61013_ELDER, DANIEL_20121126

I
�-'CAMA / IJ DREDGE & FILL NO. 61013
GENERAL PERMIT Previous permit #
❑New ❑Modification [-1!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 I SA NCAC
7 Rules attached.
i
Applicant Name Project Location: County
I
Address Street Address/ State Road/ Lot #(s)
City State ZIP
Phone # (^) Fax # (__) Subdivision _ _
Authorized Agent City- _ _--------- ---- ZIP_
Affected ,`l CW C EW O PTA 1 ES PTS Phone # (_ _ } River Basin
I OEA ❑ HHF D I UBA C N/A
AEC(s):Adj. Wtr. Body_ (nat /man /unkn
7 PWS: FC:
ORW: yes / no PNA yes / no Crit.Hab. yes / no Closest Maj. Wtr. Body __-
Type of Project/ Activity
Pier (dock) length
Platform(s) - -- ,,,
z
Finger pier(s)_
Groin len h -' -- -
number -
Bulkhead/ Riprap length
avg distance offshore
max distance offshore
Basin, channel
i
...... -
cubic yards__-
Boat ramp
Boathouse/ Boatlift
- -- - _ - ----_-- f -_—_
-- _--_---= .
Beach Bulldozing
_
_
_,—
Other
Shoreline Length
T
SAV: not sure yes no -+.__
Sandbags: not sure yes no
Moratorium: n/a yes no j
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
(Scale: ) I
- See note on back regarding River Basin rules.
Permit Officer's Signature
Issuing Date
Expiration Date
Application Fee(s)
Check #
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 thatthis project is consistentwith the North Carolina Coastal Management Program.
River Basin Rules Applicable To Your Project:
E. Tar - Pamlico River Basin Buffer Rules ❑ Other:
El 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)

N.C. DIVISION OF COASTAL MANAGEMENT
AGENT AUTHORIZATION FORM
Date C� /j,j
Name of Property Owner Applying for Permit:
Q Ponald
Mailing Address:
TivcrMn Li.
� Lo A/ Viq 2z36,5q
I certify that I have authorized (agent) pj i ('C(�1 / /"! aYl0C, Gff'i"AM to act on my
behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to
install or construct (activity) La, d' r-L
at (my property located at)
This certification is valid thru (
Property Owner
fl
Date

DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION FORM
CERTIFIED MAIL - RETURN RECEIPT REQUESTED
I hereby certify that I own property adjacent to T1bwW KdleY g ba" KI �Ide� 's
(Name of Property Owner)
property located at
1 (Address, Lot, Block, Road, etc.)
on pa Cr�ei� in ey r , �D�_ 1 ' C D CO • N.C.
an
(Waterbody) (City/Townd/or County)
Agent's Name #AamI ROi� D�
�be i5op Mailing Address: PO -Bo
4
Agent's phone #: �` 2-qq- 01M �� �t ��al NC 2Is-71
He/She has described to me as shown below the development he/she is proposing at that location,
and I have no objections to the proposal.
---------------------------------------------------------------------------------------------------------------------
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(Individual proposing development must fill in description below or attach a site drawing)
10
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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.
(Property Owner Information)
Signature
Print or Type Name
I Q 51; /fi \J Ln
Mailing Address
A) �U � ��
City/ tate/Zip
-70
Telephone Number
AwUs+ a0 I -DL-
Date J
(RippftwPr
er Information)
ign ure
Print or Type Name
Mailing Address
a�(52W4
City/State/Zip
Telephone Number
Da

DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION FORM
CERTIFIED MAIL - RETURN RECEIPT REQUESTED
I hereby certify that I own property adjacent to�bmW Keller g DCAh icl Cldev- 's
(Name of Property Owner)
property located at
1, (Address, Lot, Block, Road, etc.)
on f e F— in e� (, j�airn 1 i c o �� • N.C.
(Waterbody) (City/Town and/or County)
Agent's Name #:`�Yalrll�l� RO►(1 `�5��1 MailingAdd-r}e-ss:
Agent's phone #:2—!q" �� �� I� Y1 1 QI NC 215-7
He/She has described to me as shown below the development he/she is proposing at that location,
and I have no objections to the proposal.
---------------------------------------------------------------------------------------------------------------------
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(individual proposing development must rill in description below or attach a site drawing)
10
,� nson Ke1(Cr%Cider
-Dra4 Pro
If you have objections to what is being proposed, you must notrfy 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.nccoastalmangementnet/contact dcm.htm or by calling 1-888-4RCOAST. No
response is considered the same as no objection if you have been notified by Certirted Mail.
(Property Owner Information)
Signature
I�aMICL- �Cklf
Print or Type Name
2�l?, ��yeY-ion Ln
Mailing Address
rfi lP n Nl m AA 2M59
City/ tatelZip
� 0--J 30 l - 3�D 2
Telephone Number
A yU + �D I
Date
(Riparian Property Oymer Information)
Si t re
Print or Type Name
Mailing Address
City/StatelZip
Telephone Number
Date

T
PAY
TO THE
ORDER OF z
B PRE=�COTT MARINE CONSTRUCTION
PO BOX 874 252-249-0149
ORIENTAL, NC 28571
jo'�j-
3385
56-30/537
DATE 472
VC DOLLARS
First Citizens
Bank
FOR
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