41335_YATES, JAY_20050425

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I ICAMA / DREDGE & FILL S
GENERAL PERMIT ✓`Previous per #
hNew ❑Modification i L-]Complete Reissue LIPartial 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
ElRules attached.
Applicant Name ­Jv Project Location: County
Address _y% Street Address/ State Road/ Lot #(s)
City r7 ems.,. I `e. State.N C- ZIP 1�7 `-,{' J J. j _ : �c:� y ,, C
Phone # Fax # O Subdivision G<L• 11 -f��
Authorized Agent E-I' lei ,• ,. ,; l i City T/ :, ¢ k �, i !_1h4�.�./VE ZIP ' J
C CW ff�E1N E*TA ❑ ES ❑ PTS Phone # ( ) River Basin � y
Affected _
Ll OEA ❑ HHF ❑ IH f I UBA ❑ N/A
AEC(s): Adj. Wtr. Body- nat 7man unkn
f PWS: ❑FC: ��Q°�� q� `
ORW: yes / no PNA yes / no . Crit. Hab. yes / no Closest Maj. . Body �Czk
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
oT
Shoreline Length �. r
yl/,y
SAM not sure yes no; ---
Sandbags: not sure yes
Q
Moratorium: n/a yes
no
Photos: yes
no
Waiver Attached: yes
no
A building permit may be required by:
Notes/ Special Conditions
Agent or Applicant Printed,
Name
Signature Please read compliance statement on back of permit"
Application Fee(s) Check #
(Scale: )
,ice J�-•`-� rr ••� C- ' � �' I
-- See note on back regarding River Basin rules.
Permit Officer's Signature
Issuing Date Expiration Date t f)q
V
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, certifythat 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:
F _I 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 (910-395-3900) for more information on how to comply with thesebuffer rules.
Division of Coastal Management Offices
Central Office Elizabeth City District
Mailing Address: 1367 U.S. 17 South
1638 Mail Service Center Elizabeth City, NC 27909
Raleigh, NC 27699-1638 252-264-3901
Location:
Parker -Lincoln Building
2728 Capital Blvd.
Raleigh, NC 27604
919-733-2293 / 1-888ARCOAST
Fax: [phone]
Fax: [phone]
(Serves: Camden, Chowan, Currituck,
Dare, Gates, Pasquotank and Perquimans
Counties)
Morehead City District
151-B Hwy. 24
Hestron Plaza II
Morehead City, NC 28557
202-808-2808
Fax: [phone]
(Serves: Carteret, Craven, Onslow -above
New River Inlet- and Pamlico 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
910-395-3900
Fax: [phone]
(Serves: Brunswick, New Hanover,
Onslow -below New River Inlet- and
Pender Counties)
www.nccoastalmanagement.net
Revised 10/05/01

APR-21-2005 17:03
P.01
TOWN OF PINE KNOLL SHORES
100 MUNICIPAL CIRCLE
PINE KNOLL SHORES, N. C. 28512
Phone # [phone] Fax # [phone]
•
!E--� 'A, IbAlffik
AX9
::T-4 / ".V/ 1/1 Z-1
FIRM:
FAX:
i
DATE:
0
R.E/REN ARKS:
e
8"on
NUMBER OF PAGES (including this sheet):
ORIGINAL TO FOLLOW BY MAIL: Yes No
IU information contained in this facsimile is privileged and confidential information intended only for the use of the
individual or entity named above. If the reader of this message is not the intended recipient, you are hereby notified that any
discussion, distribution or copy of this communication is strictly prohibited If you have received this communication in
error, please notify us immediately.

