Anderson, Pete

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©CAMA / ❑ DREDGE & FILL`
° 1
GENERAL PERMIT
A B C D
Previous permit#
New ❑Modification ❑Complete Reissue El Partial Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environment and Natural Resources r
and the Coastal Resources Commission in an area of environmental concern pursuant to I SA NCAC
,"
Applicant Name s, r �.
Rules attachi:d.
j a
Project Location: County
;
Address '"' `,! `
Street Address/ StatT Road/ Lot #(s)
City ? r Avg 4 ')0 State i
Ip
X s
•ter.i.
H)`
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�� E_Mail'`--w.---•—.
Phone # (
Subdivision I
Authorized Agent a y
City ; ! ! ZIP
❑ CW 6-EW PTA ❑ ES ❑ PTs
Phone # ( `" " �-- River Basin '. I " ° .( I._. C
Affected
❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ WA
AEC(s):
Bod
Adj. WWiny t nat :man unkn
❑ PW3.
Closest Maj. Win Body
ORW: yes / no PNA yes / no
I Type of Project/ Activity
t
Pier (dock) length "TM"
Fixed Platform(s) -..•+
Floating Platform(s)
Finger pier(.) r ,-y
Groin length
number
Bulkhead/ Riprap length
avg distance offshore
max distance offshore
Basin, channel '■-�'
cubic yards .,....�
Boat ramp ,
s
Boathouse/ Boatlift.
Beach Bulldozing "
Other
Shoreline Length
SAV: not sure yes ;n no
Moratorium: n/a yes 'no-:
Photos: yes . =no.,•
Waiver Attached: 4( yes `; no
A building permit may be required by:
( Note Local Planning Jurisdiction
Notes/ Special Conditions i1
(Scale:
❑ See note on back regarding River Basin rules.
(%
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I-.J,t
Permit Officer :
,
Signature I?lease read compliance statement on back of ermit Signatu_ r
1.. 1
Application Fee(s) Check# Issuing C
{ &pimgodba''Ye'

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 [)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
Neuse River Basin Buffer Rules
El Other:
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 Resources. Contact the Division of Water Resources at the Washington Regional Office (252-946-6481) or the
Wilmington Regional Office (910-796-7215) for more information on howto complywith these buffer rules.
Division of Coastal Management Offices
Morehead City Headquarters
400 Commerce Ave
Morehead City, NC 28557
252-808-2808/ 1-888-4RCOAST
Fax: [phone]
(Serves: Carteret, Craven, Onslow -
North of 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 - South of New River Inlet -
and Pender Counties)
http://www. nccoastaimanagement.net/
Revised 08/27/ 14

•.
Authorized Agentf Affected
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ORW: yes 1. PNA yes no Closest Maj. Win :..
lType of Project/ ActlA
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ME
Shoreline Length _Ln
SAV: not sure yes
Moratorium: n/a yes
Ono
Photos:
Waiver Attached. yes
A building permit pay be required by:
( Note Local Planning Jurisdictio
Notes/ Special Cop ditions
❑ See note back regarding River Basin rules.
N
PermiiiSer's P ' ; tgn'Arp'e
ire" 'lease read compliance statement on back o ermi
- r e' 1
ation Fee(s) , Check,#,
)1te I .
pirat o Da

Sep 2515 12.32p p.2
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ADJACENT RIPARIAN PROPER. OWNER STATEMENT
I hereby certify that I own property adjacent to pei-a
AD N me of Property Owner)
property located at.
(Address o lock,,{ioad, '
on 1r� , in,=--! ('t� �L N.C.
(Waterbody) (CitylTown and/or County)
CP
0
10
The applicant has described to me, as shown below, the development proposed at the above
me.
I have no objection to this proposal.
I have objections to this proposal.
DESCRIPTION ANDIOR DRAWING OF PROPOSED DEVELOPMENT
proposr-tig development must fill.in descrip#bn-below or attach a :sfte diaWing)
. REC VG
0 5 zm5
- - l' it"o CJTY
WAIVtK Sht; JJON
erstand that a pier, dock, mooring pilings, boat ramp, breakwater, boathouse; Lift, or groin
be Set back a minimum distance of t 5' from my area of riparian access unless waived by
If y u wish to waive the setback, you must initial the appropriate blank below.)
I do wish to waive the 15' setback requirement. RECEIVED
I do not wish to waive the 15' setback requirement. OCT 12 2015
(Pro!Jm. rty Owner Information)
Print br 7ype lVam
Ira Posse, I Y�
Mail��glan�l+ f7C (11C- �g51 s�
cay%5tateop
91b-yzt „��i CI AIJA -
Tale#,hone Number/email address
Dow I
(Adjacent Property Owner Information)
®CLAIM HD CITY
Signature'
Print or Type Name rn -
Mailing Address
ity/siate/Zip 0
hAk-- Telephone Number/small address
Date
(Revised Aug. 2014)
'Valid for one calendar year after, s►gnstvre`
i
1
o�

Sep 2515 12:37p
P.1
1 cftl4c=m7
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OCT 12 2019
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10/05/2015 08:18 FAX [phone] JE Cameron DOS & Assoc
Sep 2 15 12:45p �..._.. _ p.3
AWAMNT RIPARIAN PROPERTY m 0=3 smur w
�i I
hereby certify that I own property adjacent to pei-s. W cb1z5DAz---) 's
property 1000t91 at 12MIN of Property Owner)
(Address, Ioc
on T -� 1 in �ii N.C. .
(Waferbody) (City/Town and/or County)
The applicant has described to me, as shown below, the development proposed at the above
�i Location.
I have no objection to this proposal.
) I have objections to this proposal.
tMSCRIPTION ANDIOR DRAWING OF PROPOSED, DEVELOPMENT
On,d-&;f ial*proposfhg*d e�!�f fl/l:ln, desiq 'Won' below oraltadr in s&ft draWin_gj
C*
0 003/003
3M&M S CTION
I understand that a pier, dock. mooring pilings, boat romp, breakwater; boathouse; lift, or grain IVED
mist be set back a minimum distance of 151 from my ams of riparian scoess unless waived ECE
me, of'you wish to waive the setback, you must Inttlal the appropriate blank below.) 015
I do wish to waive the I V aetbaak requirement
1 do not wish to waivethe 1S aetback requirement.
w information) 'aces r!y Owner
,Pmr or Type Name
OwTrng Address
Clfy/Sta OV10
Telephone Numberlam ff addrrrss
"Valid for one calendar yaw after signature'
Telephone Numberl ema# address
Date' K h C h' i/ h D
(Revlsed'Aug. 2014)
pCT052
DCM- MHD CITY
OCT 12 2015
DCM- MHD CITY

10/05/2015 06:19 FAX [phone] JE Cameron DOS & Assoc fa 002/003
.� Sep 251512:45p - p.2
�wA 16MPM&WC&MC2WW >B1li••RS���OQM1Ci
l
16 V
:1.
:RECEIVED
OCT 0 5 2015
DCM- MHD CITY
0s
RECEIVED
OCT 12 2015
DCM- MHD CITY