42460_CAMERON, EVERETT_20050815

*3'65
❑ CAM k / L 7 DREDGE & FILL ( 1 J� �`• ` µ
GENERAL PERMIT " Previous permit #
LCNew El- Modification ElComplete Reissue ❑Partial Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environment and Natural Resourc
and the Coastal Resources Commission in an area of environmental concern pursuant to 15A N AC
�L O Rules attached.
Applicant NameProject Location: County_
Address ^' r Street Address/ State Road/ Lot #(s)
City , c . State ZIP
Phone # ( ) -' `j ' 7 �17 Fax # ( ) Subdivision
Authorized Agent 17 r 'S City_ ZIP
Affected L~- Cw 1� EW ❑ PTA El ES ❑ PTS Phone # .(�_ f %"l River Basin
OEA Cl HHF �:: IH ❑ UBA ❑ N/A ,pr
AEC(s): �: PWS: ❑FC: Adj. Wtr. Body _nat /man /unkn)
ORW: yes / no PNA yes / no Crit. Hab. yes / no Closest Maj. Wtr. Body !%
Type of Project/ Activity
Pier (dock) length
Platforms)
Finger piers)
Groin length
number
Bulkhead/ Riprap length
avg distance offshore
max distance offshore
Basin, channel
cubic yards
Boat ramp
Boathouse/ Boatiift
Beach Bulldozing
Other
Shoreline Length y�
SAM not sure yes no
i_
Sandbags: not sure yes no
Moratorium: n/a yes 6
11 / f
Photos: yes noWaiver Attached: yes ho -- -- - — -- ---
A building permit may be required by: j ❑ See note on back regarding River Basin rules.
Notes/ Special Conditions
(Scale. )
t '
I
Agent or Applicant Printed Name
Permit Officer's Signature
Signature ** Please read compliance statement on back of permit
Application Fee(s) Check #
Issuing Date Expiration Date
Local Planning jurisdiction Rover File Name

f
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:
F Tar -Pamlico River Basin Buffer Rules 1 Other:
1 —1 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 (910-395-3900) for more information on how to comply with thesebuffer rules.
Division of Coastal Management Offices
Central Office Elizabeth City District
Mailing Address: 1367 U.S. 17 South
1638 Mail Service Center Elizabeth City, NC 27909
Raleigh, NC 27699-1638 252-264-3901
Location:
Parker -Lincoln Building
2728 Capital Blvd.
Raleigh, NC 27604
919-733-2293 / 1-888-4RCOAST
Fax: [phone]
Fax: [phone]
(Serves: Camden, Chowan, Currituck,
Dare, Gates, Pasquotank and Perquimans
Counties)
Morehead City District
151-B Hwy. 24
Hestron Plaza II
Morehead City, NC 28557
202-808-2808
Fax: [phone]
(Serves: Carteret, Craven, Onslow -above
New River Inlet- and Pamlico 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
910-395-3900
Fax: [phone]
(Serves: Brunswick, New Hanover,
Onslow -below New River Inlet- and
Pender Counties)
www.nccoastalmanagement.net
Revised 10/05/01

rA
HCDENR
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
August 17, 2005
Mr. Everett Cameron
212 Pond Dr
Atlantic Beach, NC 28512
Dear Mr. Cameron:
Attached is General Permit #42460C.
In order to validate this permit, please sign all three (3) copies as indicated. Retain the white
copy for your files and return the signed yellow and pink copies to us in the enclosed, self-
addressed envelope. If the signed permit copies are not returned to this office before the initiation
of development, you will be working without authorization and will be subject to a Notice of
Violation and subsequent civil penalties.
We appreciate your early attention to this matter
Mark Hardeman /lsb
Coastal Management Representative
Enclosures
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

Fax sent by : ZS22470759 Alan Shelor Real 08/08/05 09:18 Pg: 2
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PI RAVIOORING PILINGSIROATI.IFTIBOATIIOUSE)
I hereby certify that i own proNrty adjacent to S
(Name of Property Owner)
PfOf,crty Wcatt-d at
-ok—
(Ixt, Block, Road, etc.)
on — �� ,in� UM4, _ _ N.C.
(VVatcrbo[ly) (Town and/or County)
fi► h.—G ticscribsd 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
pilin;;Vbo.lilift/bo,ttbouse must ba sat back a minimum distance of fifteen fret (15') from my area
of riparian necess unless Waived by me.
...� 1 11, turd. wish W w-nive the setback requirement -
I li-0 wish, tp waive thut setback requirement.
-------------------------------------------------------- -
D SCIOM'ION ANDIOR DRAWING OF PROPOSED TWVF',i3OPNIi;NT:
(-Co he filled its by indirfdual proposing dereloprnaut)
g4'
---------------------------- ------ —----------------- ---------------------------
Signature
Ai L
Print or Type; Name
g��� Sr?41 Z'
Telephone Number
—_
Date: p j
�rw #- Lo'�a9 163

