61012_MILLER, WADE_20121127

❑rAMA / C DREDGE & FILL fL- NO. 61012
GENERAL PERMIT Previous permit #
❑New ❑Modification ❑Complete Reissue 0Partial 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
c
❑ Rules attached.
Applicant Name Project Location: County_
Address Street Address/ State Road/ Lot #(s)
City State ZIP _
Phone # ( ) Fax # O Subdivision
Authorized Agent City__-_ _ _ ZIP_.
Affected ❑ CW ❑ EW C' PTA ❑ ES _I PTS Phone # ( ) _ _ River Basin
OEA ElHHF -i IH -- UBA I N/A
AEC(s): Adj. Wtr. Body- 1nat /man /unkn)
C PWS: C FC:
ORW: yes / no PNA yes / no Crit.Hab. yes / no Closest Maj. Wtr. Body ---
Type of Project/ Activity
Pier (dock) length
Platform(s)
Finger pier(s)
Groin length
number___
i
Bulkhead/ Riprap length
avg distance offshore
max distance offshore
Basin, channel
cubic yards
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing
Other
Shoreline Length
SAV: not sure yes nc
Sandbags: not sure yes nc
Moratorium: n/a yes nc
Photos: yes nc
Waiver Attached: yes nc
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 #
(Scale: ) I
See note on back regarding River Basin rules.
Permit Officer's Signature
i,
r c
/r
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, 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 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/ 1-888-4RCOAST
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)

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North C;; i mina [),;apartment )f Environment - nd Natural F:asources
ivision of I,oastaf Manac -.,vent
8everiy Eaves Perdue, Govei: »r
,lames 11, Gregson, Direc L,:,r I)ae Freeman, secretary
Date
A plicant Naml
Mailing Address
to act on my
I certify that I have ituthori zed (agent) . 'A
behalf, for the put P Ise of a )plying for i,nd obtaining f. CAMA Omits necessary to
install or Constrwil 3ctivit' )
at (location)
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This certificati.o �i v� i - -Signature
400l;c-nmerceMet!lle, Morehead f;it,, North Carolin<<28557
Phony: FAX: 1S?•247-3330\ lntr!rr:;t: www,nccDcl:3talmanagement.net
Ar 11,ai Opt: od inity 1 Affirmall ie °coon Employer :;;cyded 110% F osl Onsumer Piper

A.1U4 (ENT 11PARIAi1 PRUPERTj,' 'DWNER SrIVATEMENT
Itereh r cert.i that ] awn propert adjacent to
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Applicant's phoiz; 6Ui/� Mailing Adt •ess: L/
H6 has described t one, as Mown below the developrnen, ie is propwinjl at that location, and, I
have.no objeo:iorls ., his p3 �)posal.
r[ON ND/OR DR ► G OF PRI 1 POSED DEVELOPMENT:
o be fi l !ed in by pro y owner •pro, -ring developun enr)
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Mail.hrj Address
CitykState/Zip
(Ripari:si '`reperty Owner Information)
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Signature
Print or Type Name
Telep Nu bI
Date

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hereb : cer'.i Y that ] awn propert, r adiacent to of rP -► ; �)
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INTRACOASTAL MARINE CONSTRUCTION
3515 WHITE DR.
MOREHEAD CITY, NC 28557
Date
Pay to tfle
Order
2950
66-112/531
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BRANCII BANKING AND TPLIST COMPANY
I -800-BANK BBT BBT.com
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