56081_KEDJIERSKI, FRED_20100728

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❑�AIVEl 1 ❑DREDGE & FILL I A- It 15'6
GENERAL PERMIT Previous permit #
❑New ❑Modification ❑Complete Reissue ❑ artial 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 I SA NCAC
❑ Rules attached.
Applicant Name
Address
City i R
1 f
, i 1 r.1 State_ ZIPf!
Phone#Fax#(
Authorized Agent
❑ CW
JD EW D PTA ❑ ES ❑ PTS
Affected
AEC(s): ElOEA
❑ HHF ElIH ❑ UBA ElN/A
❑ PWS:
❑FC:
ORW: yes / no
PNA yes / no Crit.Hab. yes / no
Project Location: County
Street Address/ State Road/ Lot #(s)
Subdivision
City ZIP
Phone # ( 'T River Basin
Adj. Wtr. Body (nat /man /unkn)
Closest Maj. Wtr. Body
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Agent or Applicant Printed Name `
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Signature Please read compliance statement on back of permit
Application Fee(s) Check #
PermitOfficer's Signature /
Issuing Date / Expiration/ Da/te �?
Local Planning jurisdiction j Rover File Name 1

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/ 1-888ARCOAST
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

NC Division of Coastal Mgt. Habitat Impact Computer Sheet
Applicant: Fred Kejierski
Date: July 28, 2010
General Permit #: 56081 C
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 and/or
restoration or
and/or temp
restoration or
temp impact
temp impacts)
impact amount)
temp impacts
amount
OW
Dredge ❑ Fill ❑ Both ❑ Other g
350
350
HG
Dredge ❑ Fill ❑ Both ❑ Other g
50
50
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
252-808-2808 :: 1-888-4iRCOAST :: www.iiccoastainia5ia_qEtme�nt.net

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7 ■ 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.
1. Article Addressed to:
i
Y)ann
s
1/1 "c-
_Q Agent
❑ Addressee
Is delivery address different from item 1? Ll Yes
If YES, enter delivery address below: ❑ No
3. ervice Type
Rified Mail ❑ Express Mail
❑ Registered ❑ Return Receipt for Merchandise
❑ Insured Mail ❑ C.O.D.
4. Restricted Delivery? (Extra Fee) ❑ YeS
2. Article Number 7004 1350 0001 6537 9458
(Transfer from service label)
PS Form 3811, February 2004 Domestic Return Receipt ,Qclyv-e" 102595-02-M-1540

UNITED STATES POSTAL SERVICE
First-Cla, , Mail
Postage & Fees Paid
USPS
Permit No. G-10
• Sender: Please print your name, address, and ZIP+4 in this box •
Do fox �mc a�� �

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT'
I hereby certify that I own property sdjacent to ,'s /s
Al(Name of Pro rty Owner)
property located at A &enln5(tea—Dv
0,ot, Mock Road, etc—)
on wkrd Cvec , in o e 11t�� pah, l I c-() , N.C.
(watert�oay) (Town andlur County)
Applicant's phone #: �``t� ` 1 0 JMailing Address: o `7 Pen o lLeA Di
lC,'AIC— M.S71
He has described to me, as shown below, the development he is proposing at that location, and, I
have no objections to his pmposai_
DESCRI]MON AND/OR DRAVANG OF PROPOSED DEVKWFNIENT:
(To be fdW in by pwpe rry owner proposing develDP )
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(Information for Property Owe Applying
for Permit)
S zip l�� d�---
M"g Address
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City/State/Zip
Telephone Number
Signature Date
MparinnProp"
owner Infiwomtiou)
r
` Signature
Print Type Name
Telephone Number
ULV 1�
Date

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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:
Preci k�ed ►�� ' I
Mailing Address:
OrlenI4.. A/c, Q�S 7/
I certify that I have authorized (agent) ' Ge's (0 �' I * n C (00 Y Wf i6 rto act on my
behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to
install or construct (activity) ft CLn lr Ve ,C_ (JCGIL,
at (my property located at)
This certification is valid thru (date)
� C� lit KA
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Owner Signatu
Date
400 Commerce Avenue, Morehead City, North Carolina 28557
Phone: [phone] FAX [phone] k Internet: www.nccoastaimanagement.net
An Equal Opportunity 1 Affirmative Action Employer — 50% Recyded 110% Post Consumer Paper

