Bennett, Jack Rose C/O Sailfish Properties & Rentals LLC

CAMA / ❑ DREDGE & FILL
GENERAL PERMIT Previous permit#
]New ❑Modification ❑Complete Reissue talReissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environment and Natural Resources
anq he.Coas I esa ces Commission -in an area�°f a , oniTnta c9ncern pursuant to 15A NCAC
if �.. "w..fy1 t i.`}L<.� , 4Rules ttached.
Applicant`Name t Project Location: County
Address �' Y` `� ' 'f # " �� F �` } �lr ' Street Address/ State Road/ Lot #(s)
ity �k't' State ZIPt'
Phone # () '"
t.
3 Fax # (_
Authorized Agent..
Affected ❑ CW ,.-b EW
_NPTA ❑ ES ❑ PTS
AEC(s): ❑ OEA ❑ HHF
❑ IH ❑ UBA ❑ N/A
❑ PWS:
❑ FC:
ORW: yes (no) PNA
yes / ;0 Crit.Hab. yes )..tn
Subdivision ` %'`� (-?�
City ZIP
Phone # (_) River Basin
Adj. Wtr. Body nat an unkn
Closest Maj. Wtr. Body j',
Type of Project/ Activity �:"t i 7~f' ?%1, O + .. t on ""1 r; r 1 1 ► r V ( ;C:_ � i t � r (", f'Ij &t ,,- / . i
(Scale: )
Pier
Platf
Fing
Groi
Bulk
Basii
Boat
Boat
Bea(
Oth,
Shor
SAV:
:Sand
Mo
Phot
Waiv
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distance offshore-
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max distance offshore
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cubic yards
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A building permit may be required by: ! ( i _ ty / i r '� ❑ See note on back regarding River Pasin rules.
Notes/ Special Conditions( t y'((' •' ( !' l' `t t�"rj j�i
f i3� `' r'% t r `(�f t?iiit) J' ,?X — l� �`f -T4l:a `t Iln Yt 1,� C� i:d ii
A \/
t':� ��._{�Z �� x�,#i;t I ���t �n�" r'Ir"'fir; �..f,;��i,��:/r )!�'t� />rt �./• 1
�entpr'Applicant Printed PermttOffi rs Sign a re v
--- � � .,ram � f.�. /�' ..-`�` •,,._.,, +'`�,%y' �,'
Signattrre [* Please read compliance state nt on back of permit Issui gbate Expiration Date
eO 10` , r
Application Fee(s) Check # Local Plan ' giuns fiction 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, certifythat this project is consistentwith the North Carolina Coastal Management Program.
River Basin Rules Applicable To Your Project:
0 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/ I-888-4RCOAST
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

NC Division of Coastal Mgt. Habitat Impact Computer Sheet
Applicant: Bennett
Date: 5-30-2013
General Permit #: 62300C
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
temp impacts)
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
OW
Dredge ❑ Fill ❑ Both ❑ Other ®
600
600
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 ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
252-808-2808 :: 1.888-4RCOAST :: www.nccoastaimanagement.net revised:02/03/10

CERTIFIED MAIL • RETURN RECEIPT. REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN ON
OWNER NOTIFICATION/WAIVER FORM
Name of Property
b
Address of Property:
or Street #, Street or Road, City & Countt/j
Applicant phone # .aZ 5TR' o, `j ��� Mailing Addrea ,a,,, F /A� /q l
I hereby certify that 1 own property adjacent to the above referenced property. The individual
applying for this permit has described to me as, shown on the attached d_ yawing the development
theylar6. proposing. A'descnbii66`br dr6WIfig,:with dtmensions 'n ust fie provided with'.this letter.
/\ I have no objections to this proposal. I have objections to Us proposal.
if you have. objections to what is being proposed, you musthotify the Division of Coastal Management
(DCM) In writing within 10 days of receipt of this. notice. Contact Information for DCM offfces..Is
available at tvww.nccoastalmangementnet/contact_dcm.htm or by calling 9-888-4RCOAST, No
response Is considered the same as no objection if "ou have bee» notrted by Cered MaJI
WAIVER SECTION
I understand that a pier;. dock, mooring pilings, breakwater. boathouse, or lift must be set back a
Minimum distance of it' from my area of r!Wah 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.
I do not wish to waive the 15' setback requirement.
;Propeerty Owner Informatfo (Rir an Prope y er information)
Si u:
Print or Type Name PdAVrType Name
Marling Address
_ Nei LA/ ponl.
City/state2ip jr$ 7
Telephone Number
Date
Ia5- F-lfJC/4 �-oo
Mailing Address
city/Stateop
Z ZZ 3g
Telephone Number
Date
-•aS'�� ��.F'S�. S"', �(� 'rain c� r.I,,tiP: ,,,

CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM
Name of Property
a -S;9 . ff -,r-A —Pei o P E/ ,' - S -4 _ 1�E n-? N 15-
Address of Property:,
(Lot or Street #, Street or Road, City & County)
Applicant phone #: fk/ Mailing Addresa�A F As AL
I hereby certify that I own property adjacent to the above referenced property. The individual
applying for this permit has described to me as shown on the attached drawing the development
they are proposing. A description or dramh6,* with dimensions `must 6e provided with this letter.
I have no objections to this proposal. I have objections to this proposal.
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.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boathouse, or lift 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 Informatio
ignature
Print or Type Name
1
Mailing Address
City/State/Zip -r-O $ 9 7 p
9}4, Sg0- �24
Ix-
Tel6phone Number
Date
(Riparian Property Own/ear )Infor tion) N
Signature
n
Print or Type Name .
Mailing Address
4 7—
City/StaterZip
L5�'5�/ �3�1
Telephone Number
Date
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