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MA DREDGE & FILL
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E'qCA
GENERAL PERMIT
A B C D
Previous permit #
Mi�New ElModification El Complete Reissue El Partial Reissue
Date previous permit issued
As authorized by the State of North Carolina, Department of Environment and
Natural Resources
G( 4
and the Coastal Resources Commission in an area of environmental concern pursuant
to I SA NCAC
Applicant Name
El Rules attached.
Project Location: County
Address
Street Address/ Statp Road/ Lot # (s),
City State N�_Zlp;_)
J
Phone # E-Mail
Subdivision
Authorized Agent
City Ci zip
'dCW tltW 'bkA
\P ES El PTS
ff
Phone# River Basin cc
Affected
0 OEA El HHF El lH 10 UBA 0 N/A
AEC(s):
Adj. Wtr. Body— r, (Inat /man /unkn)
(fZ] PWS:
f
Cyes)/ PNA /
Closest Maj. Win Body
OIRW. no yes Ir)
Type of Project/ Activity J e,
YTO
Pier (dock) lengtkri_��('
Fixed Platform(s)
A
Floating Platform(s)
Finger pier s)
77
Groin length
.--nuWber
Qtlkhek Riprap length Y" Tp
avg distance offshore
max distance offshore
Basin, channel
cubic yards ---
Boat ramp
Boathouse 11 Boatlift)
;11 !`I
Beach Bulldozing—
Othern��a"K
Shoreline Length
SAV. not sure yes
Moratorium: n/a yes
Photos: yesno'
Waiver Attached: yes r�
A building permit may be required by: Uri
Note Local Planning jurisdiction)
Notes/ Special Conditions
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E*J Rel`no\t�i
VL
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A4 i� i�14.,\W'),kn YIA'ek
(Scale: P
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,on back regarding River Basin rules.
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% Agent or Applicant Printed Nakne"
Permit Officers Print?d Name
Signature Please read compliance statement on back of permit
Signature
...... ..
Application Fee(s)
Check#,
Issuing Date
Expiration Date
e
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 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 comply with these buffer rules.
Division of Coastal Management Offices
Morehead City Headquarters
400 Commerce Ave
Morehead City, NC 28557
252-808-2808/ I-888-4RCOAST
Fax: 252-247-3330
(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:252-264-3723
(Serves: Camden, Chowan, Currituck,
Dare, Gates, Pasquotank and Perquimans
Counties)
Washington District
943 Washington Square Mall
Washington, NC 27889
252-946-6481
Fax: 252-948-0478
(Serves: Beaufort, Bertie, Hertford, Hyde,
Tyrrell and Washington Counties)
Wilmington District
127 Cardinal Drive Ext.
Wilmington, NC 28405-3845
910-796-7215
Fax:910-395-3964
(Serves: Brunswick, New Hanover,
Onslow - South of New River Inlet -
and Pender Counties)
http://www.nccoastalmanagement.nett
Revised 08/27/14
y
N.C. DIVISION OF COASTAL MANAGEMENT
NOTIFICATION OF COASTAL WETLAND DETERMINATION
Pursuant to NCGS 113-229(n)(3), and 15A NCAC 07H.0205(a) A B OC
Property Owner:t �� `_ ��: Mailing Address:-l. ��F % `�' ^`1l t 1 �� ✓
Site Address: >�" ?, �, ; --., ±�� n r L��I-
Project Location: Count/7- US/NC/SR #
River Basin Adj. Water Body .+
Indicate Which of the Following Apply:
Coastal Wetlands have been identified on the above described property. The project (as currently
proposed) may impact these wetlands but no official delineation was performed. The Division of Coastal
Management suggests that you request a formal delineation by this Division to evaluate potential impacts to
Coastal W tlands and project design alternatives.
Coastal Wetlands have been identified on the above described property. At your request, an official
Coastal Wetland delineation was performed by the Division of Coastal Management. The Division of Coastal
Management suggests that you have the delineation surveyed. The Division will verify the surveyed line, which
will then remain valid for a period not to exceed 12 months from the delineation.
Coastal Wetlands species identified on -site:
V Spartina alterniflora
Distichlis spp.
_Cladium jamaicense
_Spartina cynosuroides
Juncus roemerianus
Limonium spp.
Typha spp.
Salicornia spp.
Scirpus spp.
�partina patens
Check any field indicators that apply to establish regular or occasional flooding:
tidal water observed on -site (do not check if during or following Tropical Storm/Hurricane)
crabs/holes V"wrack lines staining tidal water connection
periwinkle elevatiop-changes other (please describe)
DCM Official __ (r t�le
1 Itle I l
Date
RECEIVED
MAR 0 6 ?n'A
In the event iDu wish to appeal this jurisdictional call, you may request a second opinion by contactin .my
supervisor, L} Z�! \ �1� (DCM District Manager) at a,71 c�1 1: 04 t; I
Visit our website at www.nccoastalmanagement.com
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N.C. DIVISION OF COASTAL MANAGEMENT
AGENT AUTHORIZATION FORM
Date
Name of Property Owner Applying for Permit:
7'`+oIJ
Mailing Address:
322 C, W a)0�
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ca
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I certify that I have authorized anent) s t;�'a O,Z —4:F> to act on my
behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to
13 install or construct (activity) 6 U� S,�
at (my property located at) 3 D 7
This certification is valid thru (date)`
ature
Date
RECEIVED
MAR 0 6 203
H-m-- AAH In"
■ 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.
■ Attach this card to the back of the mailplece,
or on the front if space permits.
A. Signature
X _3' ✓
0 Agent
❑ Addressee
B. Received by n ted Name)
C. Date of Delivery
1. Article Addressed to: D. is Couvery address different from item 1? Yes
if YES, enter delivery address below: ❑ No
O' c Ca e i o S r'-4 CA 3. Service Type
� �� ���] � ❑ Certfied Mail' ❑ Priority Mai! Express'"
�- j 1 v O Registered ❑ Return Receipt for Merchandise
Q Insured Mail ❑ Collect on Delivery
4. Restricted Delivery? !Extra Fee) 13 Yas
2. Article Number _._ _ . _..... ____._...... _ ...... _.. ....... _.._
frransterfromservice k1 7013 3020 0002 3479 9075
PS Form 3811, juiy2OV"--1. Domestic Return Receipt
■ 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.
■ Attach this card to the back of the mailplece,
or on the front if space permits.
1. Article Addressed to.
El Agent
R ed by nted Name) 0 D te ot Delivery
D. is delivery address di lereent from item 1? ❑ Yes
If YES, enter delivery address below: ❑ No
3. Service Type
O Certified Map ❑ Priority Mail Express-
c ._ ,1 O Registered 13 Return Receipt for Merchandise
J i5 1 Q' E3 Insured Mail 0 Collect on Delivery
4. Restricted Delivery? (Extra Fee) 13 Yes
2. Article Number, .......... ..__. .............. . .........
{rransferfrom service Caber 7 013 3020 0002 3 4? 9 9068
PS Form 3811, July 2013 Domestic Return Receipt
RECEIVED
14lR 00 7(11K