APR-21-2005 17:03 P.02
GENERAL INFORMATION
LAND OI�VNER
Name Jay Gild Teresa Yates
Address 3609 Coventry Court
City nville State NC _� Iip 27858 Phone [phone]
To
AUTHORIZED AGENT
Name pddie Cameron Construction Inc,. --
Address !. P. O. Box 1647 (2407 Bridges St.) — ------__T--
City Mol:ehead City State ?_` _ Zip 28557 Phone [phone]
LOCATI9N OF PROJECY, (Address, street name and/or directions to sitc. If not oceanfront, what is the name of
the adjacerjtwaterbody?) 105 Mulberry Court. P. .11 Shares, NC 28512
DESCRIPTION OF PROJECT: (List all proposed construction and land disturbance-)
code and Pine Knoll Shores
SIZE OF;LOT/PARCEL: square feet acres
PROPO�ED USE, Residential X (Single-family _-X Multi-Earnily ) Commerical/Industrial
Other I
TOTAL ENCLOSED FLOOR AREA OF A BUILDING IN '['HE OCEAN HAZARD AREA OF ENVI-
RONME�TAL CONCERN (AEC): _ _ sgt=e feet (includes all floors and roof -covered decks)
SIZE OFIJ BUILDING FOOTPRINT .AND OTHER IMPERVIOUS OR BUILT UPON SURFACES IN
THE COASTAL SHORELINE AREA OF ENVIRONMENTAL CONCERN (AEC): sq. ft.
(Calculatigns include the atea of the roof/drip line of all buildings, driveways, covered decks, concrete or masonry patios,
erc. that arc within the applicable AEC:. Attach your calculations with the prnjecr drawing.)
Choose the AEC area that applies to your property-.
(1) within 75 feer of Normal i-IiF)i Water for the Estuarine Shorelinc AEC
(2) within 575 feet of Normal High Water for the Estuarine Shoreline AF.0 . adjacent to Outstanding
Resource Waters
(3) widiin 30 feet of the Public Trust Shoreline AEC
(COMICr your Local Permit Ufficer if you are not sure which AEC applies to your property.)
STATE SiTORMWATER MANAGEMENT PERMIT: Is the project located in an area subject to a
State Storr4water Management Permit issued by the N.C. Division of Water Quality?
YES NO
If yes, list the total built -upon arca/i npervious surface allowed for your lit or parcel. square feet.

APR-21-2005 17:04 P.03
OTHER I'�RMITS MAY BE REQUIRED; The activity you are planning;nay require permits other than the CAMA minor
development permit. As a service we have compiled a list of the kinds of permits That might be required. We suggest you check over the list
with your LV -,) to determine if any of these apply ro your project- Zoning, Drinking Wirer Well, SepricTank (or other sanitary waste r
treatment syslen), Building, Electrical, Plumbing, Hearing and Air Conditioning, Insulation and Energy Conservation, FIA Certification,
Sand Dune, Sediment Control, Subdivision Approval, Mobile Home Park Approval, Highway, Connection. and others_
2
STATEMENT OF OWNERSHIP:
1, the under�igncd, art applicant for a CAMA minor development permit, bc4 cidier the owner of property in an AEC or a
person authorized to act as an agent for purposes of applying for a CAMA rninor dcvelopro.ent permit, certify that the person
listed , ut owner on this application has a signifieanr interest in the real property described therein. This interest can fie.
described as' (check one)
X an owner or record title. Title is vested in _,Jay & Teresa Yates see Deed Book 910 —
page 19 in the Carteret County Registry of Deeds,
i
an owricr by virtue of inheritance. Applicant is an heir to the estate of
probate wasl in County.
if odic; interest, such as wriaea contract or lease, explain below or use a separate sheet and acrach to this applicarion.
NOY'IFI(ATION OF ADJACENT PROPERTY OWNERS:
l furtherxnc re cerrify that the following persons arc owners of properties adjoining this property_ I affirm That I have given
ACTUAL PIOTICE to each of thern concerning my intent to develop this property and to apply for a CAMA permit.
i (Name) (Address)
(1) Staizley Sakowski 13733 Aleppo, "Sun City West, AZ 85375
(2) Jac"s 11Passino 107 Mulberry Ct., Pine Knoll Shores, NC 18512
(3)-
(4)
FOR DENTLOPERS IN OCEAN HAZARD AND ESTUARINE HAZARD AREAS:
i
I acknowledge that the,land owner is aware that the proposed development is planned for an area which may be susceptible to
erosion an&or flooding. I acknowledge that the local permit officer has explained to me the parricuIar hazard problems associ-
ated with this lur. This explanation was accompanied by recommendations concerning stabilization and 800dproofing tech-
niques.
PERM15SION TO ENTER ON LAND:
I furrhermoire certify that I am authorized m grant and do in fact grant permission to the local permit officer and his agents to
enter on the aforementioned lands in connection with evaluating information rclatcd to this pr.rmit application.
This application includes: general information (this form), a site drawing as described on the back of this application, the
ownership statement, the .AEC hazard notice where neecs5ary, a check for $100,00 made payable to the locality, and any infor-
mation as may be provided orally by the applicant. The details of the application as described by these snurccs arc incorpt?rared
without reference in any permit which may be issued. I)eviation from these details will constitute a violation of any permit. Any
person developing in an AEC without perrtut is subject ro civil, criminal and administrative action.
This the il day of Tf 1 20 O
Landowner of person authorized to act as his agent for purpose of filing a CAMA permit applioa(i<?tt_

