60198_BRAZELLE, DIANE_20120510

J CAMA / J DREDGE & FILL
GENERAL PERMIT
New ❑Modification Complete Reissue -1Partial Reissue
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
Address
., ^' ! State �ZIP
City , •, i <',.'� ;�'t-
Phone # (__} �,(,i - L'� Fax #
Authorized Agent
Affected ` ' CW --I EW 2 PTA DES f-- PTS
AEC(s): OEA ❑ HHF ❑ IH UBA ❑ N/A
C PWS: C' 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/ Boatli�ft )0 at 10
Beach Bulldozing
Other 1 . I i
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
Agent or Applicant Printed Name
Signature "Please read compliance statement on back of permit"
Application Fee(s) Check #
9- P6 No. 60198
Previous permit #
Date previous permit issued
❑ Rules
Project Location: County
Street Address/ State Road/ Lot #(s)
Subdivision
City�} ZIP l
Phone # ('') + _tr��,-7 River Basin
Adj. Wtr. Body_ r nat man /unkn)
Closest Maj. Wtr. Body
(Scale: )
See note on back regarding River Basin rules.
Permit Officer's Signature
t'
Issuing Date Ex0irati6n Date
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, 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 [J 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)

REED
May 4, 2012 MAY 0 7 Z01Z
Barry Guthrie
CA M A DCMM CITY
400 Commerce Ave.
Morehead City, NC 28557
RE: Proposed dock and boat lift for 1678 Island Rd, Harkers Island, NC
Barry Guthrie:
In pursuit of a CAMA permit for a dock and boat lift, I am enclosing a signed
riparian property owner's statement from the Willhauck property. For the
Overton property, I am enclosing copies of the certified mail receipt and the
signed return receipt cards that were returned to me. After Ms. Overton received
her copy, she informed me of 3 other property owners that I would have to
inform also: Thomas Overton Jr., Libby Pitman, and Marlene Jennings. You will
also find return receipt cards for these 3. Although I enclosed self- addressed
stamped envelopes, none of the Overton forms were returned to me.
I am also enclosing a check for $200.
I am ready for a site visit and the dock and boat lift will be built by Bently and
John Brooks, phone [phone]. If you have any questions, I can be reached at
252-670-4967.
Thank you,
J �
Diane Brazelle

TA900I 10 T16 ACS Tax System
Parcel Inquiry
Parcel Number
R 7344.05.19.7868000
2012
Tax Codes District Code
8 Taxpayer 33989
Twn / Sch 0008
MARION ETLJX ELIZ WILLHAUCK
Spec Dist 16
19 C FOUNTAIN
MANOR DR.
User Codes
Deed Book/Page 0475 00063
Plat Book/Page
GREENSBORO
NC 27405
Property Addr: House# 1684
Street Name ISLAND
Alternate
More?
Street Type RD Dir Unit
CiStZp HARKERS ISLAND
NC 28531
Escrow 900012
More?
Legal Description
WACHOVIA MORTGAGE CO
Plat
Other
More?
Lot/Block
Deeded Acres .31
Previous 33989
More?
LOT ON SR 1335
MARION ETUX ELIZ WILLHAUCK
Deed? Values?,Y,
Delete ?
Action

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CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM
Name of Property Owner:
ri
Address of Property: I L I F Bk a- { a i , i-LLK tefe "S
(Lot or Street #, Street or Road, City & County)
Applicant phone #: %-S-Z - ("'1C - Mailing Address: �� i � j!rt.l IaCe bi-�� e
L✓ree�►ShE,�t� YY' � ��(��
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 proposing. A description or drawing, with dimensions, must be provided with this letter.
I have no objections to this proposal. I have objections to this proposal.
If you have objections to what is being proposed, you must notify the Division of Coastal Management
(DCM) in writing within 10 days of receipt of this notice. Contact information for DCM offices is
available at www.nccoastalmangement.net/contact dcm.htm or by calling 1-888-4RCOAST. 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, or lift 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.
(Property Owner Information)
Signature 0 U
-" L-il -b' flu,, e -�6 (aZ-e i (P
Print or 71fpe Name
Mailing Address
&t-e-enSboolo , nL 21461
City/State2ip
%S�- (0,1 o - LM L
Telephone Number
Date
(Riparian Property Owner Information)
Signature
F lt'ZAhie-7l> D, t`llh4 oc'e
Print or Type Name
ig�. At,,
Mailing Address
City/State/Zip
(3 3 61 a 7'
Telephone Number
Date

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TA900I 10 T16 ACS Tax System
Parcel Inquir;
2012
Parcel Number
R 7345.17.10.7004000
Tax Codes
District Code
8 Taxpayer 19500
Twn
/ Sch
0008
THOMAS L OVERTON
Spec
Dist 16
User
Codes
P 0 BOX 73
Deed
Book/Page
0533 00418 533
418
Plat Book/Page HARKERS ISLAND NC 28531
Property Addr: House# 1676
Street Name ISLAND Alternate More?
Street Type RD Dir Unit
CiStZp HARKERS ISLAND NC 28531
Escrow 190447
Legal Description CENTURA MASPAY
Plat Other
,Lot/Block
Deeded Acres .30 Previous 19500
LOT SR 1335 HARKERS ISLAND THOMAS L OVERTON
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DIANE BRAZELLE
5501 WALLACE DR.
GREENSBORO, NC 27407
Pay to the
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66-68/531
— 07
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