56377_FARLOW, GARY_20100922

❑ CAMA / ❑ DREDGE & FILL InvGENERAL PERMIT 1
Previous permit #
❑New ❑Modification ❑Complete Reissue ❑Partial Reissue 4- 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
❑ Rules attached.
Applicant Name A Project Location: County
Address CeIJ Street Address/ State Road/ Lot #(s)
City State ZIP
Phone # ( ) Fax # () Subdivision
Authorized Agent City. ZIP r (n
Affected - Cw ❑ Ew ❑ PTA ❑ ES ❑ PTS Phone # ( ) River Basin f` i
AEC(s): ❑ OEA _ HHF ❑ IH ❑ UBA ❑ N/A Adj. Wtr. Body (nat /man /unkn)
❑ PWs: ❑ FC:
ORW: yes / no PNA yes / no Crit.Hab. yes / no Closest Maj. Wtr. Body
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Agent or Applicant Printed Name
Signature ** Please read compliance statement on back of permit **
Application Fee(s) Check #
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, 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 comply with these buffer rules.
Division of Coastal Management Offices
Raleigh Office
Morehead City Headquarters
Mailing Address:
400 Commerce Ave
1638 Mail Service Center
Morehead City, NC 28557
Raleigh, NC 27699-1638
252-808-2808/ I-888-4RCOAST
Location:
Fax: [phone]
2728 Capital Blvd.
(Serves: Carteret, Craven, Onslow -above
Raleigh, NC 27604
New River Inlet- and Pamlico Counties)
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)
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

NC Division of Coastal Mgt. Habitac :�Cjv--
Applicant: Greg Smith
Date: September 20, 2010
General Permit #: 56377C
Describe below the HABITAT disturbances for the application. All values should match the name, and units of measurement
found in your Habitat code sheet.
TOTAL Sq. Ft.
FINAL Sq. Ft.
TOTAL Feet
FINAL Feet
(Applied for.
(Anticipated final
(Applied for.
(Anticipated final
DISTURB TYPE
Disturbance total
disturbance.
Disturbance
disturbance.
Habitat Name
Choose One
includes any
Excludes any
total includes
Excludes any
anticipated
restoration
any anticipated
restoration andlor
restoration or
and/or temp
restoration or
temp impact
temp impacts)
impact amount)
temp impacts)
amount
HG
Dredge ❑ Fill ❑ Both ❑ Other ®
310
310
HM
Dredge ❑ Fill ❑ Both ❑ Other ®
310
310
OW
Dredge ❑ Fill ❑ Both ❑ Other ®
310
310
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑

■ Complete items 1, 2, and 3. Also complete
item 4 if Restricted Delivery is desired.
■ Print your name and address on the reverse
so that we can return the card to you.
` ■ Attach this card to the back of the mailpiece,
or on the front if space permits. !*i
1. Article Addressed to:
149 , += (f'dGc.a N )-\0
2-7265
A. nature
``13 Agent
X 1 i. + ,\y�
'v\!w r �Yi DALC Addressee
B. Received by (Printed`yarne) I C. Date of Delivery
D. Is delivery address different from item 1? ❑ Yes
If YES, enter delivery address below: ❑ No
3. Service Type
❑ Certified Mail ❑ Express Mail
❑ Registered ❑ Return Receipt for Merchandise
❑ Insured Mail ❑ C.O.D.
4. Restricted Delivery? (Extra Fee) ❑ Yes
2. Article Number 7007 071,0 0001, 5273 2721,
(fiansfer from service label)
PS Form 3811, February 2004 Domestic Return Receipt 102595-02-M-1540

UNITED STATES POSTAL SERVICE
First -Class Mail
Postage & Fees Paid
USPS
Permit No. G-10
• Sender: Please print your name, address, and ZIP+4 in this box •
(56 R L v,
!kiEtz
Z�Sss�
IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII

■ Complete items 1, 2, and 3. Also complete A, Signat
item 4 if Restricted Delivery is desired. ❑ Agent
X
■ Print your name and address on the reverse l�A Jr, ❑ Addressee
so that we can return the card to you. B. Re eived by (Prfnte Name) C. ate of Delivery
■ Attach this card to the back of the mailpiece,
or on the front if space permits.
D. Is delivery address different from item 1? ❑ Yes
1 1. Article Addressed to: If YES, enter delivery address below: ❑ No
3
3, ServicpType
®,Certified Mail CI Express Mail
i v t
�1SL
Registered Retum Receipt for Merchandise
❑ Insured Mail ❑ C.O.D.
4. Restricted Delivery? (Extra Fee) ❑ Yes
2. Article Number
(Transfer from servicelabeo 7007 0710 0001 5273 2882
PS Form 3811, February 2004 Domestic Return Receipt 102595 o2-M-i540

