57186_CLARK, TERENCE_20110517

❑CAMA / ❑ DREDGE & FILL
J' GENERAL PERMIT Previous permit #
❑New ❑Modification ❑Complete Reissue El Partial Reissu 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
❑ Rules attached.
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Applicant Name Project Location: County
Address Street Address/ State Road/ Lot #(s)
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City 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
Subdivision
City,_.:, . ZIP
Phone # ( --- j-'"'"''� River Basin /
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Adj. Wtr. Body "'' ,F ''__(nat /man /unkn)
Closest Maj. Wtr. Body
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Agent or Applicant Printed Name
Signature ** Please read compliance statement on back of permit **
Permit Officer's Signature
Issuing Date f
Expiration Date w
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, 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
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/ 1-8884RCOAST
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 i i i t, act Computes Sheet
Applicant: Terence Clark
Date: May 17, 2011
General Permit #: 57186C
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
impact 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
OW
Dredge ❑ Fill ❑ Both ❑ Other ®
1,405
1,405
HG
Dredge ❑ Fill ® Both ❑ Other ❑
1,620
135
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 ❑
s -808- 8 8 :: 1-888-4 AST — www.nccoasIgL%anagament.net revised.- 0210310

N.C. DIVISION OF COASTAL MANAGEMENT
AGENT AUTHORIZATION FORM
Date how
Name of Property Owner Applying for Permit:
a -[A Ld- D. On U k
Mailing Address:
8 0 S W ILk�Awl bVIV6,
I certify that I have authorized (agent) Y UL V - -0 C �D Ul a, S to act on my
behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to
install or construct (activity)r t�(.i 11\ U'
at (my property located at) LET S /.
ZSS3Z
This certification is valid thru (date)
Property Owner Signature #Date

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NCDENR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
Beverly Eaves Perdue James H. Gregson Dee Freeman
Governor Director Secretary
AGENT AUTHORIZATION FORM
Date: Mau a l Z D
Name of Property Owner Applying for Permit: Name of Authorized Agent for this project:
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Owner's Mailing Address:
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Agent's Mailing Address:
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Phone Number (>qq 8
I certify that I have authorized the agent listed above to act on my behalf, for the purpose of applying
for and obtaining all CAMA Permits necessary to install or construct the following (activity):
(my property located) at
This certification is valid thru (date)
Property Owner Signature
127 Cardinal Drive EA, Wilmington, NC 28405 One
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May 2, 2011
Terry and Cathy Clark
805 Wickham Drive
Winterville, North Carolina 28590
Dear Terry and Cathy,
I have enclosed for you the Division of coastal management Adjacent
Riparian Property Owner Statement.
I look forward to meeting you soon.
Sincerely,
ames R. Copland, III
JRC,III/dbw
Enclosure

CERTIFIED V A TT — RETURN RECEIPT RE L ESTED
DIVISION OF COASTAL MANAGEINIENT
AD3ACE_iT RIPARIAN PROPERTY OtiN_ ER STATEINIENT
Name of Property Owner:
Address of Property
(Lot or Street
Applicant's phone 9: )6A,?Qa-' roC�S'
,')!reet or Koad, City & County)
Mailing �C�)
Address:
CAMAM
bi&wle go, aY5­9t)
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 descrio-ion of dra, in=.
with dimensions. must be provided with this letter.
___Z I have no objections to this proposal. I have t objections ,l o 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. Correspondence should be mailed to 127 Cardinal Drive Est.
Wilmington, NC 28405-3845. DCM representatives can also be contacted at [phone]. No response is
considered the same as --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
IS' 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' set back requirement.
I do not wish to waive the 15' set back requirement.
(Property Owner Information)
6
Signatur
— �a U a, k ca c
Print or Type Name
Q -S t;Nfau4 b
Mailing Address
�L /& k c. 28 s,7o
City / State / Zip
Telephone Number2,S 2 — 7e Z _Z 6- "
Date
(Riparian Property Owner Information)
Signature
Print or Type Name
Mailing Address
City / State / Zip
Telephone Number
Date
127 Cardinal Drive Ext., Wilmington, North Carolina 28405-3845
Phone: [phone] FAX: [phone] Internet: wrwr.nccoastalmanagement.net
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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.
1. Article Addressed to:
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A. Signature
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B. Received by ( Printed Name) C.
❑ Agent
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D. Is delivery address different from item 1? TJ Yd:
If YES, enter delivery address below: ❑ No
3. Service Type
❑ Certified Mail ❑ Express Mail
❑ Registered ❑ Return Receipt for Merchandise
❑ Insured Mail ❑ C.O.D.
4. Restricted Delivery? IFY+r'^^' ❑ Yes
2. Article Number 000 2 6032 9 7 8 5
(transfer from service label, 7 1 18 7 d
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PS Form 3811, February 2004 Domestic Return Receipt 102595-02-M-1540

