48127_HARRIS, DUANE_20070308

3
❑ CAMA / ❑ DREDGE & FILL 'c►I 7 /A
GENERAL PERMIT
❑ New ❑ Modification ❑ Complete Reissue El 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 15A NCAC
Applicant Name
Address
City
State ZIP
Phone # ( ) Fax # (� )
Project Location:
Street Address/ S
Subdivision
us permit #~
revious permit issued
j /- C)o i
❑ Rules attached.
( Lot #(s)
48127
C-
Authorized Agent City ZIP
AffectElCW ❑ EW El PTA ❑ ES ❑ PTS Phone # ( } River Basin
AEC se: ❑ OEA ❑ HHF [IIH ❑ UBA El N/A Ad'. Wtr. Body ` gnat /man /unkn)
(} ❑ PWS: ❑ FC: 1 y
ORW: yes / no PNA yes / no Crit.Hab. yes / no Closest Maj. Wtr. Body
Type of Project/ Activity
Pier (dock) length,1
Platform(s) b X 6
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
- I
Shoreline Length ` I
s
SAV: not sure yes no-
-t
Sandbags: not sure yes n�
Moratorium: n/a yes no
Photos: yes �no
Waiver Attached: yes no
A building permit may be required by:
Notes/ Special Conditions
Agent or Applicant Printed Name T-j
f.
Signature Please read compliance statenrentbn back of permit
(Scale: )
❑ See note on back regarding River Basin rules.
Permit Officer's Signature
Issuing Date Expiration Date
Xo -�n(�4� I Iq
Local PfanningJurisdiction Rover File Name
Application Fee(s) Check #

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 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/ 1-888-4RCOAST
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

12/22/2013 02:42 FAX Z 003
�i North Carolina Department of Environment and Natural Resources
` Division of Coastal Management
Charles S. Jones, Director
xj;zhael F )=aslcy, Govcmar
I
Date - o� 1 ` 6e7
Applicant Name Z Q. ,r
Mailing Address
William G Ross If., Sedsrnrnry
I certify that I have authorized (agent) FQJcf& Foley Contractors, Inc. To act on my
behalf, for the purpose of applyiing for and obtaining all CAMA Permits necessary to
install or construct (activity) b4v
at (location
This certification is valid thru
Signature
400 Commerce Avenue, Morehaed City, North Carolina 28557
Phone; 252-808-2808/ FAX [phone]/ Internet w��1�.nccoastalmans�cr�ert.net
An Equal Oppurtunityi Affirmative Action Employer-5O%Recycled/ 10% Post Consumer Paper

12/22/2013 02:42 FAX
Z 001
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIERIMOORING PILINGSBOATLIF IBOATHOUSE)
Ivhereby certify that T own property adjacent tQ l Uri rrr, r 's
(Name of property owner)
property located
V
(Lot, block, road, etc.)
of& 1 c,,4 AJ%T-, i n A) F&1) d),F J -C. & , N.C.
(Water body) (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/boatlif}/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_
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT.,
(to be f filed in by individual proposing development)
k
r
Foley & Foley Contractors, Inc.
Pbotie#: [phone] §IP&M
Fax#: [phone]
Print or Type Name
Telephone Number and Date

12/22/2013 02:42 FAX Z 002
02/21/2*007 16:06 25263BOG24 RCffllNSDN AND STITH HA6E IVIIe1
�ACEift IiiPAMA14 MOPEATY Q17i 91k sg".R'AUNU 1
k
(Ntma of property owner)
pmputy located atg Li 0
(Lat, block. Ltd, err.)
in /r_� Eli-) o&!j)
(Wilber body) ('town etwor ceuntg)
1,1e bas described to me, as shown below, the drmlapment be is proposing act that
itl RM4 1 hMV 90 *WfiOU* W biS PR]7OUL I WXtMV=diha A Piet'/YSt00609
pilWgAoaxiifdbomithome must be set bwk it mmimm &S92= of Mean #fit (15') frOm
tt area of ripafia# accem caress waived by me.
I do tut wish to waive the setback requvemeart.
I do wish to waive that setback requaremettL
MCMMON AND/Olt DRAWING OV PROMD OMLOPMNT:
(to be filled im by indn►kh *jprgwft dekdd,pmerto
Voiq & Foley Cons, Inc..
Vwd - [phone]
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FOLEY & FOLEHY(2CO6N 25RACTORS, INC.
P52)1810 OLD AIRPORT RD.
NEW BERN, NC 28562
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ORDER OF
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