Chaney, Barry

PCAMA / ❑ DREDGE & FILL
A B ' C D
GENERAL PERMIT
Previous permit#
C New ❑Modification El 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 15A NCAC�
; !
`© Rules attached.
Applicant Name ...�"`'' f e ! ` ~`) t" r
Project Location: County
Address . �fE :%_�_ 3 . 04' : ; -
Street Address/ State Road/ Lot #(s)
City State--U' ZIP
Phone # ( �)''- ' �i f_ { rn E-Mail
Subdivision
Authorized Agent
City - + t {''� ZIP
❑CW 3EW DPTA El ES ❑PTS
Affected
Phone# ( ) River Basin % a''(--J {
r t T
❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A
AEC(s):
Adj. Wtr. Body 1 t o4nat ;/man /unkn)
((
- r
ORW: yes � �no PNA yes (° no
Closest Maj. Wtr. Body �-�—,
Type of Project/ Activity
Pier
Fixe
Float
Fing
Groi
Bulk
Basi
Boat
Boat
Beac
Oth
Shor,
sAv
Mo
Phot
Wa'
(Scale:`"
length
ME
0
NAME
SON
MOMME
NONE
a
NONE
NONE
EFOUNialillIMM
number
■
ead/ Riprap length
No
No
mom
Bill
max distance offshore---�—
MEMEN
MEN
ME
M
M
NONE
ME
,channel
cubic yards
Z
mom
M
MEMO
LEE
mom
MEMNON
ENNE
ME
MEMO
Bulldozing
MEMO
WKWON
M.
w1Wwwft"w
M
M
mom
0
IMMEMMINAREM
ILI
MMM.M
IN
M
not sure yes no
MENNEEMN
0
MUM
NONE
MEN
NIMMEM
ME
MEMO
itorium. n/a yes
MENNEN=
M
EMME
ME
MM
Nk
'IMMON
ON
NEON
jl
A building permit may be required by:
( Note Local Planning jurisdiction)
Notes/ Special Conditions
j / f
Agent or Applicant Printed Name
Signatdre , !* Please read compliances tement on back of permit
Application Fee(s) Check #
❑ See note on back regarding River Basin rules.
Permit Officers,Printed Name
/ �
Signature �� .'_� � '• �i
Issuing Date .`i Expiration Date

r
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 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
❑ Neuse River Basin Buffer Rules
Other:
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 how to complywith these buffer rules.
Division of Coastal Management Offices
Morehead City Headquarters
400 Commerce Ave
Morehead City, NC 28557
252-808-2808/ 1-888ARCOAST
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)
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 - South of New River Inlet -
and Pender Counties)
http://www.nccoastaimanagement.net/
Revised 08/27/14

hereby certify that I own property adjacent to �� 4- T td� L�ii� �✓c� 's
ame of Prolferty Owner)
property located at 30
h
(Address, Lot, Blo k, Ro , e .)
�on c?�f Csf'ee , in c�dt .2 �-�t , N.C.
(Waterbody) (City/Town and/or County)
The applipant has described to me, as shown below, the development proposed at the above
i
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)
RECEIVED
MAY 0 4 2015
WAIVER SECTION RECEIVED
I understand that a pier, dock, mooring pilings, boat ramp, breakwater, boathouse, lift, or spiq 12015
must be set back a minimum distance of 15' from my area of riparian access unless waived b
e. (If yoywish to waive the setback, you must initial the appropriate blank below.) �'"`� 4d>l},`
m
V v v a I do wish to waive the 15' setback requirement.
)'j4�S}o3`I I do not wish to waive the 15' setback requirement.
ll (Property Owner Inforn tion) (Adj ent Pi
Signature
Print or Type N� CA /
DJ V O
Mailing ddnesp-
city/w.7 X'9x
Telephone um er/email address
Date
Sign Ja*.'J'0kl �v ►V ► / �/!' Dv
Print or Type Name
3 0 !2 Jda,
Mailing Address G 2,a S�
13f/a.CA -M-►/ i/ (o'
Cityg ate/Zip
�5 -sal-15
Telephony Num r/email address
p.S/0 3 //S
Date*
(Revised Aug. 2014)
L
*Valid for one calendar year after signature*

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to /rR "Ve 's
--��-- (Name of Pr perty Owner
property located at O `J© 'v C
(Address, Lot, BlRo , e .)
on I�F�Ktn/s CReek_ , in .�S�A.- % GI/L , N.C.
(Waterbody) (City/Town and/or County)
The applicant has described to me, as shown below, the development proposed at the above
loc tion.
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)
WAIVER SECTION
I understand that a pier, dock, mooring pilings, boat ramp, 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.
I do not wish to waive the 15' setback requirement.
(Property Owner Information)
"Si ature
Print oI
e Name
. S o s
& ,
Maili Add s
iUc
2� - ,
City/State ip
70 02 G Se0 7
Telepho Nu ber/email address
y'3��T
Dat
rmation)
5*ei,�
Print or Type Narr{e� J — 7—
Ma­ ddress �/ l✓�
RECEIVED
City/ tat /ZZ S4 � �-y �/ �r•
Telep ne umber/email address MAY 1
Date*
(Revised Aug. 2014)
"Valid for one calendar year after signature*

