52678_HARDESTY, JOHN_20081202

❑CAM,A. )/ --'DREDGE & FILL 1/
GENERAL PERMIT Previous permit #"
❑New ❑Modification --'Complete Reissue W❑Partial 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
Applicant Name
F i
Address
City ; i s ? t? State NC..- ZIP '
Phone # (,) "��� (j(^ Fax #
Authorized Agent �' ! ' rt ,i C-�-J
.�� CW .J EW LLD PTA .0 ES ._ !! PTS
Affected OEA HHF ❑ 1H ElUBA 7-N/A
AEC(s}:
PWS: CFC:
ORW: yes / no PNA yes / no Crit.Hab. yes / no
❑ Rules attached.
Project Location: County
Street Address/ State Road/ Lot #(s) -- 7
----- ' V
Subdivision
City ZIP
Phone # () River Basin 'f f_.
Adj. Wtr. Body- - e. (nat ' an nkn)
Closest Maj. Wtr. Body—'
Type of Project/ Activity
y
(Scale: �� )
f
-t` (-
Pier (dock) length _
Platform(s)_
Finger pier(s)
Groin length
number i
Bulkhead/ Riprap length �
avg distance offshore
max distance offshore J _
Basin, channel-
cubic yards
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing
Other
Shoreline Length
SAV: not sure yes no
Sandbags: not sure es no
Moratorium: n/ yes es no
Photos: yes no t
Waiver Attached: yes no
A buildingpermit may be required by:
P Y 90
Notes/ Special Conditions
__
i
I
-
—i
-
_ - --_ -
See note on back regarding River Basin rules.
S g
f• -
- I
Agent or Applicant Printed Name
Signatu(re� Please read compliance statement on back of permit
Application Fee(s) Check#
Permit Officer's Signature
Issuing Date Expiration Date
AI
, I1
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 [)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
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)
Revised 08/09/06

NOU-21-2008 14:17 From: 7o:2527266079 P.1/i
ZZ/2i12a9E 1a;3E 252726e079 DEANWES PAC_ 01
ACENT RIPARIAN PROPERTY OWNER STATEMENT
"A A PIER/MOOIt'1?VG PU.QVG"QATUI T/BOATHHOUSE)
I �by certify that I own pm*tty edjaoeot to
(Name of Property Owner)
pmPerty at
(Lot, Hoch. Road, ek.)
on .. , 2 V5 J2- N.C.
rbodp) -- (Town as&or Counts')
has described io ice, as shown below, the developmad he is proposing at that location,
and, I h. do objections" oposal. I waderstmd tbbat a pieclmooring pitingsuatlif Ibmthouse
muse be back a minitntui, i�no�cc of fifteen feet (151 %m my azea of ri*an access unims
f
wwvcd b�' Me. as '
i1413A wish taFwaive the smock requirement.
I !t wish to wai4" mdock regvi t
-- GUMPTION Alq"R DRAV4XG OF IMOPOSED DEVELOPMENT-
(7'o beamed W by U dtvt"prvP'psfr8 devdVff wnt)
,� ►,� r, �' le- �'�- '� � � � L � �,, A t. �." � t.%Fi 1 NLS 7 ice• a �'t• a Z' A R.
-... _r—t......r - __
(App pool t Information)
.. - - ...—
(Iii a formation)
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MQitirlQ
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Dote ��
D&e

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent tQW42 - 's
U (Name of Property Owner)
property located at a y 3-e � 6c--r--t-9—
(Lot, Block, Road, etc.)
on ���G.�T-e L , in IL S N.C.
(Waterbody) (Town and/or County)
Applicant's phone #: 6� Mailing Address: DJ �-
kL N , 27�-) /`Z
He has described to me, as shown below, the development he is proposing at that location, and, I
have no objections to his proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by property owner proposing development)
OLq 7e-,Wr V, L- -.--
-------------------------------------------------------
(Information for Property Owner Applying
for Permit)
Mailing Address
City/State/Zip
2*-- 16 G 1
Telephone Number
Signature Date
(Riparian Pr er wner Infor tion)
Signature
,WAINI,# /�- MILJ11,
Print or Type Name
Telephone Number
Date

AN;A
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
Michael F. Easley, Governor James H. Gregson, Director William G. Ross Jr., Secretary
Date j /. 2 1 016
Name of Property Owner Applying for Permit:
V,
Mailing Address:
I certify that I have authorized (agent) to act on my
behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to
install or construct (activity)
at (my property located at) / 1 `t
This certification is valid thru (date)
R4
Property Owner Signature
Date
400 Commerce Avenue, Morehead City, North Carolina 28557
Phone: [phone] \ FAX: [phone] \ Internet: www.nccoastalmanagement.net
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