47198_MATHEWSON, CHRISTOPHER_20070131

t
❑CAMA / ❑ DREDGE & FILL
GENERAL PERMIT reviouspermit #
LINew ❑Modification ❑Complete Reissue ❑Partial Reissue ate 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,-.- o" t 00 (r Project Location: County
Address I �-.l- j Y\„ t ')6% 1 �' C, °: ill Street Address/ State Road/ Lot #(s)
City t State L. ZIP` 1 i
Phone # O . Fax # (}
Authorized Agent S
Affected ❑ CW ❑ EW ❑ PTA Q ES ❑ PTS
❑ OEA ElHHF ElIH ElUBA [IN/A
AEC(s):
❑ 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�A vD X
Beach Bulldozing
Other -'
Shoreline Length
` -
SAM not sure
yes
Sandbags: not sure
yes
Moratorium: n/a
yes
Photos:
yes
Waiver Attached:
yes no --
A building permit may be required by:
Notes/ Special Conditions
Agent or Applicant Printed Name
Signature Please read compliance statement on back of permit
Application Fee(s) Check #
Subdivision
City "S ZIP
Phone # O River Basin < r_
Adj. Wtr. Body T� <. >` (nat, /man /unkn)
Closest Maj. Wtr. Body =t C-f
(Scale: )
K See note on back regarding River Basin rules.
Permit Officer's Signature
Issuing Date Expiration Date
i)GIM,,C, (t,.
Local PlanningJurisdiction 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, certifythatthis project is consistent with the North Carolina Coastal Management Program.
River Basin Rules Applicable To Your Project:
Fj Tar - Pamlico River Basin Buffer Rules ❑ Other:
E] 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
Central Office
Mailing Address:
1638 Mail Service Center
Raleigh, NC 27699-1638
Location:
Parker -Lincoln Building
2728 Capital Blvd.
Raleigh, NC 27604
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)
Morehead City District
400 Commerce Ave
Morehead City, NC 28557
202-808-2808/ 1-888-4RCOAST
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
910-796-7215
Fax:[phone]
(Serves: Brunswick, New Hanover,
Onslow -below New River Inlet- and
Pender Counties)
Revised 06/29/05

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AUG-03-2006 WED 01:46 PM NC DIV OF COASTAL MGMNT FAX NO. 4
P. 02
ATVACU"L'`414' RY1'f4A1*A1V PROPERTY ONVNFR STAT "M1,Nrl'
(FORA I'NEItIAM ORING PILINGS/80,4LIF2YBOATHOUSE)
I hurolyy certify that I own property adjacent eo , .^_ . _` /c.
(Name of Property Owner)
(LIA, Block, Road, etc.)
N.C.
(IV;1(pubody) (Tow►y andlor Cqunty)
TIc h:.ss dcscrilxd to typo, m shown below, the development he is proposing at that location,
and, 1 have no objections to his proposal. I understand that a pier/moorin,
lyi(in�s/U�� tfiitlt�alihouse must be s--t back a minimum dist-lnCe, of fifteen Feet (15') from my area
of cipari�tn acccx< unlos.s %Vaivcd by mo.
-- -- 1 J.q_t)nt wisiti to W:1ivc tltia sotb,ick r,'cluire1nec1t.
I Ou, `Fish to %valvc that s:,,Iback rc:qulrenim.
f ND/0I, r>12,1.1VING Of` PROPOSED DENTLOI',tiI1:�LNT:
(To be felled in by individual proposiit; development)
/74
. --------------------... ..............I _...-.---------------.----------------------
Signature9rA. �T f�v/�
Print or Type Name
Telephone Numbe7
Date: IO2— �('�(�

AUG-03-2005 WED 01:46 PM NO DIV OF COASTAL MGMNT FAX NO, 4 P. 02
A1)JAC:x'i` 'f RTl'A.R1*AtV I>ROPElR.7 Y O`VNER STATF.-M]1 N '
(FOR A 1'IL;R/AMORING PILINGSIBOA-11IF IBOA17100SF)
I horehy certify that I own properly adjacent to _&2/ r� %Z Mmy"d w
(Natjtc of Property Owner)
projv,rty located at
(Lol, Block, Road, etc.)
on ru_ _ C�� L ....... , i n l�.� � j'�1YY�/( e N.C.
(Towu and/or County)
Ile kis d scdbod to mo, as shown below, the development lie is proposing at that location,
and, I have no objections to his proposal. I understand that a pier/mooring
hilin�s/b��ulift/b��aihouse must be set hack 1 rninirnum disumce of fifteen feet (15') from my arca
of ciparian acccs< unless %vaived by me.
1 Jl.o_t)n wish to w,livc the Setback requirement.
-ish to V;alve th�it sllJack requirement.
I)I'SCRII' ION ANMOR r)12:1WING OF PRO['OSED DEN' FI,OPM1?i\T:
(To be filled in by iadividual prvposina development)
Si�na!ure _
Print or Typc Name:�7 5�2 - - 6 4<,-)- 6 <V
—
Telephonz Number
Date: �—

Authorized Agent Consent Agreement
I gW(s Zt��,�x)j0A/ , hereby authorize _AffB e (-,%A l CaV6XI to act
(Property Owner) (Autho fized Agent)
on my behalf in obtaining CAMA permits for the locations listed below.
Jobsite Address:
L F NT t N C Z 9 5-7
Property's Owner's Mailing Address:
Poo U90 x 169.7
o,Pf��N NC 58571
Property Owner's Signature:
Authorized Agent Signature:
Date: /,;;K / 2 c A C