdiction Rover File Name
Application Fee(s) Check #

' +t
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 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/ 1-8884RCOAST
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

ADJACENT RIPARIAN PROPERTY OWNER s*rATEMFNT
(FOR A PIER/VNCOVERED BOAT LIVY) -
t hereby certify that i owe property adjacent to �� Z< C� a� �� _ _ _ s
mama at Preptrty ner)
property located at
-(Let, Block, Road, etc.)
on 'T in
(i� ofo rbsdy) (Towrn amMor County)
He bas described to me. as sbowa below, the development he Is peopatiwa at that bcshon,
and I have so objettlos" to his proposal. 1 understand tltst a pltowwtovsre.d boat NA snuat bt st+
back at a oelrisauaa of llfisets (15,) from any ores of ripaorisw aeeaas unless waived by ntr.
7 .tw aat rr8.h *.b walwo the setback rinuirlAent.
,/,!�L
,.'xlsT- 1 4APAIC HeAd
lure M -� Lc I1 L �,
T 8 k e t' -` N F iv('

4 2
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
Michael F. Easley, Governor Charles S. Jones, Director William G. Ross Jr., Secretary
Date -�4— /%._ U
Applicant Name
Mailing Address
MC
70
I certify that I have authorized (agent) 4 to act on my
behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to
install or construct (activity).�-�_��
at (location) J
This certifi
Signature
400 Commerce Avenue, Morehead City, North Carolina 28557
Phone: [phone] FAX: [phone] Internet: www.nccoastalmanagement.net
An Equal Opportunity 1 Affirmative Action Employer — 50% Recycled 110% Post consumer Paper

'PEMD-rX - --;-2 .
A:DJA CTM RIPARLA N PROPERTY OWNER S TA.MMN7
(FOR A P1MMOORING PfLWGSIROATUFTIBlaA7HOU5, )
I hemby =dfy d= I own pmpeny aft to ✓�� ./�i� �
(Nam of Property 4 er)
pmpeery b=d at
(I,at, w-14 Road, etc.) `
(Watwbody) (TOaad(ar CMAY)
lie bas gibed to me, as shown below, the deve #ment he: is proposing a: tt : lrc2don,
and, I have no olr eswdms to bis p gmsaL I under=ad tit a pie:i maarza
piBnptozrfttoathouz m= be se: back a aiaimum distance of fif=n feet (U') fmm my area
of nPUM
accen imictx waived by me"
I do not wish to. waive the setback requirement
I la wish to waive tar setback rcruirern=t
J.
DE'rSC4U'I ON ANWOR DRA'WE G OF PROPOSED DEVELOP1yMN:
(To be jihad in by Lm&v&ual pmpos.ng drvatopmeye)
� - ---
/3cr+z iif,T
Q �
V l��
C r
i
Si namrr
Print or Type Name

LARRY G
P O Box 997?RNOLD
Morehead City, NC 28557
2071
66-21/530
BRANCH 77615
Pay to the — Date
Order of Y
WACHOVIA
Wachovia Bank, N.A.
wachovia,
For
1:0 5 3000 2 1ED: Jos466 L894 286ii�
207
NP