Blinson, Anthony

GAMA / ❑ DREDGE & FILL 11410 2792
ENERAL PERMIT Previous permit#
New ❑Modification ❑Complete Reissue ial Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environment and Natural Resources / G L
and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC
©Rules attached.
applicant Name r� � � ' n �f �'� Project Location: County �Cv "f �/ el -
Street "�-State
r' ('Street Address/ State Road/ Lot #(s)
City i G c" r ZIP
Phone # %Q)�%'�I E' r Fax #' (_!) Subdivision / r�
Authorized Agent - %c �I d r' �� f?- City '�`'r�e ��` i� ZIP ' F>
Affected 'Urw `fftW ..BfTm ❑ ES ❑ PTS
AEC(s): ❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A
❑ PWS: ❑FQ
- ORW: yes 7 no PNA yes /( Crit.Hab. yes / no
rr ► / ,r
Fpef Project/ Activity ,l V
'-4)0" x(,' r/, c <<
Pier (dock) length U �%
Platform(s)
Finger pier(s)
Groin length
number
Bulkhead/ Nprap length
avg distance offshore
max distance offshore
Basin, channel
cubic yards
Boat ramp `
Boathouse/ Boatlift
Beach Bulldozing
Other
Shoreline Length '
-SAV: not sure yes Po
;Sandbags:1 not sure yes VQ
Moratorium: n/a yes fno/
Photos: yes n°
Waiver Attached: ves no.
Phone # ( ) River Basin K1 . t,6,i
Adj. Wtr. Body 15t-0 "n � a man unkn
Closest Maj. Wtr. Body 60 25� t--ce, u,"
/ . 3f "
(Scale: 60 ) I
A building permit may be required by: r 'J1,0 tt jj ❑See note on back regarding River Basin rules.
Notes/ Special Conditions A t / � /70 / 1I J A a i'.4 / �, N , k f Lr r, �� nl r� 1 �� r f r �9C t' /c

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 Headauarters
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

Ai2i
WDENR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
Pat McCrory Braxton C. Davis
Governor Director
Date -7I�g1ZVIS
Applicant Name
Mailing Address o272—q rDZEStUI u9 4,
AWLIi_ NCr, oL7bl b
John E. Skvarla, III
Secretary
:y. l�4'irIVEIi •.
JUL 2 4 2013
DCM-MHDCITY
I certify that I have authorized (agent)to act on my behalf, for the
purpose of applying for and obtaining all CAMA Permits necessary to install or construct (activity)
10 q &n&Wo Ajor
�5rnaAIV
This certificaOn is valid
Signature
(date) cT —ls�1t�T 3�
400 Commerce Ave., Morehead City, NC 28557
Phone: [phone] FAX:[phone] Internet: www.nccoastalmanagement.net
An Equal Opportunity IAffirmative Action Employer
at (location)
No thCarolina
;Vahmalloff

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to 5169.90d E. A�J W aU14l.45- 's
(Name of Property Owner)
property located at �� 0 1 E0Lb #)a e7m cRUL,n �s �
• (Address, Lot, Block, Road etc )
on _ �Ksl� s""""`1 , in 1:;, t'(d �� �� �� U.C.
(Waterbody) (City/Town and/or County)
The applicant has described to me, as shown below, the development proposedMUME%bove
location.
I have no objection to this proposal. JUL 2 4 2013
1 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)
r
-- A
fo m c e
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 __ z — I wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(Pr perty Own r Information)
ignatu e NSb9A)
�� L
Print or T e Name
019 rat-sryi u'� P.n.
MglAddress IC,
City/State/Zip
922-116.!�2R2
Telephone Number
-1 / 14 2,0 13
Date
(Adjacent Property Owner Information)
Si�?�g�furei2o, • V/� /�
��
Print or Type Name _
22 a 7t-
Maili Addre s
-22617
City// -X- %Olo d
Telephone Number
711 7Z1,3
Date
5'
(Revised 611812012)

JUi--24-2013 10:04 FROM: TO:12523936285 P.2
1 J
oo • .
RECENED
ADJACENT RIPARIAN PROPERTY OWNER STATEKENT JUL 2 4 2013
I hereby certify that I own property adjacent to rAN f 0 nl'u L- i (q'S c)t-J _ 's
(NarAe of Property -ownewmmill)Crry
property located at I_ry 2r��'D Die J;S aaa IyG
(Address, Lot Block, Road, et
on y9r ky� in ,�'/l7F��s-Gli ke C-G� , N.C.
(Waterbody) (CitylTown andlor County)
The applicant has described to me, as shown below, the development proposed at the above
locatio _
I have no objection to this proposal.
I have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(Ind(vldual proposing development must fill in desk ption below or attach a site drawing)
Lam)
Pr+;L ✓,
r vA
3athouse, lift, or groin must be set
back a minimum distanco of 15' from my area of riparian access unloss waived by me. (If you
wish to waive the setback, you must Initial the appropriate blank below.)
P.
I do wish to waive the 15' setback requirement.
I do not wish to waive the 16' setback requirement.
(P party Owner Information) (Adja ont Property Owne nformation /
trr/ %� _
7 a. G
b , &n1sw _ Nl R0n! 0 . 5 Tl�_ U) M-P-T. UE,
Print or Type Name Print or Type Ne e
Nra5T M i\-r— IF_.
Mailing Addross Mailing Address
IdfA /K. __R A L6-i G 4 vsta
t .Qa9z _ 0fy/S� 9p BK?.
0
Tel phone Number Telephone Number
7%14/2r13 7-
Data Dale
(Revised W1812012)