60389_DAVIS, EMMITT R JR_20120807

� �
t I CAMA / G DREDGE & FILL
NO. 60389
^' GENERAL PERMIT
Previous permit #
[�,NeW ❑Modification El Complete Reissue El Partial Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environment and Natural Resources ,,,,,,,$ �
15A NCAC Ii I �
and the Coastal Resources Commission in an area of environmental concern pursuant to
,•,` S Rules attached.
Applicant Name x?71�
Project Location: County
� I
Address I - r�': q
Street Address/ State Road/ Lot #(s)
City K, A State IV, ZIP '.'r-7 U56(')
ko ' C1
Phone # ( ) Fax #t (_)
1 `
Subdivision
Authorized Agent { , ( NO r r , T'
City_ .r.Y+Q C , ZIP
C CW i3,EW APTA %i ES ElPTS
Phone # (i j0) `�� �G`6�f River Basin
Affected I OEA ❑ El IH UBA N/A
AEC(s):
'
Adj. Wtr. Body ,.�� h i � k' s 'P t nat /man unkn
PAS: FC:
u,
ORW: yes / :no PNA yes / no Crit.Hab. yes / no
_ Closest Maj. Wtr. Body� 0 �
_
Type of Project/ Activity��
(Scale: _ 20 ' )
Pier (dock) length
Platforms)-�
Finger pier(s)I
Groin length
number
1
,Bulkhead/ Riprap length
avg distance offshore
max distance offshore
Basin, channel
cubic yards
Boat ramp
Boathouse/ Boatlft*
Beach Bulldozing
Other
-
,
----�
-
-- - .
VAC
_
I
_
- —
-- �- - -
-w
_ t
—
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- -
i
Shoreline Length
SAV: not sure yes
Sandbags: not sure yes o
Moratorium: n/a yes tn0
Photos: yes (no
Waiver Attached: yes no I
A building permit may be required by:
Notes/ Special Conditions
o
1 +
I
'
on back regarding
�� ,
---
---
River Basin +rules.
.9
-
f ) P w ^_ ' �( ❑ See note
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Agent orApplicani Printed Name
Signature ** Please read compliance statement on back of permit
i��'t;� i';g!.d�i
Application Fee(s) Check #
f�
PermitOffice; Signature
Issuing Date Expiration 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 ❑ 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/ 1-888ARCOAST
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)

05-Aug 1 20120 9:25AM BRASS LANTERN
r-5 No
HCDENR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
6504i001P, lzia
Michael F- Easley, Governor James H. Greg$Qn, Director William G. Ross Jr., Secretary
0
; M
Applicant Namejowl*
Mai"g Address 21 A4 �- ]�• .
<� L
I certifythat I have authorized (agent) '- d�i� I
(g ) to act on my
behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to
install or construct (activity)
This certification is valid thru (data)
Signature
400 Commerce Avenue, Morehead City, North Carollna 28557
Phone: [phone] FAX- 262.247-M3011ntemat: www.nccoastalmartagement.not

Aug. 1 2012" 9; 25AM' "v`BRASS LANTERN No. 6504 `P. 2"„ vv'
trOR A I Jc;nrufvvftING PXINGSIBOA TLIP 7BOATHOU�r.)
I hereby certify that I own property adjacent to _ y r s ,1 ? 's
(Name of Property Owner)
property located at
Block, Road, etc.).
on _ ("f}IKQ R e N.C.
(Waterbody) ('Town and/or County)
He has described to me, as shown below, the development he is proposing at that location,
and, I have , no objections to his proposal. I understand that a pier/mooring
piIingvboatlif /boathouse must be set bank a minimum distance of fifteen feet (15) from my area
of riparian access unless waived by me.
I do not wish to waive the setback requirement.
I da wish to waive that setback requirement.
DESCRIMON AND/OIL DRAWITIG OF PROPOSED DEVELOPyILN'r:
(To be .failed in by individual proposing development)
• �Dn� 'k xf ��
Signature.
Print or Type Name
Telephone Number
Date: )

Aug. 1 2012 9:25AM BRASS LANTERN No.6504 P. 3
(-Vint A FIERItY1V URING PXiINO IBOATL, FTI-6pATHOUSE)
I hereby certify that I own property adjacent to
's
(Nome of Property owner or Applicant)
Mailing address'if different from location address
a
(town, state and zip) Gam' a
Phone numbers you can be reached at a t
property locaWd at .LL1'
(Lot, Block, Hogdj etc,) ~
0n
(Waterbo5ly)' to
{Town andlor County) ' N.C.
Ht; has described to me, as shown below, the devel—opment he is .proposing al teat location, `
and, I have no sib jeetions to his proposal, I understand must that picrlmbortng pilings/boatlift/boat},ouse
waivedd by tne, set back a rcrinimum distanco of fifer feet (IMOm my area of riparian access unless
I do not wish to waive the setback requirement, "
I do wish to waive tha4 setback requirement,
- --- •DESt:RIPTION -- •-- •-- ••- •----•------•---------------------------
--•---•-------,--..
�IOR DRAWING Op pp opOSED DEVELOPMENT":
(To be filled In by Individual proposing development)
--- •------•----- .............. 0......
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Atute
Sam

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jfr. or✓lfrs. Bobby ,Davis 5-70 66-30/531 16668 �
dvG'DC 173S269 P# 569-4141 Vea11797039 154
3147 DwisAaray Road V
ICiostall NC 28504 O - 7 ' / -2--
PAY TO
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