Fax sent by : 2522470759 Alan Shelor Real 08/08/05 89:18 Pg: 1
ADJACENT RIPARIAN PROPERTY OWNER STATF.MF,NT
(FORA Ple RAVOORING P11,1NGSIBOATLIMBOA1'110USB)
I hereby certify thlt t own props rty adjacent to i e l i
's
��1 n (Name of Property Orner)
PIONrty located at
(r.ot, Block, Road,
on ) ', -D
( VV 0rbady) , in L ` -� N C
(`Town and/or County)
fie
flas d;.xribcd to me, as shown below, the development he is proposing at that Location,
2n�, havr no objections to his proposal. I understand that a picrlmooting
pilir-gs/b(tat(ifubo;ttbousc must be set rack a minimum distance of fifteen feet (15') from my area
Of riparian access unless waived by me.
._ .. }JQ--1lJLA Willi to w;6ve the setback requirement,
31.2 wish to w;live that setback requirement_
---------------------------------------- - __
UrSCIITMON AND/OR DRAWING OF PROPOSEr) UV)t;IMMEN .
{710 be fitted in by indiridual proposing (ieuclopmriir)
--------------------- - -------------------------- - -------- - ------ - --------- -------
-Q st,;
Signature
Print or Type Name
Telephone Number

�4MA/eREF3GE & FILL N? 42460
-� ERALA PERMIT Previous permit #
- ew ❑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 Project Location: County � A¢ "d- do
Address /P- ie-4AJ ,e3 Or Street Address/ State Road/ Lot #(s)
City �� 6 /�'A-�_ State /iJt✓° ZIP
Phone # (, 55A ;-17 TTFax # (!) Subdivision /
Authorized Agent '77/ 1, 6;, r) xn e---:� City 7��/��t /1G �� �� ZIP o2Y5` c2-� /�
Affected ❑CW W -�'P`rA ❑ES ❑PTS Phone# �5 �`7-7 �� River Basin Gt)A, CJu-1�C.
❑ OEA ❑ HHF ❑ IH ❑ USA ❑ N/A 6
AEC(s): Adj. Wt� ody XZW !?L IoDrr ve S5a/,, n /unkn)
❑ PWS: ❑ FC:
ORW: yes no PNA yes nF) Crit. Nab. yes / no Closest Maj. Wtr. Bodyy
Type of Project/ Activity I�? rD /1 /i Qe-LJ Vr 1
(S tcJ i.Cj" (Scale:
Pier (dock) length
Platform(s)-
Fingerpier(s)
Groin length
number -- - �—
ulkhe Riprap length
avg distance offshore
max distance offshore �.
Basin, channel -- --
cubic yards_
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing
Other
_--------_
ereic
Shoreline Length
Pr11�
SAM not sure yes ---------- — -- - -- - -- - — - -- - ---
Sandbags: not sure yes ®,�
Moratorium: n/a yes 1 `
Photos: yes l
Waiver Attached: yes -------- -- ------
A building permit may be required by:
E See note on back regarding River Basin rules.
Notes/ Special Conditions /� &4,C 4 f/ /14
Agent or Applicant Printed Name
Permit Officer's Signature
Signature ** Please read compliance statement on back of permit
a �a L
e....ic...,.i— cee,�N
Issuing Date Expiration Date
Local Planninv Iurisdiction
Rover File Name

FIRST CITIZENS BANK
MOREHEAD CITY. N.C. 28557
OUTER BANKS MARINE CONSTRUCTION, INC
1501 FIRST AVE
MOREHEAD CITY, NC 28557
[phone]
PAY TO THE
ORDER OF
1649
66-30/531
137
8/8/2005
* * 100.00
One T-Tundred and 00/1************************************************************ DOLLARS
D.E.N.R.
MEMO
11200 16 4 91" ':0 5 3 100 300l:00 13 1 2 18 2 1 2 711■
AP