48932_MOSS, CLIFTON_20070611

CAMA / ❑DREDGE & FILL t
-. GENERAL PERMIT
ONew ❑Modification ❑Complete Reissue ❑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 ...� il. t d, Project Location
Address `r:.." " , j"f w +:.._,w 9; r+' Street Address/
City Sta
Phone # ( ) Fax # () Subdivision
Authorized Agent t, , 7"f'""""i^�� City ' ZIP
Affected ❑ CW ❑ EW 171 PTA ❑ ES ❑ PTS Phone # ( ) River Basin
❑ OEA ElHHF ❑ IH ElElUBA N/A
AEC(s): Adj. Wtr. Body .i�'k"�;'�.� - (nat /man /unkn)
ElP WS: ❑ F C.
ORW: yes / no PNA yes / no Crit.Hab. yes / no Closest Maj. Wtr. Body
Type of Project/ Activity
aus permit #
previous permit issued
inty
Road/ Lot #(s)
Pier (dock) length-
Platform(s) 2.4044
Fingerpier(s) `f 111,
1 ..
Groin length - -
number - -- -
Bulkhead/ Riprap length
avg distance offshore i -- —
max distance offshore']
Basin, channel
cubic yards
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing
Other
I
�a(L
Shoreline Length
SAV: not sure yes nq
Sandbags: not sure yes not
Moratorium: n/a yes no
�7
Photos; yes no
Waiver Attached: —
Ce)
, r
A building permit may be required by:
Notes/ Special Conditions
Agent or Applicant Printed Name
Signature Please read compliance statement on back ofoumot
Application Fee(s) Check #
4832C
(Scale: `
❑ See note on back regarding River Basin rules.
Permit Officer's Signature
Issuing Date ( / Expiration Date
Local PlanningJu sdiction 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 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 howto complywith 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/ 1-888-41RCOAST
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

A=id=*A
NDw�t
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
Date / - 2 6 - .2 0 0 7
Applicant Name /' r't x _Ton EL ti
Mailing Address �t� e j'` �� ,✓ ►'
MAY 7. 2!
007
City DCM
I certify that I have authorized (agent) Gl �'{o,v - p►� o s S to act on my
behalf, for the purpose of applying for and obtaining all LAMA Permits necessary to
install or construct (activity) Zorvcla- e f /il A(ly j�w;o c e. d- &4 �'LIiI u.41`
at (location) L c s 10i, cv e aZ cl e !� �,�( C' f �y N L
This certification is valid thru (date)
Signature
�1A
1 . 2007
400 Commerce Avenue, Morehead City, North Carolina 28557
Phone: [phone] FAX: [phone] Internet: www.nccoastaimanagement.net
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AJJjA%—n,,N 1 K1YAKlr'1IN YROI-PERI'Y OWNER STATEMENT
(Foj? A PIER/11100RING PILINGS/B0,4TLIFT/BOATHOUSE)
I I-ereby certify that I own property adjacent to _61 "lyii -3 ,_ /►qa �% s
SGt A101 i A CJ4L i - 49wit 40e4 (Name of Property Owner or Applicant)
Mailing aci(lress it dilierent from location address 6—QV I (,/,8-66 A, -/-
(town, state and zip) .�r� Fc� �'� �y •G.- .�, P,:C�f7
phone numbers you can be reached at .. --I
property located at 4,�24--A
(Lot, Block, Road, etc.)
N
F
on 0,V ed S- L eCe4�, L in N.0
Waterbody) (Town and/or Count;,) %
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 pierimooring pilinUs/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. 5�,,��li 4a 6e-, S u�w
I do wish to waive that setback requirement.
initials h t,V Q u
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DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
be filled in by individual proposing develop mem)--
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Print or Type Name
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Telephone Numbe;
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ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIERIMOORING PILINGS/BOATLIFT/BOATHOUSE)
' ' �-
II I hereby certify that I own property adjacent to L L �4e l I
Ly (Name of Property Owner or App ica
�oflPR 44(� � � •
Mailing address if ditYerent from location address °/ �'��� � -A e_
(town, state and zip) T,,r e t ed e Vi/' L. .�, �P S's 7! ?Opp f
phone numbers you can be reached at
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property located at .4" J.
(Lot, Block, Road, etc.)
1 �
on :o�✓ oR S �rr t �'��rvw �- in A car 4 ie c N.C.
waterbody) (Town and/or County)
He has described to me, as shown below, the development he is proposing at that locat'
and, I have no objections to his proposal. I understand that a pier/mooring pilings/boatlift/boatho e
must be et back a minimum distance of fifteen feet 5 m s b 1 from m area of riparian access un1 s
( � y P s
waived by me.
I do not wish to waive the setback requirement. S`����� �� 6v S un•r> e
in' 'als
do wish to waive that setback requirement.
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DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
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May-08-2007 05:47am From -PROPERTY CONTROL
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