APP-21-2005 17:05 P.04
i
I
I
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1
April 8, 2005
Mr. Jacques 11. Passino
107 Mulberry Court
Pine Knoll Shores, NC 28512
Dear Mr. Passino:
This letter is to notify you, as an adjacent landowner of Jay and Theresa Yates, 105 Mulberry Court, Pine
Knoll Shores, NC, that he is going to construct a 6' deep dock, 5' in from each end of the property line.
Should you have no objections to this proposal, please check the statement below, sign and date in the
blanks below the statement, and return this letter to Eddie Cameron Construction, Inc_, P. O. Box 1647,
Morehead City, NC 28557, as soon as possible.
Should you have objections to this proposal, please send you written comments to the town of Pine Knoll
Shores, NC, 28512. Written comments must be received with ten (10) days of receipt of this notice.
Failure to respond in either method within ten (10) days will be interpreted as no objection.
Sincerely,
Eddie Cameron, III
President
I have no objection to the project as presently proposed and hereby waive
that right of objection as provided in General Statute 113-229.
I have objections to the project as presently proposed and have enclosed
comments_
Signature and Date

APR-21-2005 17:05 P.05
I
April 8, 2005
Mr. Stanley Sakowski
I 13733 Aleppo
i
Sun City West, AZ 85375
Dear Mr. Sakowski:
I I
This letter is to notify you, as an adjacent landowner of Jay and Theresa Yates, 105 Mulberry Court, Pine
Knoll Shores, NC, that he is going to construct a 6' deep dock, 5' in from each end of the property line_
i
Should you have no objections to this proposal, please check the statement below, sign and date in the
blanks below the statement, and return this letter to Eddie Cameron Construction, Inc., P. O_ Box 1647,
Morehead City, NC 28557, as soon as possible.
Should you have objections to this proposal, please send you written comments to the town of Pine Knoll
Shores, NC, 28512. Written comments must be received with ten (10) days of receipt of this notice.
Failure to respond in either method within ten (10) days will be interpreted as no objection.
Sincerely,
Eddie Cameron, III
President
I
I have no objection to the project as presently proposed and hereby waive
that right of objection as provided in General Statute 1 13-229.
1 have objections to the project as presently proposed and have enclosed
comments.
_._._...._.._-.. __ Signature and Date
i
TOTAL P.05

JAN-04-1900 15:13
P.01
TOWN OF PINE KNOLL SHORES
100 MUNICIPAL CIRCLE
PINE KNOLL SHORES, N. C. 28512
Phone # [phone] Fax # [phone]
AXO
TO:
I
FIRM.
Fes:
DATE
DUMBER OF PAGES (including this sheet):
01RIGINAL TO FOLLOW BY MAIM: Yes No
In r
The information contained in this facsimile is privileged and confidential information intended only for the use of the
individual or entity named above. If the reader of this message is not the intended recipient, you see herby notified that any
discussion, distribution or copy of this communication is strictly prohibited If you have received this communication in
error, please notify us immediately.

JAN-04-1900 15:13
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4ilw $dol
TOWN OF PINE KNOLL SHORES
100 Municipal Circle
Pine Knoll Shores, NC 28512
252-247-4353
PAY ****100 DOLLARS AND NO CENTS****
PAY
TO THE NC DENR
ORDER 400 COMMERCE AVE.
OF
MOREHEAD CITY, NC 28557
FIRST CITIZENS BANK & TRUST COMPANY 66-030
MOREHEAD CITY, NC 28557 531
No. 041689
DATE CHECK NO. CHECK AMOUNT
APR 25,2005 41689 0000
THIS DISBURSEMENT HAS BEEN APPROVED AS REQUIRED BY
THE LOCAL GOVERNMENT BUDGET AND FISCAL CONTROL ACT.
i1'04 168911' J:0 5 3 100 3001: L 3 L 50 1860 5I1'