58134_CROWS NEST YACHT CLUB_20110627

OCAMA / ❑DREDGE &FILL
GENERAL PERMIT Previous permit#
ONew ❑Modification ❑Complete Reissue []Partial 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
❑Rules attached.
Applicant Name l t ' ? Project Location: County '—
Address
City State ZIP
Phone # O Fax # ( )
Authorized Agent
❑ CW ❑ EW U PTA
Affected
AEC(s):
OEA ❑ HHF ❑ IH
❑ PWS: ❑ FC:
ORW:
yes / no PNA yes / no
❑ ES ❑ PTS
[I UBA ❑ N/A
Crit.Hab, yes / no
Street Address/ State Road/ Lot #(s)
Subdivision
City ZIP
Phone # ( ) River Basin
Adj. Wtr. Body (nat /man /unkn)
Closest Maj. Wtr. Body
Type of Project/ Activity
(Scale: � )
Pier (dock) length f
Platform(s)
Finger pier(s)
Groin length
number
Bulkhead/ Riprap length
avg distance offshore
max distance offshore
Basin, channel
cubic yards
Boat ramp
Boathouse/ Bgatlift ) .
Beach Bulldozing
Other_
— --
i
-
f �
Shoreline Length ;
I
SAV: not sure yes no
Sandbags: not sure yes no
Moratorium: n/a yes no
Photos: yes no
Waiver Attached: yes no f
A building permit may be required by: ❑ See note on back regarding River Basin rules.
Notes/ Special Conditions
Agent or Applicant Printed Name
Signature ** Please read compliance statement on back of permitkz Z
Application Fee(s) Check #
Permit Officer's Signature
A//
w
Issuing Date Expiration Date
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, 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,
Onsiow -below New River Inlet- and
Pender Counties)
Revised 08/09/06

' ,.� -:✓ S^_ -: ..'rr � _ 3 r J A.0plicant:
Y�pz
M:. 'f ,x.n✓'•n
S h4�
Date''
6 (C/-1
Describe below the HABITAT disturbances for the application. All value*should h 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
im a(;t mount)
TOTAL Feet
(Applied for.
Disturbance
total includes
any anticipated
restoration or
temp im acts
FINAL Feet
(Anticipated final
disturbance.
Excludes any
restoration and/or
temp impact
amount
��K)a
Dredge ❑ Fill ❑ Both ❑ Other
-V
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 ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
'�{_i:�-iiv1.=J ��-L� .. "�-iyi':_3 �,"''GU�l.t91 ...+a�•w`.?r.rrL�_..��,'.,?h.a.�.�n.�..r.;....�yY..rr..,'#-r,,;3:::a..�� r:)'r5'�i �J�

f -ekl! I J,4: L14 I* rO M! 6.A-M MHU' - IY To, ?�E66ci'9 p4wlel
NCDENR
North CarcI,:ra Department of Environmetit and Natural Resources
VvIsIon of Coastal Management
SCYCrly UYSS Pardee, Ccven%;r I Joires H. Gregion, Director Use Freemian,
Date JUN 22 2011
bC'&f*IID
Q71-
Applicant NarAc 5
Mailing Addr4ss ZC--)
I cartify that I have Autbgrized (went? Mc., Lpa, - ; to act
On y
behalf, for the purpose Of BPPIYID9 for had obtaiabig all CAMA Icrrniti necessary to
install or construct (activ$ty) :7--li S: 14 it Lj �'4-
at (JOCAUGO + c 1,, b
This eutificatt �n is valid thru (date)
Signature
1 400 Cwmarce Avenue, Mcrve;-;d pity, NDrh Carcl:na 28557
Phow 252-808-280� 1, FAX: [phone], Interne!: www..ncooasjajniaiasemtM.ne,,
AO FqLal A00r EM00YU - SIN PSCYCIOd', 10% POW O7NMW PAPW

