56826_JOHNSON, EMMITT_20100521

J 151&/ 6
❑CAMA / ❑ DREDGE & FILL
GENERAL ,PERMIT / Previous permit#
❑New ❑Modl'ficatiq-h El Complete Reissue El Partial Reissue A-\ 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 I SA NCAC
Applicant Name
Address
City r''LSO4-1
State ZIP
Phone # ()
Fax #
Authorized Agent
Affected ❑ CW ❑ EW
❑ PTA ❑ ES ❑ PTS
AEC(s): ❑ OEA ❑ HHF
❑ IH ❑ UBA ❑ N/A
❑ 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/ Riprap length
avg distance offshore
max distance offshore
,Basin; channel
cubic yards
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing
Other
Shoreline Length
7 o
' "a
SAV: not sure
yes no
i
Sandbags: not sure
Moratorium: n/a
yes no
yes no
1 Y
Photos:
yes no
Waiver Attached:
yes no
A building permit may be required by:
Notes/ Special Conditions
4
-
Agent or Applicant Printed Name
M.-.
p/-`
Signature ** Please read compliance statement on back of permit **
Rules attached.
Project Location: County
Street Address/ State Road/ Lot #(s)
Subdivision !f p ice`:, !)O -14 _
city ZIP 71 L
Phone # (?) 12i$ River Basin
Adj. Wtr. Body a� a 1 GAT rN' IS (nat Anan unkn
Closest Maj. Wtr. Body � n r-t � v,r r
(Scale: )
e
.01
❑ See note on back regarding River Basin rules.
Permit Officer's Signature
3 a 1z
Issuing Date Expiration Date
Application Fee(s)
Check #
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, certifythatthis 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/ 1-888ARCOAST
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

NC Division of Coastal Mgt. Habitat Impact Computer Sheep
Applicant: Emmitt Johnson
Date: 9/21 /10
Permit #: 56826C
Describe below the HABITAT disturbances for the application. All values should match the name, and units of measurement
found in your Habitat code sheet.
Habitat Name
DISTURB TYPE
Choose One
TOTAL Sq. Ft.
(Applied for.
Disturbance total
includes any
anticipated
restoration or
temp impacts)
FINAL Sq. Ft.
(Anticipated final
disturbance.
Excludes any
restoration
and/or temp
amount)
TOTAL Feet
(Applied for.
Disturbance
total includes
any anticipated
restoration or
temp impacts
FINAL Feet
(Anticipated final
disturbance.
Excludes any
restoration and/or
temp impact
amount
Shallow Bottom
Dredge El Fill ❑ Both ❑ Other O
—impact
1050
1050
High Ground
Dredge ❑ Fill El Both ❑ Other ❑
2100
2100
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
252-808-2808 :: 1-888-4RCOAST :: www.nccoastalmanagernent.net revised:02103/10

NCDENR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
Beverly Eaves Perdue, Governor James H. Gregson, Director Dee Freeman, Secretary
Date
Name of Property Owner Applying for Permit: r r j
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Mailing Address: Jop,)—b
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I certify that I have authorized (agent LDS `-)nA�e-s to act on my
behalf, for the purpose of applying for and
,obtaining all CAMA Permits necessary to
install or construct (activity) .M A-� �% t� ,4 �1C 2 olc', L,44I G .41
at (my property located at) Z- Z1'A—rAi+s be, Zl q 9y 14s b V, I, J�
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This certification is valid thru (date) -beC 31 2-0 10
9-g-iv
Property ne ure `/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
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SEP 13 2010
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■ 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.
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D. Is delivery address'different,fMm Item 17 \Yps
if YES, enter delivery addresrsctlow:p
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3. S ice Type
rtiffed Mail ❑ Express Mail
❑ Registered ❑ Return Receipt for Merchandise
❑ Insured Mail ❑ C.O.D.
4. Restricted Delivery? (Extra Fee) ❑ Yes
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CERTIFIED MAIL • RETURN RECEIPT REQUESTED RECEIVED
DIVISION OF COASTAL MANAGEMENT CEP 13 2010
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONMAIVER FORM
orenead City DCAA
me of Individual applying for Permit:
Address of Property: 2-7-1
LEM�Al�-+
:i JP-- —RRA(&�O' v+ . AJ
(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 prop sing. 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 orcay [phone] within
90 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)
Mailing Address
City/State/Zip
2S2 -- 1;d
Telephone Number
S-zq -tom
Date
(Rip�arn" Property�Owner I f mation)�
S nature
Print or Type Name 1
Telephone Number
Date