48999_HILL, GARY_20070710

❑CAMA / ❑ DREDGE & FILL - r
r. GENERAL PERMIT V Previ
❑New ❑Modification ❑Complete Reissue ❑Partial Reissue Date
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
Applicant Name L7A e �/ C ' f Project Location: County
it #
permit issued
Address Street Address/ State Road/ L�t #(s)
City i State ZIP
Phone # () Fax # (,) Subdivision
Authorized Agent City
ZIP
Affected ❑ CW ❑ EW ❑ PTA ❑ ES ❑ PTS Phone # ( ) River Basin
AEC s : OEA ❑ HHF ❑ IH ❑ UBA El N/A Ad'. Wtr. Bod
() y (nat Iman /unkn)
❑ PWs: ❑FC:
ORW: yes / no PNA yes / no Crit.Hab. yes / no Closest Maj. Wtr. Body
Type of Project/ Activity
(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
Beach Bulldozing - ---- -
i
Other
0
Shoreline Length
SAV: not sure yes no
Sandbags: not sure yes no _—
Moratorium: n/a yes no
i
Photos: yes no 41 1I r
Waiver Attached: yes no
A buildingpermit may be required b : ❑ See note on back regarding River Basin rules.
P Y 9 Y Sa S
Notes/ Special Conditions
Agent or Applicant Printed Name
Signature ** Please read compliance statement on back of permit
Permit Officer's Signature
r
Issuing Date? Expiration Date
Application Fee(s) Check # Local Planningf urisdiction 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 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 Morehead City Headquarters
Mailing Address: 400 Commerce Ave
1638 Mail Service Center Morehead City, NC 28557
Raleigh, NC 27699-1638 252-808-2808/ 1-888-4RCOAST
Location: Fax: [phone]
2728 Capital Blvd.
Raleigh, NC 27604
919-733-2293
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

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Delivery Record:
Page 1 of 1
10 UNITEDSTATES
POSTAL SERVICE cR
Date: 06/11 /2007
D
JUN
� 7 Zpp j
� �tY City
v
Dear Postal Customer:C44
Die-� � y ,Q�, �I,% 1
The following is in response to your 06/11/2007 request for delivery information on your
Certified item number 7006 2760 0002 0746 4515. The delivery record shows that this item
wasctelivered on 05/31/2007 at 10:52 am in SANFORD, NC 27330. The scanned image of the
recipient information is provided below.
Signature of Recipient:
Address of Recipient
.1 . � Not
MW" I �" W�' �
Thank you for selecting the Postal Service for your mailing needs. If you require additional
assistance, please contact your local Post Office or postal representative.
Sincerely,
United States Postal Service
http://pts.usps.gov/pts/requestDelivery.do?eventLocation=SANFORD%2C+NC+27330&tr... 6/11 /2007

Permit No. G-10 • •
SOMMONAW►-
N� ON r
• Sender: Please print your name, address, and ZIP+4 in this box •
I,I,I,,,l1Ai,,,I1„I,,,li,,,IliA,,,i„1111111
■ Complete items 1, 2, and 3. Also complete
item 4 if Restricted Delivery is desired.
■ Print your name and address on the reverse
so that we can return the card to you.
■ Attach this card to the back of the mailpiece,
or on the front if space permits.
1. Article Addressed to: i
fANTc✓�l ! 9-1
14 4 Z 1
�.�-7 3 3 0
2. Article Number
(transfer from service label)
PS Form 3811, February 2004
X Agent
❑Addressee
B. R ived I y (Printed Name) C. Date of Delivery
D. Is delivery address different froA item 1? ❑ Yes
If YES, enter delivery address below: ❑ No
3. Service Type
❑ Certified Mail ❑ Express Mail
❑ Registered ❑ Return Receipt for Merchandise
❑ Insured Mail ❑ C.O.D.
4. Restricted Delivery? (Extra Fee) ❑ Yes
7006 2760 0002 T?46 4515
Domestic Return Receipt 102595-02-M-1540

7'dH VX175 1,11ta-lyrow 7Z71C' �-I�
CERTIFIED MAIL - RETURN RECEIPT REQUESTED (o d4Y
DIVISION OF COASTAL MANAGEMEN 1Z p--y�__7
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIO At7K FOR
Name of Individual applying for Permit:
Address of. Property:
J-UN 1 -I. ?007
(Lot or Street #, Street or Road, City & County)
Mo rehead. City DCM
.I hereby certify that I own property adjacent to the above reference property. The
individual applying for this permit has described to me as shown on the attached drawing
the development they are proposing. A description or drawing, with dimensions, should be
provided with this letter.
I have no objections to this proposal.
If you have objections to what is being proposed, please write the Division of
Coastal Management, 400 Commerce Avenue, Morehead City, NC, 28557 or call (252)
808-2808 within 10 days of receipt of this notice. No response is considered the
same as no objection if you have been notified by Certified Mail.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boat house, lift.or sandbags
must be set back a minimum distance of 15' from my area of riparian access unless
waived by me. (If you wish to waive the setback, you must initial the appropriate blank
below.)
do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
Signature Date
Print Name
Telephone tuber With�Arode
421 IV3��H
Are �-1 I1r4�
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U. F. S., LLC
CAMA
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Item to be Paid -
Permits All Phases
3688
Check Number: 3 68 8
Check Date: Apr 10, 2007
Duplicate
Check Amount: $ 2 0 0.0 0
Discount Taken Amount Paid
200.00
LR22019LN1 HOMAN COMPANY OF NC, 252-247-5766 PRINTED IN U.S.A.

Adjacent Riparian Property Owner Statement
(FOR A PIER/MOORING PILINGS/BOATLIFTBOATHOUSE)
I hereby certify that I own property adjacent to 01 5P . is
Name of Property Owner
property located at Sea Gomel C `3t `B1oc6c c Lo� 20
Lot, block, road, etc.
on n a C o ct S lul W A �er VV �.r , in Cat -�c g-,_ �-
. NC
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.
V/ I do not wish to waive the setback requirement.
O
I do wish to waive the setback requirement.
4
Y:7
z
Description and/or Drawing of Proposed Development
(To be filled in by individual development)
the proposing
0
M
C7
Print or type name V
Vele:phone number
Date

Proposal:
1. 6' wide walkway extending 50' from mean high water mark.
2. 2 (two) Dolphin pilings placed 50' from mean high wate mark, and 75' apart.

. 88-15y531
. •' • - ' .. .�: ,. _ _ _.... _ WACHOVIA BANK, N.A.
3688
MOREHEAD CITY, NC M57 DATE
U. F. S., LLC
101 DOLPHIN WAY Apr 10, 2007
BEAUFORT, NC 28516
252.728-7576 AM0Ub1'& * * * $ 2 00 . 00
Memoi,ot20
TOTHE Two Hundred and 00/100 Dollars
ORDER
OF
CAMA
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1
041E I 00S44 III'
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