Bennett, Brantley

11 I�CA'M'A El DREDGE & FILL
-Ci eU 1'/ (C
GENERAL PERMIT
QSNew
Previous permit #
FModification ElComplete Reissue
ElPartial 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
Applicant Name r k 'k L
0 Rules attached.
Project Location: County
Address
Street Address/ State Road/ Lot #(s)
City—LI 0 State 1 ZIP
Phone # is E-Mail
Subdivision
Authorized Agent i i
City A ZIP
I--] Cw PEW bTA DES 0 IPTS
Phone# ',IvN(-I'River Basin,
Affected
0 OEA 0 HHF DIH 0 UBA ON/A
AEC(s):
-
Adj. Wtr. Body man (nat I/unkn
0 PWS:--
t'r"N
Closest Maj. Wtr. Body 'c
ORW. yes Ak2 PNA yes no)
Type of Project/ Activity r-') (r' k ;:' ti
L . (Scale:
Pier
Fixed
Float�
Fing!
Groin
Bulkl
Basir
Boat
Boat
Beac
Otho
Shor
SAV
Mor.
Phoi
Wah
1; 1 F r- L f MMAW I A JATA�
ng Platform(s)
r pler(s)
NOR
mom
ME
I
length
MMMMMNMMMWMMMMM
MEN.
"ROWNSEEMILUMINMEMEM
number-----
6
MEN
Ail
Om
mommmi
'ead/ Riprap length
avg distance offshore
max distance offshore_
,channel
Now
cubicyards
Ell
0
ramp
SMUMORYMEMMENINMEMEMEMEM
MEMEMEMEMEME
WENMEMOINMEMEMEMEN
-iouse/ Boatlift
Bulldozinjz
a
MEMEMEMMOMMEMMI
-
11
MENEWOMMEMEMEMEMNOMMEM
ip,
MEN
MEN
No
0
MMMMMEMmKMMMMMMMM
0
fline Length
notsure no
MMEMMEMMMUMUMMUM
M1
EMEMENE
MR
yes
,toriurn: n/a yes no
MON
fs: y�s no
NNE
ME
EMOMMOMMEM
er Attached: Ge—s) rn�
..ate
A building permit may be required by:
( Note Local Planning jurisdiction)
Notes/ Special Conditions 11).iAn
Agent or Applicant Printed Name
Sigga!ure "Please read compliance statement on back of permit�*
Application Fee(s) Check#
El See note on back regarding River Bas n rules.
771
;c/
Permit Of�icer`s Printed Name
Issuing Date Expiration Date

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 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/ I-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.nccoastalmanagement.netl
Revised 08/27/14

ADJACENT RIPARIAN.PROPERTYUWNE&QJ TEMENT .
I hereby certify that I own property adjacent to y"
et ame f prpperty�Q�v�erj
Prop�y located
(Address, L t, 8to kt R ad,
on ON in a
(Waterbody) (Cltyffoin dlor County)
's
N.C.
The appli7r.
as described to me, as shown below, the development proposed at the above
location.
have no objection to this proposal.
I have objections to this proposal.
DESCRIPTION ANDIOR DRAWING OF PROPOSED DEVELOPMENT
(Individual proposing development must fill In description below or attach a site drawing)
�-e--e IN `-A .�
,1
RECENED
[Eel
DCM ►`AHD CV
2FCIS
AFC D
oe. 10i�
Cpy
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boathouse, lift, or groin must be set
back a minimum distance of I5 from my area of dpadan access unless waived by me. (If you
wish to waive the setback, you must f nitlat the appropriate blank below.)
I do wish to waive the I& setback requirement.
1 do not wish to waive the 45'setbacik requirement.
tV C—
Telephone Number
0- ooZ
Dale `t/2.o`�
(Adjace t Property 0 In formation)
SI ratrtga
ree
jg�►IQS '`:P-off �!%JSa�i
Pith I orTyp Name P
111
Mas UingAddre
Dale
f,? 77
Number.
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t
(RevlSad B/1WO12)

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to as rim- s
(Name of Property Owner)
property located at o 9 r5 S4're ,_.,4-r' c C Sal 2—
(Address, Lot Block, Rpad, tc.)
on in ,A-►-t -t
(Waterbody) (City/Town and/o County)
The applicant has described to me, as shown below, the development proposed at the above
Io
1-�• 1 have no objection to this proposal.
1 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)
av4
�FCo 2Fo
aC/ry
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boathouse, lift, nor 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.
Print or Type Name
_moo. 135 9
M Fling Ad ss
City/Statp/Z p
Telephone -Number
91q -Z-1O — VID 14
Date
It tZ.0 I , I
f
(Adjacent Property Owner Information)
Si,enature
Print or
c. _R L a- a 5-1 Z-
I'u C_:_ Z S I `Z—
Telephone Number .
Date—.- 32 -?.1G-- r> 43
(Revised 611812012)

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ISLAND MARINE CONSTRUCTICN
1286 ISLAND ROAD
To: HARKERS ISLAND, NC "=I
252-726- 419
From:
Re: Authorization Letter
authorize
A w r c w c. -e to act as my agent for the sole purpose of
obtaining/signing permits to perform work at