Bobolia, Michael

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XCAMA DREDGE & FILL 0
W19 W-3
�N Z ) 67520 A B D
GENERAL PERMIT Previous permit # New DModification El Complete Reissue Partial (0
al Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environment and Natural Resources 0 9
and the Coastal Resources Commission in an area of environmental concern pursuant to I SA NCAC
Vikulesttac
Applicant Name I Project Location: County
Address—, Street Address/ State Road/ Lot #(s)
City, r"q State ZIP
41 1,14
Phone # 4il i--` 14' E M Subdivision
Authorized Agent
"' I
A V ; "�"t .r City ZIP
El CW ,d'EW -�UPTA 0 ES 0 PTS Phone#
Affected River Basin
1:1 OEA El HHF 01H El UBA 0 N/A
El PWS:
ORW: yes/ PNA ,"rev/ no
Type of Project/ Activity
Pier (dock) length
Fixed Platform(s)
Floating Platform(s)
K
Finger pier(s) . . . . . . .
Groin length
number
Bulkhead/ Riprap length
ayg distance offshore_
max distance offshore
Basin, channel
cubic yards —
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing
1-711 Other -
Shoreline Length
SAV- not sure yes /no4"�'
Moratorium: n/a yes no
Photos: yes no
Waiver Attached: yes ( no
A building permit may be required by:
( Note Local Planning jurisdiction)
Notes/ Special Conditions
jAgeni or Applicapt Printed Name
Sigture "Please read compliance statement on back of permit"
g4
Ap plicationfee(s) Check #
Ell
Adj. wtr. Body IV C, ,-(na& /man /unkn)
Closest Maj. Wtr. Body
(Scale:
El See note on back regarding River Basin rules.

1.
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 [)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 that 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:
0 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 Washington District
400 Commerce Ave 943 Washington Square Mall
Morehead City, NC 28557 Washington, NC 27889
252-808-2808/ 1-888-4RCOAST 252-946-6481
Fax: [phone] 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)
(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.nccoastaimanagement.net/
Revised 08/27/14

A
.�a� A
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
Pat McCrory Braxton C. Davis
Governor Director
Date & 12-Z )
Applicant Name W C H AFL . LA-y" -56 66 L I A
Mailing Address 26 q S pd g E' kD
John E. Skvarla, III
Secretary
I certify that I have authorized (agent) ALI' Vj to act on my behalf, for the
purpose of applying for and obtaining all CAMA Permits necessary to install or construct (activity)
C 2 `Doc K- F(oo, ����. D �>E,K sys }ems , at (location)
ZJq
This certification
Signature
thru (date)
Uk C--,
8-/=js
RECEVED
Itm 8 01015
40"+k0H' W
RECEIVED
JUN 2 3 2015
Pry f i-►v mo Zia+
400 Commerce Ave., Morehead City, NC 28557 One
Phone: [phone] FAX: [phone] Internet: mw.nccoastalmanagement.net NorthCay�rollina
An Equal Opportunity i Afrirmafive Action Employer (�aA ally

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to i)��`PL� ,s
"I j g4 k� l�.D (Name of Property Owner)
_ ... property located �'_
(Address, Lot, lock, Rc�ad,4 tc.)
on IJ � Ey'E'p , in _� 'iN� N.C.
(Waterbody) (City/Town and/or County)
The applicant has described to me, as shown below, the development proposed at the above
locat_
I have no objection to this proposal.
I have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(individual proposing development must fill in description befog or attach a site drawing)
H
F- 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.) RECEIVED
I do wish to waive the 15' setback requirement. JUN 8 0 1015
I do not wish to waive the 15' setback requirement.
M&pe y O ne�"Mn)
S.
D0211� ;5 at� e7 L lA
Print or Type Name
Z- 9 6h�io`e �d
Maili g Address
/0 &CS'P t k C
C 2,- d lLlp& Z%
Teleph ne Number
o�3 020 0'�
Date
�*4440mff wv'
(Adjacent Property Owner Information)
Sagnat re
Xa-qwok\a( Sr,
Print r ype Na e
e
Ma' ing Address
I� �-� /JC �1�r76
bity2t�� p - & - BUJ
RECEIVED
Telephone N mber
_ 2Z — JUN 2 3 1015
Date
(Revised 611812012)

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to N1 C—ma- 4- L.,� lw L lq- 's
2D �/1©% � • _ (Name of Pro .. party Owner)
n -(Address, L t1®ck ,lioad,!
on OV�� Ktti�t�- , in ' 11 N.C.
(Waterbody) (City/Town and/or County)
The applicant has described to me, as shown below, the development proposed at the above
10'n.
7. 1 have no objection to this proposal.
I 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)
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.)
I do wish to waive the 15' setback requirement. RECEIVED
I do not wish to waive the 15' setback requirement. JUN 3 0 1015
kt':t-1 o
(Property Ow Ition) (Adjacent Property Owner Inf�on)
AQUA 12
S Signature
��fi L�U
Print or Type Name Print or Type Name
aoq .Su09-L >ZD 210 5140RE
Mailing Address MajW g Addrf�ss
N EUA a T �Z Zsr��i D IBC
City/s atelzJ* / I ,//� Clf /statelz,p /-
Z� (D2Z �`?3Y �LS� -? Zfo • �Sl� (D RECEIVED
Tele ho e N mber Telephone Num er
p �' 3 2015
to ZZ ?CIS a�22 Z� I.� JUN 2
Date Date t4-4agk1l� + ?l
(Revised 611812012)

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910C:LA CZI I ffE IT
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m' m Project NameIEZ Dock Solutions
m Pro ect Name
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} o� �C PREPARED FOR Me:,,-rz�
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Customer C
DRAWING NUMBER rou_ FREE No. 252-764-1234
Drawing Number PHONE NO.
DRAWN ar DATE
Drawn B Date 252-648-8026