Bordeaux Jr., Kelly

CAMA El DREDGE & FILL
GENERAL PERMIT Previous permit #
ErNew ElModification El Complete Reissue ElPartiall Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environment and Natural Resources
V'k
and the Coastal Resources Commission in an area of environmental concern pursuant to I SA NCk
ched.
Rules atta
'Applicant Name f\
Prpject Location: County i
'Address 1I _el n t Street Address/ State Road/ Lot #(s)
City
State t�li zip
J r,
F e I
Phone # ax # Subdivision
Authorized Agent City ZIP
Affected 0CW 1�11EW _,bPTA .[jES 0 PTS
AEC(s): El OEA 0 HH1- LJ 1H I] UBA El N/A
0 Pws: DFQ
ORW: yes 1PNA no Crit.Halb. yes 1(,6&')
Type of Project/ Activity r-1
Pier (dock)
Finger pier(s)
Groin length
number
Bulkhead/ Riprap length
avg distance offshore
max distance offshore
Basin, channel
cubic yards
Boat ramp
Boathouse/ Boatlift
Beach BupdoZing N
Other (o
Shoreline Length
o - SAV: got sure yes //n
:Sandbags: not sure yes
Moratorium: n/a yes s no
Photos: yes no
I Waiver Attached: (__Y�1' no
Phone # River Basin
Adj. Wtr. Body V!­:�rn i(n_aDman /unkn)
Closest:; Maj. Wtr. Body —
(Scale:
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A building permit may be required by: A
f
El See note on back regarding River Basin rulers.
Notes/I Special Conditions
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ent.orAprl'- t Printed Name PermitOfficer's Signature f
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SignaturePlease read compliance statement on back pe7it** Issuink Date
Pie Expiration Date
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Application Fee(s) Check# Local PlanningJurisdiction 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 F� 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/ 1-888-4RCOAST
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

EIS
North Carolina Department of Environment and Natural Resources
Division of Coastal. Management
Pat McCrory Braxton C. Davis John E. Skvarla, III
Governor. Director Secretary
Date
Applicant Dame S. V E LL y
Mailing Address l 2 S" Qy 6 + q{yNcS L4(V C5-
t3EAr�tFa ^� N � Z ff S � L
/KU r>
I certify that I have authorized (agent) �E�c `A,2syc5 r; �c�c,�— o act on my behalf, for the
purpose of applying for and obtaining all CAMA Permits necessary to install or construct (activity)
DO L!c at (location)
jz637ep �.c�- Cfw q�t. C2E�.cJ
This certification is valid thru (date)
Signature
v
RECEIVED
•' MAR 2 5 2014
DCM-MHDcrIy
400 Commerce Ave., Morehead City, NC 28557 One
Phone: M-808-28081 FAX: [phone] Internet: wwwmccoastalmanagement.net NofthfC/ ir6llina
An Equal OpportunitylAffirmaUveAdon Employer �bKF �bblf

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to KIELcy o/t pEA-1 k, s
(Name of Property Owner)
property located at l 25 CZy �► At4r&�S LA•rt C
(Address, Lot, Block, Road, etc.)
on W A , G 2.Fr IL , in Rci4� Foz-r c� r , N.C.
(Waterbody) (City/Town and/or County)
The applicant has described to me, as shown below, the development proposed at the above
location.
- ) 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 below or attach a site drawing)
2,1 o'
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.)
-1 � � I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(Property Owner Information)
Signature
Print or Type Name
tZs Q,decj vats c E
Mailing Address
(3��Fe.cr/N C �ZpS-c c
CifVlState/Zip
LSZ- zGS ZS'IZ
Telephone Number
3 — 7-3 --to #-/ CEIVED
Date"
MAR 2 5 2014
nt Property Clwr�4r Information)
Print or Type Name
1 X_3 CZ V""-\ A t-�
Mailing Address
Fiec,u C.,CA A/C-
City/State/Z*
Telephone Number
Date
(Revised 611812012)
DCM MAD CITY

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to S 99Bda-o ak, Is
(Nanie of Property Owner)
property located at 12-5 ezQ EF.-j A-0 0 E5 LA-e4
(Address, Lot, Block, Road, etc.)
on w C/L(_ Etc , in t3C A-"FD A:i / G44-7�C--r- , N.C.
(Waterbody) (City/Town and/or County)
The applicant has described to me, as shown below, the development proposed at the above
to A .
VI 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)
`t> o C k
WAIVER SECTION
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.)
1 do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(Property Owner Information) (Adja ent Property Owner Information)
Si nature Sign ture ,�,��
I�El.[-�1 Ro no�ly At/1'C:/�' " ' 1�►-.yJG�2�
Print or Type Name Pri not (oi Type Name
� p _ . �%
IZ�- 6Qv�s.1 q�vNG$ LAND 1 U - T/��' M (2d
Mailing Address Mai ' g d ss
City/State/Zip City/State/Zip
Z s-z 2_GS 29� 2-IsZ-
Telephone Number `' TelephoneNumb r
313/2y �I a t?.3 1V
Date AR 2 5 2014 Date
DCNIMgDc, (Revised 611812012)