Bailey, Carolyn

&..ti'iAMA / ❑ DREDGE & FILL :r62787 C,
GENERAL PERMI Previous permit#
JAew ❑Modification ❑Complete Reis artial Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environment and Natural Resources `1 / / v�
and the Coastal Resources Commissi n in an area of environmental concern pursuant to I SA NCAC 7i7 (r V
El Rules attached.
Applicant Name- t �✓1 _. WCeV--Project Location: County cc/ t"i
Address ) :? Street Address/ State Road/ of #(s)
f i) %/C ZIP
C ty 1 � State
Phone # (_) ir��' '+ Fax )' Subdivision
uthorized Agent /e"I City C)(c' rt'� .,' ZIP
❑ CW ❑ EW ❑ PTA OES ❑ PTS Phone # ( ) River Basin g Ll
Affected ❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A
AEC(s): Adj. Wtr. Body /LC -/c)/-1ter nat man unkn
❑ PWS: ❑FC: I
ORW: yes ,6o--) PNA yes no) Crit.Hab. yes / no Closest Maj. Wtr. Body
7 /
Type of Project/ Activity e (a r -r 1-7
(Scale: )
Pier
Platf
Fing
Groi
Culk
Basil
Boat
Boat
Beac
Oth,
Shor
SAV:
Sand
'Mo
Phot
Waiv
ieO
eiprap
iii
i�ii
length
MEN
max distance offshore
channel
a
■'�
■iip■i
ea■ocubic
yards
not sure ��l yes
A building permit may be required by: tii�f t F '� ❑ See note oT back regarding River Basin rules.
Notes/ Special Condition /(j p '� i ' "' % `� i f' } '� J 'f ��' l G', ✓ V Of i
1
Agen rAppI`— Printed ame Permit(
t tt, ,J
Sure " Please read compliance statement on back9f permit * Issuing Dace raiion pat ;
►�,� ram.`
'Application Fee(s) Check # Local Planningjurisdiction „ Rover File Name
�:...., ..., x.u.... W:.. .� ..._ ,.....•. �, ..__.,. __. _ .t �_w . .. w , a

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, certifythat 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)
Revised 08/09/06

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to Callo /3a;/c 's
Name of Pr perty Owner)
property located at a 3 29 5h� /00; ve
(Address, Lot, Block, Road, etc.)
on Ncw �Q;.,t✓ , in /l Zeo4,0 cif!j Ca�to�arL , N.C.
(Waterbody) (City/Town and/or County)
The applicant has described to me, as shown below, the development proposed at the above
location
I have no objection to this proposal.
have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(Individual proposing development must rill in description below or attach a site drawing)
ore
ev
%sr� aX R EnV D
JUL 15 2013
y
DC 4 MHD CITY
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boathouse, lift, or groin must be set
back a minimum distance of 15' 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' setback requirement.
I do not wish to waive the 15' setback requirement.
(Property Owner Information) (Adjacent Property Owner Information)
C�� , A � a�
S' ature Signature ,/�
C-0. r d � t/ft ltJ I5 A t-l.,►q R-T''
Print or Type Name Print or Type Name
:13.A sh..-c d-3 d l S bpn.r— 17 h � +`
Mal7ing Addre s Mailin Address
� /1ioh N.G � $SS% �If01'cua C « i- l v c o�
City/State/Zip Cit /State
192 - 7.16- 733 7
Telephone Number Te one Nrber
2%3 7[ J / l 3
Date Date
(Revised 611812012)
f- [-�-7

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to Lov'0l Y '6a'dt-mil 's
( ame of Pro erty Owner)
property located at � 3.1 S 60e AA.;�c
(Address, Lot, Block, Road, etc.)
on 044 w � * /Q. tee✓- —,in' 1HC%AC hea�0 6i f, �a,.'t��f- , N.C.
(Waterbody) (City/Town and/or County)
The applicant has described to me, as shown below, the development proposed at the above
location.
✓ I have no objection to this proposal.
I have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(Individual proposing development must fill in description below or attach a site drawing)
f �r
o�
0
.� • i er 0 p o 'a n
14 . ,o a A. Q
fie' r O b 4.He-
�D�►�,p. {.•ram �
�G Ilaf� �/k hem oP
CI~IVBD
le boo
JUL 15 2013
WAIVER SECTION" M•MHP CITY
I understand that a pier, dock, mooring pilings, breakwater, boathouse, lift, or groin muse se
back a minimum distance of 15' 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' setback requirement.
I do not wish to waive the 15' setback requirement.
(Property Owner Information)
coulg��
Si ature
V-(5 l �a
Print or Type Name
2 3 a 9 Ac..,,t A.,; -ie.
Mailing Address
4400ehe J G: f j I.C. -7
City/State/Zip
252 - 7a6,133
Telephone Number
I - IS-- 2Q)3
Date
(Adjacent Property Owner Information)
SiO-)n A V
Ja N MY
Print or Type Name
9-53 f 5W0/zC p41 vt
Mailing Address
, Mo r.EHCAP GtrY� NL 2� SS7
City/State/Zip
—0 76 J
Telephone 14umber
?1l.S ;Z01,3
Date
(Revised 6/18/2012)

i •
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
Pat McCrory Braxton C. Davis
Governor Director
Date 7` Is = 2vl 2
Applicant Name Caoo&q &; )e y
Mailing Address 3 �`� �'k�^� /,W je
Aoeti&-Q c r r2 N• C. 2 gss 7
John E. Skvarla, III
Secretary
I certify that I have authorized (agent) /9/,ue 06,fe.- /Lf�%Ae &Hsl to act on my behalf, for the
purpose of applying for and obtaining all CAMA Permits necessary to install or construct (activity)
�M--e CXls4iM JQ,/�-A&c,0 •' Qc SPA er;s ¢)� at (location)
toe-kx iH F-eaAi o)c AIRAea/
This certificati is valid thru (date)
Signature GZJL
a— 30 - 2012
RECEIVED
JUL 15 2013
Dcm-MHD CIrY
400 Commerce Ave., Morehead City, NC 28557 One
Phone: [phone] FAX: [phone] Internet: www.nccoastalmanagement.net No2'1thCarohna
An Equal opportunity 1 Affirmative Action Employer Nahn 491/off