43607_JAMES, TIM_20060112

1_-iCAMA / H DREDGE & FILL
GENERAL . PERMIT
❑New 1-'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
rp
Previous permit #_
Date previous permit
Applicant Name I ' 1 ` 7 Project Location: County
Address Street Address/ State Road/ Lot
City N y' State ; }J ` ZIP
Phone # Fax # O Subdivision "
ZIP Rc�:. - r
Authorized Agent � City "
Affected 11 CW D EW ❑ PTA F� ES ❑ PTS Phone # ( ) River Basin
AEC(s): OEA ❑ HHF ElIH ❑ UBA El N/A Adj. Wtr. Body (nat /roan /unkn)
❑ PWS: 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
L�J
(Scale: )
Shoreline Length
0''21
SAM not sure
yes
i
no — —
Sandbags: not sure
yes
no
Moratorium: n/a
yes
no
Photos:
yes
no
Waiver Attached:
yes.
no
A building permit may be required by: — See note on back regarding River Basin rules.
Notes/ Special Conditions
Agent or Applicant Printed Name
Signature Please read compliance statement on back of permit
Application Fee(s) Check #
Permit Officel's Signature
Issuing Date Expiration Date
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, 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
L] Neuse River Basin Buffer Rules
❑ Other:
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/OS

Nov 04 05 0e :2na IDELCHER 2527571072 p.1
0.
Adjacent Riparian Property Owner Statement
(FOR A PrER/i OORING PIlLINGSBOATi..IFf/1810ATHMSF.)
I hereby certify that 1 owSn property adjacent to
_ L__.1�t---
� ,r f Prod Owner —�
pzc�pe�rty located at -_ ,�_f7� 7r�--�� �� �
Lot, Mock, road, rtc.
r
01"1 a'_'YJL � C{l „ C fZ�-_ !i�%z " r' Y✓� , in _ r ' j `• 1 .- -' �
waftrb �dy Town and/or counts'
He has described to me, as s? ow.q �,el,)w, the developxr ent lae is pzoposing ai that k,cation and I have
no objections to his proposal.
I do not wish to wai ve the setback requirement,
k�--1 do wish to waive the setback requirement.
Description and/or Drawing of Proposed Development
(To be tilled in by the individual prorosing develop -meat)
Sa rd v6re
Print or type name
'telephone number
1/ i �

a
0;'N, 7 �
Adjacent Riparian Property Owner Statement
(FOR A PIER/MOORING PILINGS/BOATLIFT/$OATHOUSE) Qpt LC M
I hereby certify that I own property adjacent to -Ti'w\ Sa wy-S is
Name of Property Owner
property located at l- o f O Z S 4-a,nlyr,
Lot, block, road, etc.
on Th 1-ra Coa-Oml AtiaJ&W c1'4 , in C.wrAre+ , NC
Waterbody t 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 do not wish to waive the setback requirement.
r I do wish to waive the setback requirement.
Description and/or Drawing of Proposed Development
(To be filled in by the individual proposing development)
���,�,t hd
fcG Rom' "
Signature
Print or type ame
"lli_ 40- gg9e
Telephone number
b\ ) In&
Date
aIZ A/C
W Z7rJ7

U. F. S., LLC
2854
CAMA Check Number: 2854
Check Date: Nov 4, 2005
Duplicate
Check Amount: $10 0.0 0
Item to be Paid - Description Discount Taken Amount Paid
Permits All Phases 100.00
LR22019LN1 HOMAN COMPANY OF NC, 252-247-5766 PRRUW IN U.&A.

WACHAD TANK, N.A. 66152J531
U.2854
. F. Sy LLC MOREHEAD CITY, NC 28557
101 DOLPHIN WAY DATE
BEAUFORT, NC 28516 Nov 4, 2005
252-728-7576
PAY Mem O :
TO THE One Hundred
ORDER
OF:
CAMA
0
and 00/100 Dollars
L}� SECURITY FEATURES INCLUDED. DETAILS O A
11100 285411' 1:053 LO Z5 2911: 546 L OOS44 ills
AMOUNT
$ *****$100.00