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❑CAMA / ❑ DREDGE & FILL
GENERAL PERMIT
Previous permit #
❑New ❑Modification ❑Complete Reissue ❑Partial Reissue Date previous permid
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
Rule ttached.
i
Applicant Name
Address
CityrState ZIP /
Phone # O Fax # O
Authorized Agent
Affected ❑ CW ❑ EW ❑ PTA ❑ ES ❑ PTS
ElOEA ElHHF ElIH ElUBA ElN/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/ Ripraplength
avg distance offshore
max distance offshore
Basin, channel
cubic yards
Boat ramp
Boathouse/ Boatlift!'
� r
Beach Bulldozing
Other
Shoreline Length
SAM notsure yes no
Sandbags: not sure yes no
Moratorium: n/a yes no
Photos: yes no
Waiver Attached: i 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 #
Project Location: County
Street Address/ State Road/ Lot #(s)
Subdivision
City ZIP
Phone # () River Basin
Adj. Wtr. Body (nat lman /unkn)
t
Closest Maj. Wtr. Body
(Scale: It l )
C See note on back regarding River Basin rules.
Permit Officer's Signature
Issuing Date Expiration Date
Local Planning Jurisdiction 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, certifythat 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:
j 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/ 1-888ARCOAST
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

North Carolina
Michael F. Easley, Governor
Date / t> 91 " a6
Resources
William G. etary
Applicant Name HSL�E,4
Mailing Address bplrl) ls -8LL Ot>
I_.&
NCDENR
Department of Environment and Natural
Division of Coastal Management
Charles S. Jones, Director
i1mal
I certify that I have authorized (agent) �0E-4511E� W40;5 to act on my
behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to
install or construct (activity) L-5bPT
at (location) �O 1 S L.
This certification is v
Signature
thru (date)
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

OCT-2-2006 0B:07A FROM: TO: 252 756 6439 P:2
r
{FOR A IF-RlUNCOt'E�1a B N yet 5i'A`I'� ;Ar r.r
1 herehy G:(Cify that I ou n propem/ adjarem to „tea
(�tnre of Prgper-��r}
Pr'.)FerY 1cM,?ted ar _ksO.f _o�_-.....F��O�� . �� __7�r✓fP.�4lf}s{��
(Lot, E31ock, Road,all in C • ( terbody�
(Torn andior�(; aty3
Ue has des;.;ibed to me, as shou:n below,
1the de�t!opr)rent h . i3 -p c�1tJOf1, and, [ have no objections to his proposal, t Understandmust be set ac!c a mini Understand distanc: of -fwn feAr f1S') rrom my MA( a
j waived by me.area oI
>os wish to ►vaeve.the seibacic require + OCT 5 7006
-^-•/�- meat_ .
wish to waive char setback requirement. Morehead City DeM
DESCV-1Vn0N - ANWOR DRAW-RFG OF PROP05 • ^ - Y — _ ---- �-_
(To do ]Eb:DF:%V.Ol'1zti3:
. molted ris 6� irulualrposin drr�i�'dntl'
t3 0S�
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----------------------- ---'-- .---- —-------------- ------ ----- ------
Signature 4L
Print or 7'yp� r•�.rne
S 2 ,- 1 - 2 '
TeJr_ phone N,rni•trr
46
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ADJA CENT ' ,t k e jjU ,�N pp
,,,.)PERTY C VVNIkk
(FOfZ A 1'IER1(-"V OYEP-HD ,8 1 STATE i
011 T ��I'7) .
I hereby cer�ify that I own property adjacent to R�4
40*11
! /�{��ri�e of Property Oti�azer)
property located at - B�4 Cr' -_1 �_--_---
(Lot, Road, etc.) � --
on
to G- ' C., .
(Z ' terbodv) (Totinia arad/orlC my} N.C.
He has described to me, as shown below the de�elaprj�ent
:ar
1oc3tian, and, I have no obyevrions to hhe. is proposing at t
IS proMsaI. I understand chat a 4j/.ttridovd
y must be set back a minimum distance of t"tfte`n fel(t 45' red boat :.ir
R p
waived by me. ) from my r:0[itriattCC9SS Llll<$S
I do no wish to waive .the s8aack requireme.M.
tv
wish waive that setback requirement.
DFSCRIp' ON .ND/OR DRAWRiG OF PROFOSF 7 _J ] b 20Q6
(To be D�►;p►
JiFled in br t yidisaI Pr= l n��ciss �l�fiM-eni) ®i't� e��.
*� Ps City DcM
p��
cli*'�D
---- _- _---
2
Signature .0
Print or 7yp•2 I;?rrte
Telephone Numbf
Date:

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- _ - NOT VALID OVER $1,000.00 63379893
ISSUING BRANCH 60793� R
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DATE .7HNNARY 04, 2007 93-541/920
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II■6337989311' 1:09 20051, 111:0 1707 L045 L09 211'
■ l"HfS DOCUMENT IIAS AN AKI W( LEI IN 01IRNIARK PRIM I'ED O!". THE BACK. "IFff, FROKI' OF'FHE DOCUMENT' HAS A MICRO -PRINT SIGNATURE LINE AND BORDER. ABSENCE OF THESE FEATURES WILL INDICATE A COPY. ■
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NOT VALID OVER $1,000.000
ISSUING BRANCH f O'70`3301-MOREHEAD MOI N
63379894
DATE -7r3C jIAR%,' ri,, i'f'Iii7 93-541/920
PAY TO THE
ORDER OF
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Q� � 5 +... I , : LI &T DOLLARS SY SIGNING YOU AGREE TO THE SERVICE CHARGE
J/ AND OTHER TERMS THE REVERSE SIDE.
DRAWER: TRAVELERS EXPRESS COMPANY, INC. _ _�- �
P.O. BOX 9476, MINNEAPOLIS, MN 55480 PURC ER, SI NER D EE: FIRST INTERSTATE BANK, HELENA, MT _
DRES
II■6337989411' 1:0920054111:0170710►.5109211'
■ TH15 DUCUMIL I iV. ARTI) I(.IAI Vi5' I'RINI L'D ON D II *ACK.'IHI': FRONT OF THE 1OCUMENT HAS A 111ICRO-PRINT SIGNATURE LINE AND BORDER, ABSENCE 01; THESE FEATURES WILL INDICA7E A COPY-
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