UNITED STATES POSTAL SERVICE
First -Class Mail
Postage & Fees Paid
USPS
Permit No. G-10
• Sender: Please print your name, address, and ZIP+4 in this box •
GlgvL
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j ■ 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: ]�
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A. Signature
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❑ Addressee
B. Received by ( anted Name) C. Date of Delivery
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D. Is delivery a dress different from item 1? ❑ Yes
If YES, enter delivery address below: ❑ No
3. Service Type
❑ Certified Mail ❑ Express Mail
❑ Registered ❑ Return Receipt for Merchandise
❑ Insured Mail ❑ C.O.D.
4. Restricted Delivery? (Extra Fee)
?010 18?0 0002 6032 9?92
❑ Yes
PS Form 3811,
Return Receipt
102595-02-M-1540I

UNITED STATES POSTAL SERVICE
First -Class Mail
Postage & Fees Paid
USPS
Permit No. G-10
• Sender: Please print your name, address, and ZIP+4 in this box •
C ten t 1�
Sos b�-
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T D CLARK 71
CJ CLARK
805 WICKHAM DR
WINTERVILLE, NC 28590
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A':�
Y NCDENR
North Carolina Department of Environment and Natural Resources
Division of Coastal (Management
Beverly Eaves Perdue
Governor
James H. Gregscn
Director
Dee Freeman
Secretar✓
BUFFER AUTHORIZATION CERTIFICATE FOR SHORELINE STABILIZATION
A riparian buffer authorization is required for shoreline stabilization activities within the Tar -Pamlico & Neuse River basins
per Division of Water Quality (DWQ) regulations 15A NCAC 02B.0259 & 0233. The Division of Coastal Management
(DCM) through a Memorandum of Understanding with the Division of Water Quality (DWQ) has reviewed your project
proposal, determined that the project as proposed complies with the aforementioned regulations, and made a "no practical
alternatives" determination per those regulations.
Those activities covered by your Coastal Area Management Act (CAMA) permit have received Buffer Authorization as
long as the project is constructed in a manner that continues to meet all of the conditions listed below. Failure to comply
with this Buffer Authorization shall subject the property owner & the party (contractor) performing the construction Wor
land clearing to a civil penalty of up to $25,000 per day per violation.
1. Impacts: Impacts to woody vegetation from clearing and filling in Zone 1 (begins at the most landward of either
the waters edge or the coastal wetland line and extends 30 feet landward) shall be minimized to what must be
impacted for the sound installation of the shoreline stabilization project. Unnecessary clearing and filling in the
buffer is a violation of the riparian buffer rules.
2. Clearing & Grading: Clearing and grading of Zone 2 (begins at the landward edge of Zone 1 and extends 20 feet
landward) is allowed provided that it is re -vegetated immediately and Zone 1 is not compromised, which includes
maintaining diffused (non-channelized) flow of storm water runoff through the buffer.
3. Construction Corridors: Construction corridors are allowed for shoreline stabilization projects, but they must be
satisfactorily restored as described in condition 5 below.
4. Potential Overwash: For vertical shoreline stabilization projects (bulkheads) only; sites where wave overwash is
expected to be severe, the, first ten (10) feet landward (unless specifically authorized otherwise by DCM) from the
structure may be maintained as a stable lawn in order to provide for structural stability.
5. Site Restoration: At minimum, pre -project site conditions must be re-established. A site that was wooded prior to
this shoreline stabilization project must be restored with woody vegetation at a stem density of 320 stems per
acre. Non wooded sites may be re -vegetated with woody vegetation. Restoration must be completed by the first
subsequent planting season (November 1 through March 30) after completion of the bulkhead. Once re-
established, understory vegetation in Zone 1 is to be undisturbed and no mowing or any other activity that would
remove understory vegetation is allowed. i I t I ,
• Pre -project site conditions:
s. Project Drawing: The drawing on the CAMA General Permit is considered the project drawing of your property
indicating the location of the shoreline stabilization structure and any associated clearing, grading, and
construction corridors. This drawing will be used to aid in compliance and monitoring efforts.
By your signature below you agree to be held responsible for meeting all of the above listed conditions and verify that all
information is complete and accurate.
WA4
Printed Name
Ag=tbr Applidant Signature
�` p/
CAMA GENERAL PERMIT #: � 7136 C�
Washington Office
943 Washington Square Mall
Washington, NC 27889
Phone [phone]
Morehead City Office
400 Commerce Avenue
Morehead City, NC 28557
Phone [phone]
Permit Officer's Signature
5_//
Iss a Dat
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Version 5, 09/2009