Daniels, Ronald

i�ltj`CAMA / ❑ DREDGE &• FILL t e 0
GENERAL PERMIT Previous permit#
ElNew ❑Modification ❑Complete Reissue El 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 enviro mental concern pursuant to 15A NCAC t r
„E Rules attached.
Applicant Name �% • Project Location: County / tj
Address _t `- �'�: < ° rt/ Street Address/ State Road/ Lot #(s)
City, _' ,` t �� `-.' State'`. t. ZIP
Phone # (} z:'��' E-Mail Subdivision r.
I � � Y-
• f
Authorized Agent r c` • t , l City t-: `� -�''` ZIP
Affected ❑ Cw '❑ EW ❑Pl`A ElES ❑ PTS Phone # ( ) � River Basin'
❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A E s
AEC(s): Adj. Wtr. Body t '' � t - ✓"+yam' ` <Ca /man /unkn)
a
❑ Pws: Closest Maj. Wtr. Body
ORW: i "es no PNA yes / ;no +
Type of Project/ Activity
(Scale: �.
Pier (dock) length r '
Fixed Platform(s) ( c
Floating Platform(s)
Finger pier(s) I — -- — -- —
-Groin length�—
number I t 4
Bulkhead/ Riprap length iI Ji —
avg distance offshore j ( —_. I—
-- — --
max distance offshore I
Basin, channel
cubic
Boat ramp
Boathouse/ B,
Beach Bulldo:
Other
Shoreline Length
SAV: not sure yes no .1 I
Moratorium: n/a yes 'no
Photos: yes :no
Waiver Attached: yes no
A building permit may be required by: e^`' t •` ..a ' { ElSee note on back regarding River Basin rules.
( Note Local Planning Jurisdiction)
Notes/ Special Conditions r ;,
Agent or Applicant Printed Name a i Permit Officer's Printed Name
t
Signature Please read compliance statement on back of permit" Signature
"
Application Fee(s) Check# Issuing Date" E�piration Date

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 comply with these buffer rules.
Division of Coastal Management Offices
Morehead City Headquarters
400 Commerce Ave
Morehead City, NC 28557
252-808-2808/ 1-888-411COAST
Fax: [phone]
(Serves: Carteret, Craven, Onslow -
North of New River Inlet- and Pamlico
Counties)
Elizabeth Citv 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

May 0415 03:13p Tony McNeill 252 725 4965
MRY- -i501 Q 15: 05 From: DW MhDCTY 1 o: ys7Jbl�fb
N.C. DIVISION OF COASTAL MANAGEMENT
AGENT AUTHORIZATION FORM
Date
Name of Property Owner' Applying for .Permit:
Mailing Address:
I certify that I have
behalf, for the purpose
install or construct (act
at (my property located
p.2
ra9r•c•a
acd (agent) 5dd /1' cne-4 + to act on my
plying for and obtaining ali CAMA. Permits necessary to
LC
This certification is valid 6ru (date)
Property Owner Signature
Date

May 0415 03:13p Tony McNeill 252 725 4965 p.3
,04W120t5 13.04 fa I P.U01 fu . U1
Apr30 15 11-45a Tony McNeill 2527254965 P.1
&K!adl
r
I hereby certify that I own property adjacent to f(.^A 14L-. AJ ri tit t ts
Warne of property owner)
property located at 0 F4ftW--;- ;:rjit A,"C,_
(Address, Ukt, Black Road, etc.) o-i
n co.,�
rvt .
(Watvrbody) (Wowh and/or Gounly)
The,-*appk--aat has ckescrbLd to me, -as shown- below, the development proposed at the above
I have no o5l)"Gon to'this proposal -
I have obje4tiond to this proposal.
DESGMP-nOqA=ORDRAWING OFFrROPOSED DEVELOPMENT
(7noWdeWproposing derelopowntmuM611in do=,dpffcwbi.%woreftchasibs &awi".g)
• WAWER CTION
I understand that a pier, dd6c, mo&nq- 0i inqs, bteakwater. bdathoum, Oft. or groLrt must he set
back 3 minimum distarce of 116from my area or'doanani access unless waived by me. (If yaL.-
wish to var4e the -setback, you must In the ippioQriabe blank below.)
I do wish to waiverequirement.
the IN setback remerequirement.
I do not wish to waive the 1 V setback M uiremenL
(Property ftanaflon)
'7"
AL LL
Print or Type Name
"CAY
,Xparure-e—,
Z�0
PfintorT Na
oe
A Azrd iCi I M Dr
Taipphom Afumbqr
(Revised 6flWD12)
F.

May 0415 03:13p Tony McNeill 252 725 4965 p.4
( t�.. n/ •
• t hereby oertiiy that I awn property adjacent to ���; n G � wi, c �s 's
{Name of Pro arty Owner)
property located at yr -: r, (� �� �,.. w :�y
(Address. Lot, Blocir, Road, etc.)
On in A«�er:� Z 1� (e ter r✓::"�N.�'+.
(Waterbody) (CitylTown ancUor County)
The applicant has described to me, as shown below, the development proposed at the above
loca�tiorryy
I have no ob edon to this proposal.
I have objections to this proposal.
DESGRIPTIQd ANDIOR DRAWING OF PROPOSED DEVELOPMENT
(individual proposftr develoPinw# must fill in description below or attach a site drawing)
ID�a.%
WAIVER CTION
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 blardc below.)
_ 1 do wish to waive the 15' setback requirement.
I do not wish to waive the 15 setback requirement.
(Property Information) (Adjacent Property Owner Information)
Sign a r, S' atu e
Print of Type Name Print or T Name
1 `I 12 : ice
MaRing Address Maift Addrw
79"= %
Cityistat !zi C� matuaip
Telephone Number Telephone Number
Date Date
(Revised 6H82012)
7>

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rem-,& Ines
RAVoad Right of Way
Boundary
,Dter County
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