Blowers, Robert

b CAMA / 4 DREDGE & FILL
GENERAL PERMIT
Previous permit #
!t New ❑Modification ❑Complete Reissue ❑Partial 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 1
Applicant Name a ('', > t i�lf"'.
M]lules attach d.
Project Location: County
Address
Street Address/ State Road/ Lot #(s)
'City, i �t;'"'S E��r' State �'� ZIP
Phone # (� `)-' ;J•'f /l! /-/Y Fax # (_ "'--
Subdivision
I S' -
Authorized Agent P-, f I ! (I i " ;' i i )
City ZIP
❑ CW �O EW p PTA ] ES PTS `�
Affected
Phone # ( ) River Basin i! t f r r
❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A
AEC(s):
l
Adj. Wtr. Body i f'`. • !, " "i�� ! (nat/mang /unkn)
❑ PWS: ❑FQ
ORW: yes / no PNA yes / V6 . Crit.Hab. yes / tno?
i
Closest Maj. Win Body
Type of Project/Activity %1fi�1r`,1�(I" �Itr•1V? f �,����I
'.� ci i;%;iilij�`'��r�lli0)(rnv'1l
j 1 i
(Scale: f)
l
Pier (dock) length C
Platform(s)
Finger pier(s)
Groin length
�nu��mber '� 1
6ulkhea9/ Riprap length 7 4?X
a g distance offshore
max distance offshore�
Basin, channeI
cubic yards Ira 0
Boat ramp —
Boathouse/ Boatlift
Beach Bulldozing
Other
Shoreline Length
SAV: not sure yes (� no
;Sandbags: notsure yes t no
Moratorium: n/a yes 1 no
Photos: yes j no
Waiver Attached: yes i no
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EMEMMOMME
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MMEREMBEREN
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A building permit may be required by i
❑ Seed note on back regarding River Basin rules.
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Notes/ Special Conditions � 1� t�t�' !) t (li�
,
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� � � � �- �� /J/_ 4 f ^ ('�F•
j RECEIVED
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QCT 14 7014
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Agent o licant Printed NrF
Permit Officers Signature
Signature '* Please read compliance statement on back of permit
Issuing Date
Expiration Date
9 rrri }
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ApplicationFee(s)
C/heck#
Local PlanningJurisdiction Rover File Name
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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, certify thatthis 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

PafmcCrory -
Governor
Date
;71 1
North Carolina DepartmeWCDENR
nt of Environment and Natural Resources
Division of Coastal Management
Braxton C. Davis John E. Skvarla, III
Director Secretary
Applicant Name )C!��
Mailing Address 2 o t O
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)
at (location)
Lg
This certifi
Signature
400 Commerce Ave., Morehead City, NC 28557
Phone: [phone] FAX: [phone] Internet: www.ncooastaimanagement.net
An Equal Opportunity l Affirmative Action Employer

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
hereby certify that I own property adjacent to ICE %n`�' laws z is
(Name of Property Owner)
property located at _ 20 t a t2- UMis-E- Tip i vc-
(Address, Lot Block, Road, etc.)
on CA �•r �4 , in _ , N.C.
(Waterbody) (City/Town and/or County)
The_ applicant has .described to. me, as shown below, the development proposed at the above
on.
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)
1 -L4-
v g � L`�-+
WAIVER SECTION,,`
I understand that a pier, dock, mooring pilings, breakwater, boathouse, lift, or groin must be set
back aminimum 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.)
ss I do wish to waive the 15' setback. requirement.
do not wish to waive the 15'setback requirement.
(Pro rty Information) (Adjacent Property Owner Information)
ru�
SIRWture Si atur
via �ko
Print or Type Name Print or Type Name
Zol c7t9kL,�,�F � c, l3�3 t4d�P;o �-i��T
1� �'lin Add ess Mailing Address RECEIVED
c tic zs� 12 5 ► c ate, c,� ST
City/State/Zip 7 City State/Zip Q OCT l 4 �TJ-
Telephone Number. DCM-.TAHD Glr�
p Tele hone Nu b r
-b 2t� 1
Date
Date
(Revised 611812012)

,
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
hereby certify that I own property adjacent to Zrt:-a-,r I, lOwims s
(Name of Property Owner)
property located at 7 r71 ©►A )kLft dt� L, c
(Address, Lot ock Road, etc.)
Ili ►9
on 1A Ili A- , in 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)
.P arty- C 21 t'
`ID o c,1C
---------------------
-eLN4cx. ,F o,� V&iIiNS
WAIVER SECTION'
I understand that a pier, dock, mooring pilings, breakwater,, boathouse, lift, or groin must be set
back aminimum 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.'
do not wish to waive the 15' setback requirement.
(Pro y 0 er I for at'on)en�repe A ner Infoe,:ion)
S' nature Si a r
O hL a�T- 0"'e-rs
Print or Type Name not or ype Name
m ddress iling Addr, ss �]
tee. nb�) 119Ye�, PEcEivEe
City/State/Zip City/State/Zip
t� �3 Oo2') 2SZ 2 �►''� - OCT l
Telephone Number Telepho a Num er
DCMNIH04-1ry,
Date Date
(Revised 611812012)