53659_HANSON, RICHARD_20090507

EJ CAMA / ElDREDGE & FILL �W� /5�7m;6O., ,
GENERAL PERMIT Previous permit#
I.New '[1Modification ❑Complete Reissue []Partial Reisle 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 r !I
\ E Rules attached.
Applicant Name i t
Address I �'
City Stated` ZI lam(
Phone # (�� ��� Fax # (�)
Authorized Agent
I I CW 0 EW ❑ PTA ❑ ES ❑ PTS
Affected
AEC(s): 7 OEA ElHHF ❑ IH ❑ UBA ElN/A
❑ PWS: LTC:
ORW: yes / no PNA yes / no Crit.Hab. yes / no
Type of Project/ Activity
Project Location: County — __ —
Street Address/ State Road/ Lot #(s)
1
Subdivision
City
ZIP_
Phone # (_ _) River Basin
Adj. Wtr. Body_ '� - — _--(nat /man /unkn)
Closest Maj. Wtr. Body " -—
(Scale: ` t' )
r o
Pier (dock) length
Platform(s),f!,��L—_
Finger pier(s)
Groin length —
number
Bulkhead/ Riprap length
avg distance offshore_
max distance offshore
Basin, channel
cubic yards
Boat ramp
r
Boathouse/ Bdatlift�
Beach Bulldozing
Other
Shoreline Length
SAV: not sure yes 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:
Notes/ Special Conditions
1
II
_.
I i
i
-
-
- --------
I f f
Agent or -Applicant Printed Name
Signature Please read compliance statement on back of permit
Application Fee(s) Check #
See note on back regarding River Basin rules.
r
t
Permit Officer's Signature i
Issuing Date , 'Expiration ate
Local Planning Jurisdiction Rover File Name

e
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/ 1-888-4RCOAST
Location: Fax: [phone]
2728 Capital Blvd.
Raleigh, NC 27604
919-733-2293
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

,.
NCDENR��
North Carolina Department of Environment and Natural Resources
MAY
Division of Coastal Management �/�A�.,{� ��--yy,,,�~�ww�
Michael F. Easley, Governor James H. Gregson, Director wiltft Bade ft DGM
Date q . -Z q ' d e7-
Name of Property Owner Applying for Permit:
Mailing Address:
-7 6.y� --
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) L) '
at (my property located at)
2 / 3
This certification is valid thru (date)
jdFA
erty Owner Signat Date
400 Commerce Avenue, Morehead City, North Carolina 28557
Phone: [phone] \ FAX: [phone] \ Internet: www.nccoastalmanagement.net
An Equal Opportunity \ Affirmative Action Employer — 50% Recycled \ 1 o% Post consumer Paper

03/16/2009 02:52 15406649538 PAGE 02/02
ADJACENT RI PARI AN PROPERTY OWNER STATEM ENT x
(FOR A PIER/MOORING PI LI NGS(BOATLI FT/BOATHOUSE Low!.
I hereby acetify ttrA I own property adjaoant to
,A I P, �'s 1. .4 A% IS6 �U9
(Name of operty Owner) A
- - , � � , , , _ City DGAA
�, - _Ill =&_
(Lot, Block, Road, etc.);
I
onA in Q jGt�'1C_C/1 ► N.C.
(Water y) (Tavn and/or County)
He has descri bed to rue, as shown below, the da!vel opment he i s pro" ng at that I ocati on,
and, I have no obj ecti onto hi sproposal . I understand that a pier/moa'i ng pi l i ng%boafl ift/boathouse
must be set back a minimum distance of fifteen feet ('ji5) from my area of riparian ass unless
waived by ma
0 rg wish to waive the setback regV rement.
I do wish to wave that setback required ffd.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing demlopment)
(Applicant Information)
/o/l% <z 9o'c.x'ef 9 %V
Mai I i ng Address
R� le, a
city/aatdZap
9,1- 9-5 `�3a5
ephone Nurrber
DD9
Dat
(Rlparijan Property Qw tnfc kion)
Print or Type Name
TeiephoneNuaber
_'2,,�i��
Date

ADJACENT RIPARIAN PROPERTY OWNER STAY s EI4
(FOR A PIER/MOORING PI LI NGS/BOATLI FT/BOATHOUSE) MAY R14y
hereby certify that I own property adjacent to '
I/ J�
(Name of�eoperty Owner)
property I ocated at
(Lot, Block, Road, etc.)
n ��(f.�i r /!/ TI
on , i n .C.
(Wat ody) (Town and/or County)
He has descri bed to me, as shown below, the development he i s proposi ng at that I ocati on,
and, I have no obj ecti ons to hi s proposal. I understand that a pi er/moori ng pi I i ngsUatl i ft/boathouse
must be set back a minimum distance of fifteen feet (15') from my area of riparian access unless
waived by me.
I do not wish to waive the setback requirement.
I do wish to waive that setback requirement.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To befilled in by individual proposing development)
(Applicant Information) Seaw�0
Mailing ress
City/aate/Zi
Tel .7NumberDate
(Riparian Property Owner 1pformation)
Sg e
Pr i nt or Type Name
III I -%-1-q
Telephone Nuntxr
,Z
Date

JEANS. JOHNSON 5L
RICHARD D. JOHNSON
PH. 919-835-9308
1608 BICKETT BLVD.
RALEIGH, NCC227608
PAY
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State Embees' Credit Union®
Raleigh, North Carolina
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12 3 L770491:08604 2431
\v _- 66-7704/2531 7447
08604243130
date
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