Daniels, Mark

CAMA / El DREDGE &FILL i ;:t� , Y
.: A B C r` D
GENERAL P�R M IT Previous permit #
iMNew ❑Modification omplete Reissue ❑Partial Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environment and Natural Resources t
and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC
' © Rules attached.
t
Applicant Name `�' `r� ► -' Project Location: County. * 4
,-- ,
Address Street Address/ State Road/ Lot #(s) 11- ! �r'>ti ' f � /'�.
City + 3 State a �; ZIP..
Phone # (�") E-Mail
Authorized Agent r '• i t ? ((�: ,� i , >ti ,a r� r r �• jr'?
p CW r©EW F L] PTA El ES ❑ PTS V
Affected AEC(s): El ElHHF ❑ IH ❑ UBA ❑ N/A
❑ PWS•
ORW: yes / no .-' PNA yes
Type of Project/ Activity
r
Pier '
Fixes
Float
FingE
Groi
Bulk
Basir
Boat
Boat
Beac
Othr
Shor
Sav
Mor
Phot
Wain
Subdivision
Cityf
ZIP
Phone # ( ) River Basin
Adj. Wtr. Body 1 t I� r--� _ (nat /man /unkn)
Closest Maj. Wtr. Body
r'
(Scale:
fle h
ME
MEN
number
avg distance offshore
max distance offshore
INEEM
cubic yards
ramn
MIN
MENNUFAME101
NOW
MIN
U
—
ME
NIEMEN
I
MEMO
MAIVIM
WIN
—111 1 --
IS
IMEMEMENNEEN
0
W—F—FUNNE
Cua
�i�
ii■
MIENME
not sure yes no%�'�JMMN1=MM1=NMNMMMMM
i
MUM"WE
BE
as: yes
A building permit may be required by:. _ ` k tw'� -,�
( Note Local Planning Jurisdiction)
Notes/ Special Conditions
❑ See note on back regarding River Basin rules.
14
"Agent orLApplicant Printed Name
PermitOfficer's Printed Name
t
'f
Signature Please read compliance statement on back of permit
Signature
Application Fee(s) Check#
Issuing Date
Expiration Date

. 1i
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 ❑ 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 howto complywith these buffer rules.
Division of Coastal Management Offices
Morehead City Headquarters
400 Commerce Ave
Morehead City, NC 28557
252-808=2808/ 1-888-4RCOAST
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.nccoastalmanagement.net/
Revised 08/27/14

.LEERM
TRIMBOARD
KLEERm
D E C K I N G
o,
A M-4L-b 'ro P-;Z-I-J e7w
;5 FC- r'c- ry;).
Z`{1-1-so �
RECEIVED
NOV 17 2015
m",$=;C, LT01085
Toll Free: 866-KLEER70 (866-553-3770)
O Fax:[phone]
kleerlumber.com

AGENT AUTHORIZATION FORM FOR PERMIT APPLICATIONS
Name of Property Owner Applying for Permit:
Mailing address: SUa 9 cu} ,-Ic zw
/JL z?Gle
Telephone Number: jyr—c0r,
I certify that I have authorized ACILexy �T— (agent/contractor),
to act on my behalf, for the purpose of applying and obtaining all CAMA permits
necessary for the proposed development of n6c k
at my property located at
This certification is valid through
(Property Owner Information)
'd
Signature
lr
Print or fype Name
Title, co. owner or trustee for property
i� 7 1r
Date
411-3ii
Telephone Number
Email Address
(date).
RECEIVED
NOV 3 0 2015
DCM- MHD CITY
RECEIVED
NOV 17 2015
DCM- MHD CITY

1CAMA / t� DREDGE & FILL 1 � 6'7506 A B
GENERAL PERMIT Previous permit#
New ClModification ❑Complete Reissue CPartial Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environment and Natural Resources
0
and the Coastal Resources
Commission in an area of environmental concern pursuant
to I SA NCAC_
~
((
les atta
ed.
ApplicantName
-, 6
t S '
Project Location: CountyLl
P
Address
_
Street Address/ State Road/ Lot
#(s) 4
City VF--�n
�� StateNZlp-�V-t 0
Lead rr L ne-
Phone # (3)
-� 155E-Mail "'^
Subdivisio
Authorized Agent
---^'
Ci
Zip
�CW,£W
Affected
�fSTA ❑ ES ❑ PTS
Phone # (_) ' River Basin j f
O OEA
AEC(s):.
rJ HHF 0 IH El UBA ❑ WA
Adj. Wtr. Body
Anat man ut
El PWS:
ORW: yes
PNA yes / no
Closest Maj. Wtr.'Body
(Scales �. t
❑ See note on back regarding River Basin rules.
RECEIVED
Agent or,Appli P ' ted N PermitOfricer s Printed Nam
NOV 17 2015
Sig tune "Please read compliance statement on back of permit ee Signature
� 01g &//ff —
M H
Application Fee(s) Check # Issuip'g Dat piratiop Date