Basmajian, Dan

6CAPAA 14DREDGE '& FILL
GENERAL PERMIT Previous permit #
yNew ElModification DComplete Reissue ElPartiall 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 Ii
NRules attached.
Applicant Name Project Location: County.
Address Street Address/ State Road/ Lot #(s) I)
City
State 1 1P.
—1
Phone # z I ",',�,'Fax # Subdivision
Authorized Agent (i:' r ,t city /zip
Jr
Affected 0Lw EW tO PTA 'dPhone # Al
ES 0 PTS Pho River Basin
It %
AEC(s): 0 OEA 0 HHF 0 lH 0 UBA 0 N/A Adj. Wtr. Body(nat/man/unkn
0 PWS: DFQ
J:
0 Closest Maj. Wtr. Body
OIRW: yes /-n PNA yes / no' Crit.Hab. yes no
Type of Project/ Activity A
Pier (dock) length
Finger pier(s)
Groin length
qtuber
Bulkhea".prap length
X.
avg distance offshore
T
max distance offshore—
Basin, channel
cubic yards
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing
Other
Shoreline Length
SAV: not sure
yes
Sandbags: not sure
yes �00
Moratorium: n/a
yes rnd,
Photos:
yes 0
Waiver Attached:
Yes ino
A building permit may be required by:
Notes/ Special Conditions ti
­1 ( !
El See note
(Scale:
ick regarding River Basin rules.
Agent or Applicant Printed Name PermitOffis Signature
A�r
Signature Please read compliance statement on back of permit n Date
Application Fee(s) rs Check# Local PlanningJunsdiction Rover File Name

I.
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, certifythatthis project is consistentwith 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

a P- ° a-' "i _� n
9a�JL],., .��_ �r �. ,�
Applicant:
Date:
G
Describe below the HABITAT disturbances for the application. All values should match 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
tem acts)
FINAL Sq. Ft.
(Anticipated final
disturbance.
Excludes any
restoration
and/or temp
Impact amount)
TOTAL Feet
(Applied for.
Disturbance
total includes
any anticipated
restoration or
temp impacts
FINAL Feet
(Anticipated final
disturbance.
Excludes any .
restoration and/or
temp impact
amount
Dredge [IFill
Both ElOther
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
Dredge ❑. Fill ❑ Both ❑ Other ❑
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< ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
.� I hereby certify that I own property adjacent to eX, ifAw 's
(Name of Pr perty Owner)
property located at «-
(Address,, Lot, Block, Road, etc.)
on �a. r�/ a C , in -- ��o r• �i4si �� '�Y, N.C.
(Waterbody) (City/Town and/or County)
The applicant has described to me, as shown below, the development proposed at the above
location.
have no objection to this proposal.
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)
'E V ew
0or
JAN 0 6 2014
xi
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.)
do wish to waive the 15' setback requirement.
AIIX I do not wish to waive the 15' setback requirement.
(Property Owner Information)
s.H 4x i f of r/
rgnature
Print or Type Name
Mailing Address
City/State/Zip
Telephone Number
Date
(Adjac t ro rty Owner Information)
Signature
�- 4, (?P—
Print or Type Name
T or Wj gwurrisr
Mailing Address
City/State/Zip
5"1 - f 7 c/5yO
Telephone Number
/.2 ao
Date
(Revised 6/18/2012)

a
W.
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to it) 's
(Name of Prpppeaty caner)
property located at - Sraa 3
(Address, Lot, Block, Road, etc.)
on Cff Via, l , in -- /90 l cZF./ e ", -4-✓ , N.C.
(Waterbody) (City/Town andlo County)
The applicant has described to me, as shown below, the development proposed at the above
location.
1/ I have no objection to this proposal
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)
U/V c- ,i ✓l . y l S"�/
W 6, ff
I Al —era a/",�- m T
�tECEIY� �;
'JAN 0 6 2014.
DCM-MMCTfY
WAIVER SECTION
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.)
A111f I do wish to waive the 15' setback requirement.
AW I do not wish to waive the 15' setback requirement.
(Property Owner Information) (Adjacent Property Owner Information)
Sign ture
Print or Type Name
3)0 rjs,4_-&
Maili g Address
_C.�Gx� Ef �f/VC a "�6
City/Statemp
Telephone Number
Date
Signature v
T%✓;d ��s�l�rrr
Print or Type Name
Mailing Address
X�2a.s- W e*dd C-t
City/State/Zip
Telephone Number
9/9 7 9S'
Date %
(Revised 6/18t2012)

Styron, Heather M.
From: Jasa Ellis [e-mail]]
Sent: Monday, January 06, 2014 11:26 AM
To: Styron, Heather M.
Subject: Fwd: Permission to obtain cama permit
BegirYforwarded message:
From: Dan Basmajian <danbasmalian .gmail.com>
Date: December 17, 2013 10:12:19 AM EST
To: Jasa Ellis <jasa5(aD-ec.rr.com>
Subject: Re: Permission to obtain cama permit
To Whom it May Concern,
I hereby give Eric Ellis permission to obtain a CAMA permit on my behalf in order to build a new sea wall on
my property at 5223 Webb Court, MOREHEAD City, NC.
Dan Basmajian
Sent from my iPad
On Dec 17, 2013, at 10:07 AM, Jasa Ellis <jasa5nec.rr.com> wrote:
Dan,
If you would email back to me a statement that says that you give me {Eric Ellis) permission to
obtain a cama permit on your behalf to build a new seawall at your property at 5223 Webb Ct
Morehead City NC, I will go ahead and get the permit process started.
I will get started after the 1 st of the year.
Thank you,
Eric Ellis
205 Nottingham Lane
Morehead City NC
252 342 6775