B PRESCOTT MARINE CONSTRUCTION
PO BOX 874 252-249-0149
ORIENTAL, NC 28571
PAY
ORDER OF 1l l '0
TO THE
2017
DATE �%
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■ Complete items 1, 2, and 3. Also complete
item 4 11 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.
Article Addressed to:
I' Z5� Peri�nsu�a ��
i ��2� �vr4aD,1�� Z�dS7 i
❑ Agent
❑ Addressee
Is delivery address different from Rein 1? ❑ Yes
If YES, enter delivery address below: ❑ No
3. efvice Type
Certified Mail ❑ Express Mail
❑ Registered ❑ Return Receipt for Merchandise
❑ Insured Mail ❑ C.O.D.
i
4. Restricted Delivery? (Extra Fee) ❑ Yes
2. Article Number 7007 2680 0002 8365 1476
(Transfer from service label)
PS Form 3811, February 2004 Domestic Return Receipt IM95024-1540

UNITED STATES POSTAL SERVICE
N
0 Sender: Please print your name, addresg-, and ZTP*4*T'tfiis box
�GYlne
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B. PRESCOTT MARINE CONSTRUCTION, LLC
NC LICENSE # 67655
October 25, 2010
Ryan Davenport
Department of Coastal Management 40reh8ddC11y1)CM
400 Commerce Dr.
Morehead City, NC
RE: Kedjierski Permit Amendment
Dear Mr. Davenport,
I am requesting an amendment to General Permit No. 56081. 1 would like to add three mooring piles, as shown
on the enclosed drawing. Mr. Stephenson, the adjacent property owner to the North, has been notified of the
requested amendment and the Signed Green Certified Mail card is also enclosed.
Please feel free to contact me if you have any questions or need any further information. I appreciate your help
with this matter.
Sincerely,
Brandi Prescott Robertson
Project Coordinator
B. Prescott Marine Construction, LLC
P 0 Box 874
Oriental, NC 28571
252.249.0149
www.prescottmarineconstruction.com

No
.
CAMA / ❑ DREDGE & FILL
GENERAL PERMIT
ew ❑Modification ! 1Complete Reissue El Partial Reissue
Previous permit #
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 / /4 e
r
}R}ules attached.
Applicant:NameProject Location: County flx-t A iAddress � -j - { i L% _ Street Address/ State Road/ Lot #(s)
City t to State ZIP
Phone # a r 'r Fax #( _ Subdivision Cr,
Authorized Agent _ City . ' , �.`i
g c �.S ° f�f i 11f' Cis`"' ' 4 _ZIP _f 3S3 s� f
f
Affected El cW �'[�EW `KftA ids PTs Phone # River Basin
AEC s : OFA ElHHF ❑ IH ❑ USA ❑ WA
() ❑ PWS: ❑FC: Adj. Wtr. Body } —r (� - u/man /unkn
ORW: yes /: no PNA 4F,-J no Crit.Hab. yes /not Closest Maj. Wtr. Body A, (-'�a";F' RA 1 x-
Type of Project/ Activity
608 �
Pier (dock) length (�; yf (Scale: .i0
Platform(s) t7 _
i
Finger pier(s)
Groin length
number -'-- — -
Bulkhead/ Riprap length _► a - - - TI
_ 1
avg distance offshore r
max distance offshore
Basin, channel
cubic yards
r
Boat ramp
i
Boathouse/ Boadift
Beach Bulld g
Other V t-
-
Shoreline Length `}{
SAV: not sure yes o
Sandbags: not sure yes no r� 1 I
Moratorium: ri/ Yes no
Photos: yes n
Waiver Attached: yes n..-
r� 4 ri
A building permit may be required by:�i
Notes/ Special Conditions
Printed
f
Suture Please reacompliance statement on back gf permit
or I
Permit
See note on back regarding River Basin rules.
I
tef j / /IZg'Acpiratj nDate