S
■ Complete items 1, 2, and 3. Also complete
item 4 if Restricted Delivery is desired.
■ Print your name and address on the reverse
so that we can return the card to you.
o Attach this card to the back of the mailpiece,
or on the front if space permits.
1. Article Addressed to:
Ile 4
C�3o � �Uqu 1Y10�'✓/ '
ll��fi%rTf+X', l�i�, 02.20.30
A. sign t re
X kg,�VAgent
Addressee
B. deceived by Pr1nte,d N e) Date of Delivery
tyy �-1ltt 8.Z A��
D. Is delivery address different fro_m_i 1? - ❑ Yes
tet& IfYFfliveryaddr��belopr�/ ,❑,No
RREE �l�vCc
NOV 0 61014 /o(
- ..,�.-nllul i
3. Service Type a
Certified Mail® P`o+ iy ess"
❑ Registered ❑ Return Receip for Merchandise
❑ Insured Mail ❑ Collect on Delivery
4. Restricted Delivery? (Extra Fee)
2. Article Number 7014 0510 0002 0589 2213
(transfer from service laben
❑ Yes
i PS ForrnMl i j July 2013 1 f 1(I ( I 1(Domestic,I Wdrn Receipt

UNITED STATES POSTAL SERVICE
� T
First -Class Mail
Postage & Fees Paid
USPS
Permit No. G-10
• Sender: Please print your name, address, and ZIP+4® in this box*
ycxl'm�
'Yos .T,,
"6'e'4 arc, X/' 'mc
li�lljl:liii!111b1],IW011�l�„!,!„!!!�i„,l4:�!

CERTIFIED MAIL - RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM
Name of Property Owner.
Address of Property: o rJ o ^/ Cr vie / Gvsi
(Lot/or Street #, Street or Fkoad, City & County) r a f407
Agent's Name #: Mailing Address: /2R6
Agent's phone #:r.?S2 7� r 0/3 Z- /YA��e,P.t -fir A�vd� i✓G. "wv/
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 drawing, with dimensions must be 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 mustnotify the Division of Coastal Management
(DCM) in writing within 10 days of receipt of this notice. Contact information for DCM offices is
available at orby calling 1-888.4RCOAST.
No response is considered the same as no objection if you have been noted by Certified Mail.
WAIVER SECTION
understand that a pier, dock, mooring pilings, boat ramp, 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.)
RECEIVED
I do wish to waive the 15' setback requirement.
AI�L�
NOV 0 6 2014
I do not wish to waive the IF setback requirement.
DCM-MHD CITY
(Property Owner Information)
"Signature-
L. elvle/
Print or T Name
30S- 7-
Mailing Address
City/State/Zip '
'Talep hone Number/Email Address
Date
(Riparian Property O er Information)
Ur� W. I tJi
Signature U U
Print or Type Name
L 004 --�
Mailin Address
-
City/StateMp
Telephone Numberl Email Address
Date
(Revised Aug. 2014)

se
■ Complete items 1, 2, and 3. Also complete A,
item 4 if Restricted Delivery is desired. VX
■ Print your name and address on the revers
so that we can return the card to you. f g
■ Attach this card to the back of the maiipi`ece,
or on the front if space permits.
1. Article Addressed to:
,Q; ck- + �LW7 Aql?y r+A.v
by
❑ Agent
❑ Addressee
C. Date of Delivery
Is delivery address differbnt from item 1? LJ Ye;
If YES, enter delivery address below: ❑ No
3. Service Type
Certified Mail® ❑ Priority Mail Express-
0 Registered ❑ Return Receipt for Merchandise
❑ Insured Mail ❑ Collect on Delivery
4. Restricted Delivery? (Extra Fee) ❑ Yes
2. Article Number 1 7014 0510 0002 0589 2206
(Transfer from service labeQ
;�PSFEorm 3911; JUly 2p13111 f I 1 I,bc �stic Return Receipt
I if 1 ! I :,

UNITED STATES&Q�TA AERVICE
• llcv'1
l"" t'w L
r
First -Class Mail
Postage & Fees Paid
USPS
Permit No. G-10
• Sender: Please print your name, address, and ZIP+4® in this box*
/tlL . 2-9S-16
In�l��'Ill�nl��'IIUI�'I" �lililt,lll�llnll�,lllll�ll„��111'

t'
CERTIFIED MAIL - RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Property Owner: 4 fib L,
Address of Property: 30� 'J A.✓
(Lot or Street #, Street or Road, City & County) 70 s� Vol 7 G f/47
Agent's Name #: 7%,,o rA.r Ztw rn/c� Mailing''A//ddress: /28�i .Zs�A. 0�
Agent's phone #: �i) =S-- 013 L 14,Wele r _7,r/.vim n/e. 095-3/
i
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 pro using. A description or drawin4 with dimensions must be 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 orby calling 1-888.4RCOAST.
No response is considered the same as no objection if you have been noted by Certiffed Mail.
WAIVER SECTION
1 understand that a pier, dock, mooring pilings, boat ramp, 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.) RECEIVED
I do wish to waive the 15' setback requirement. Nnv 0 6 2014
I do not wish to waive the 15' setback requirement. DCM-MHD CITY
(Property Owner Information)
`Signature/
L, �c
Print or Typof Name
-?,o S-
'0 7- G 1/d
1013
Date
/(I
(R'paria operty Owne Information)
Sl�
Print or Type Name
,-3�'7 ��*1u
Mailin Address
City/State/Zip,—
Date
imber/Email Address
(Revised Aug. 2014)

RECEIVED
Inv 0 6 2014
,CM-MHD CITY
;col