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(F,OR A PIERINIOORING PILI-NGSIBOAIEIFTIBOATIIOLISE)
1 hereby certify that I owrl property adjacent to
(Naine of ]Property Owner)
b 2,Z0//
cy�
property located at 'ec-5 i''T �1- -b
(Lot, Blocks Road, etc.)
��a►�� it=� t h N.C.
on
(Waterbody) (Town and/or County)
'25"Z- 7U� �0`( q Mailing Address: 1 9 3�
Applicant's phone #: _ � �
Ile ]-,as descri3ed to zz,e, as slwwn bl, oIDW, the development he is prcposilig at that }ocation; and I
have ??o objcc:fions ro his prapcls�tl. I understand i.bat. a piel!ljlooring pilings / boatlift / boathouse
11711St 1)e set biiC:k fi 1T1!1111T]Lli;l distance of flf(een feet (! 5') fl-orll'_?lv i1rEa of rl}Jarlai] aCC�Ss 11r11cSS
waived by me. (If you wish to waive the setback, you must initial the appropriate blank
below.)
l do not wish to waive
I do wish to waive that setback requirement.
- -------------------------.--------------------- -- ---- -
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVE.I-.OPMENT:
(To be filled in by individual proposing development)
4
1
L � � -►� 2 N
(�� c k r P------------------------
(Information for Property Owner applying
for Permit)
Availing Address
"'ty/State/Zip
(Riparian Property Owner Information)
Signature
Print or Type :,lame
z ZG y CA4 </-p ---
—__--- _-. — - - - — Tele hone Number
e.l , home Nu
S.
Date Date

Jun 20 11 08,27p Becky Couch
@b/2 id/2 lele 190:1.4 2527265079
�I�-220-8079 p.2
ADJACE.N'I' MPAIIAN PROPER'l-y C3't NER STATEMENT 4Z�Irl�
(F'00,4NE"10 -R-ING 1L11VG.s1B0,4TUFTIB©ATHOUSE) SUN N6
I' CrObY cerei:} that! ovm properly ass; 4cczi t to
(flame of Property Uwlner) ��
property located A6 7..�, y,.� ��rT
(Let, Black, Road, Etc-} � —^
on _ ��>nr I �� — , in �, d �✓ a G +q L1r N. C.
(4�mtexbo(Town and,or County)
z 5z
AppiicAnt°sphona ;_ 1 Z� 4u � Mailing Addrlessc__-i cJ � -
ilet:xs_cJc,asilzcrl'tr� ire, a ;silty;: ka, o�vtthe deve'op,nemht isPrep_cssing nt that i.tDC?flit711, &;Id' [
c:vc fIc au cc•;t� °s to his t;mp(!8'FA- i : ;; .erSt?frCi IIsat a p,Cf11moo-' ig piT1!1j'; boathbuse
(I�i1Si 3v sQ t bot-k if lT1.11il'r:i7iT dirt"iixt of f llec.i feel (11 ) dual InY ATCQ 3f r:parie.l kwCr-"ss LISki; 3s
wzyi-ved by me. (it you wish to waive the setback, you roust inhiax flit sppropritate blank-
beiow.)
-._..- i do wish to w4,iar that setback rcquiremenL,
DESCi lrf'ION AND/Olt DRAWING OF PROPOSED DE, VELOP1V ENT:
ffo befJed In by indi4dual proposimg development)
.
L tiGa T
i 'S
'� 4 k. s i r pQ-
(lnformatimu for Property Owner .Appiy'iaq
for Permit)
Mm'Airig Address
t:icy75:ase/�ip
(Wparian Property ilwner Information)
Signtt�trc
Prins cr Type Naa; a
4iansture
Teicphc�ne Number
Dow ✓7 Data

pr7 nk
5108
MUD BUCKET DREDGING INC
507 HEDRICK BLVD
MOREHEAD CITY, NC 28557-3045
-31
Pay to the
0"fl, Of :ec?2
Fri
13RANCH BAN KING AND TpUSCOMPANY
I -800-RANK BBT BBT.T c0-
N,
FOR
3 10 1 L 2 li:000 5 2 9
t4l
I ,
III-0000S .0 5