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Image © 2010 DogitaeGlobe o2...GooSte
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Lv, Image U.S. Geological Survey
Imegeiy'Oates. May 30, 2006?-Mar 9, 2008 35°02'49.57` N 76°40.09.21" W elev SIR Eye all 24342 it

Fllled and
Grated to Flood
Level
PC A, SLIDE 36-8 `
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NOTES:
W =1
ch
I
FOR REFERENCE SEE
PC A, SLIDE 36-8 AND
THE RATIO OF PRECISION WAS
W
CALCULATED AT 1: 10, 000+
O
O
EIP = EXISTING IRON PIN
MHWL = MEAN HIGH WATER LINE
THIS SURVEY IS OF AN EXISTING PARCEL
AREA IN DYG SETBACKS b
AND DOES NOT CREATE A NEW STREET
960.o v �� IN 2DE TYD W
20.0 In Zone 1 Z
OR CHANGE AN EXISTING ONE.
sq under deck
THIS SURVEY IS SUBJECT TO ANY FACTS
THAT MAY BE DISCLOSED BY A FULL AND
ACCURATE TITLE SEARCH.
EIP
THIS PROPERTY IS LOCATED IN A FLOOD
RASE
HAZARD AREA BASED ON 'FIRM' PANEL #
370181-0295-B, ZONE A7
BASE FLOOD ELEV 9. 0' , DATED 9/4/85,
SCALE 1' = 60'
ORCHARD CREEK
'uz TE 'T
M A R K R, L E E
A SURVEY FOR
PR❑FESSI❑NAL LAND SURVEYOR
P. O, BOX 303
E R E D
K E D J I
E R S K I
ARAPAHOE, NC 28510
TELE. # (252) 249 — 0226
DATEDEC
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LOT 22, ORCHARD CREEK ESTATES
SEC, 1 & 2
7, 2002
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WANTS TO SEE YOU

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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.
Article Addressed to:
NC- V9 I
A. Signature
X
❑ Agent
e --
❑ Addressee
B. Received by (P& d Name)
C. D to of elivery
L
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D. Is delivery address different from item 1?
❑ As
If YES, enter delivery address below:
❑ No
3. Service Type
Certified Mail ❑ Express Mail
❑ egistered ❑ Return Receipt for Merchandise
❑ Insured Mail ❑ C.O.D.
4. Restricted Delivery? (Extra Fee)
❑ Yes
2. Article Number 7007 2680 0002 8365 1377
(Transfer from service label) _
PS Form 3811, February 2004 Domestic Return Receipt 10259r02-M-1540

UNITED STATES P&
gm�
%J
0 Sender: Please print your name, address, and ZIP+4 in this box 0
ot
�10 �3c)Vr4

/ • No Insurance
Coverage Provided)
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For deliveryOFFICIAL
U
Postage
$CO
W�r
Certified Fee
Fu
Postmark
1:3
Return Receipt Fee
Here
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(Endorsement Required)
0
Restricted Delivery Fee
C3
(Endorsement Required)
CO
Total Postage & Fees
is
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ent to
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S`treef, Apt IVo.;
or PO Box No. tt D
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City, State, ZIP+4444
PS Form :00 August 2006
See Reverse for Instructions

November 9, 2010
1
NUS 9 Zola
Mr. Ryan Davenport
Division of Coastal Management
Per our conversation I oppose a request from B Prescott, Marine Construction (enclosed
copy) of proposed mooring piles added to permit 15A NCAC 7 H - 1200.
Main reason being that mooring piles were put in place prior to proposed request and
were not on original pier permit. I request that the mooring piles that were put in be
removed and a proper application be submitted to Division of Coastal Management.
In addition by placing mooring piles in this location it would violate my Riparian Rights.
°5� ZT
Stanley Stephenson
256 Peninsula Drive
Oriental, NC 28571