47820_MASEY, CLINTON_20070215

❑CAMA / ❑ DREDGE & FILL 4 T1. 2 0-r-1,
-. GENERAL PERMIT Previous er it#
❑New ❑Modification ❑Complete Reissue []Partial Reissue Date p vio 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 I SA NCAC
❑ Rules attached.
Applicant Name
Address
City
State ZIP
Phone # ()
Fax # ( )
Authorized Agent
❑ CW
❑ EW ❑ PTA ❑ ES ❑ PTS
Affected
AEC(s): O OEA
❑ HHF ❑ IH ❑ UBA ❑ N/A
❑ PWS:
OFC:
ORW: yes / no
PNA yes / no Crit.Hab. yes / no
Project Location: County
Street Address/ State Road/ Lot #(s)
Subdivision
City ZIP
Phone # ( ) River Basin
Adj. Wtr. Body (nat /man /unkn)
Closest Maj. Wtr. Body
Type of Project/ Activity
(Scale:
Pier (dock) length
Platform(s)
channel
cubic yards
ramp -
r
not sure yes no
bags: not sure yes no
ratorium: n/a yes no
os: yes no
y-� -
. G
n length
number
- -- ,
Riprap length
avg distance offshore
max distance offshore
i
house/ Boatlift ��—
—
_
eline Length
--� -
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
Local Planning Jurisdiction
Expiration Date
Rover File Name
Agent or Applicant Printed Name Permit Officer's Signature
Signature Please read compliance statement on back of permit **
Application Fee(s) Check #
Issuing Date
Local Planning Jurisdiction
Expiration Date
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 comply with 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.
(Serves: Carteret, Craven, Onslow -above
Raleigh, NC 27604
New River Inlet- and Pamlico Counties)
919-733-2293
Fax:[phone]
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

North Carolina Department of Environment and Natural Resources
Division of Coastal Management
Charles S. Jones, Director
Michael F Easley, Governor William G Ross Jr., Secretary
Date 2 16 10
Applicant Name Cu N7t a E S
Mailing Address ► 1-1 UeA4F N 00 6
k
I certify that I have authorized (agent) Foley & Foley Contractors. Inc To act on my
behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to
install or construct (activity) 6c<,k— W f 600-2D&1f\ d4- /30✓li! Yi J1J . - _
at (location) A-s- )y t-A-N tj
This certification is valid thru (date)
Signature \ 11-j \ /-W.
400 Commerce Avenue, Morehaed City, North Carolina 28557
Phone: [phone]/ FAX [phone]/ Internet: www.nccoastalmanagement.net
An Equal Opportunity/ Affirmative Action Employer-50% Recycled! 10% Post Consumer Paper

kl "CZrrt 90AWAn PROMIKnOWNSIk SrTA'M rrr
I,bnebY oerdfy that I own property adjamat to + - ..,,.:3
%.g=eae oiprepW463F V TWI&WRy
Atop xty 1M-Wd at 9 4Q 4 s d I r
OAL block, read, etc.)
OA. /rg7'j�
(water body) tT� aQdlorouatys.......�... �
N.C.
He bay daacribed to me", as shewn bylaw, the d"bMem be is PTepaaini at teat
locatlon, and. Z leave no objeC600 to bye• propasal, t wdaVatxd tied a pimdrA
p tbc*tiittlb0&*0uxse mmt be setback a minim= dMancc of 3iff=u f mt (W) fi mn
tr= miea of riparilM =MS unless waived by me.
_ 140 not wish to waive the Setback tequimmetn.
I do wilih to waivc chat s +ek MgUiremen`•
DJW-' :.IMOM ANDIOR DRAWL` G OF PROP OUD DM'ELOPV- MN T:
(to be)Wed in by ih — A rapaafit8 fop�ae�tt�
S�
�X?t rat 6,
w+ r
r
Fold Folty C'UMUGURI" 1.0r, r
Phrnuff: (2�2� 6�b-231.3 M 9rgstia►ture ,
.at or Name
nnc Number eA Dare
..ti rit3 G'�1
Wa Sz:ZZ L00z-li-a33

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A Prt"00RING PILINGSIBOATLIFTBOATHOUSE)
I, hereby certify that I own property adjacent to Ch 1 I tmod«5e 's
(Name of property owner)
property located at H S )a 14E`&j
(Lot, block, road, etc.)
on WuFK P.3k. , in / gii)- lT gib C' pmaQ , 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/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.
I do wish to waive that setback requirement.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(to befilled in by individual proposing development)
------------
�'n-►ova n i X?( A 6
FOAC;'VKJ
Foley & Foley Contractors, Inc.
Phone#: [phone]
Fax#: [phone]
Print or Type Name
Telephone Number and Date