UNITED STATES POSTAL SERVICE
• Sender: Please print your name, address, 16nd ZI
�,4sS5�
Fj}Fl�Ftlif3s,}�}f3Ili fill 3ff3ii mill} 101

CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Individual applying for Permit: F7Aa L.uu)
Address of Property: "i ,q e+ 1N1—=Aur=Q CAMP F-0817'
NC OSISSG
(Lot or Street #, Street or Road, City & County)
I hereby certify that I own property adjacent to the above referenced property. The individual
applying for this permit has described to me as shown on the attached drawing the development
they are proposing. A description or drawing, with dimensions, should be provided with this letter.
I have no objections to this proposal.
If you have objections to what is being proposed, please write the Division of Coastal
Management, 400 Commerce Avenue, Morehead City, NC, 28557 or call [phone] within
10 days of receipt of this notice. No response is considered the same as no objection if you
have been notified by Certified Mail.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boathouse, boatlift or sandbags must
be set back a minimum distance of 15' from my area of riparian access unless waived by me. (If
you wish to waive the setback, you must initial the appropriate blank below.)
I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(Applicant Information) (Riparian Property Owner Information) ea-lajj�"^
(.�L
Mailing Address Signature
ERA)1t--E- CAL-A8/1N
City/State/Zip Print or Type Name
33(e -q57-2613
Telephone Number Telephone Number
.nUG-
Date Date

GARY FARLOW 10-83
P.O. BOX 65
MERRITT, NC 28556-0065
1710
68-11510 VA
Date
ei 266
_ ) 0n
Bankof America
ACN R/T 051000017
Memo
�:0 5 L0000 L 7t: 0000 268 LEI249ii' L 7 ID

Alj'A
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NCDENR.
IJorth Carolina Department of Environment and Natural Rlescurces
Division of Coastal Management
Beverly Eaves Perdue James H. Gregson Dee Freeman
Governor Director secretary
BUFFER AUTHORIZATION CERTIFICATE
FOR PIER AND DOCKING FACILITIES ACCESS WAY
A riparian buffer authorization is required for pier and docking facilities access ways through the Tar -Pamlico &
Neuse River Riparian buffer per Division of Water Quality (DWQ) regulations 15A NCAC 02B.0233 & .0259.
The Division of Coastal Management (DCM), through a Memorandum of Understanding with the Division of
Water Quality (DWQ) has reviewed your project proposal, determined that the project as proposed complies
with the aforementioned regulations, and made a "no practical alternatives" determination per those
regulations.
Those activities covered by your Coastal Area Management Act (CAMA) permit have received Buffer
Authorization as long as the project is constructed in a manner that continues to meet all of the conditions
listed below. Failure to comply with this Buffer Authorization shall subject the property owner & the party
(contractor) performing the construction Wor land clearing to a civil penalty of up to $25,000 per day per
violation.
1. Crossing is Perpendicular: Pier and docking facility access way must cross the 50 ft. riparian buffer
perpendicularly (which is defined as between 75 and 105 degrees) unless otherwise approved by DCM.
The alignment shall minimize the removal of woody vegetation to the greatest extent practicable.
2. Pervious Materials: All reasonable measures shall be taken to ensure the access way is made of
pervious materials like open -slatted wood or composite, mulch, or grass to meet the intent of the rules
to the maximum extent practicable.
s. Access Width: The width of the pier or docking facility access way shall be limited to six (6) feet.
4. Project Drawing: The drawing on the CAMA General Permit is considered the project drawing of your
property indicating the relative location of the pier or docking facility and any requested access way.
This drawing will be used to aid in compliance and monitoring efforts.
By your signature below you agree to be held responsible for meeting all of the conditions listed above and
verify that all information provided is complete and accurate.
wC ©W
Agent o Ap lic Printed Njme
Agent or p d-yt Sjgfllfture
�3
CAMA GENERAL PERMIT #:��C
Washington Office
943 Washington Square Mall
Washington, NC 27889
Phone [phone]
Morehead City Office
400 Commerce Avenue
Morehead City, NC 28557
Phone [phone]
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Version 5, 09/2009