Daughton, James

Authorized Agent r1, .``'( City t¢ ti FYI C ` (i 4 ZIP_
❑ CVN �.EW f'fFTA ❑ ES ❑ PTS Phone # 1 ) f ' ,ter River Basin
Affected ❑ OEA ❑ HHF ON ❑ UBA ❑ N/A `
AEC(s): 1:1P s Adj. Wtr. Body_:. .
(y, / (no Closest Maj. Wtr. Body
ORW: yes %o PNA yes
Type of Project/ Activity
Pier (dock) length
Fixed Platform(s)
Floating Platform(s)
' Finger pier(-) Id
Groin length'�
number
Bulkhead/ ftiprap`length
avg distance offshore
max distance offshoreg'
Basin, channel
r cubic yards
Boat ramp
Boathouse/ Boatlift----...,.»
' Beach Bulldozir
Shoreline Length
SAV: not sure y no
'■Iiil■�"A�■■�.I►1ijR���lll%■■■■■■■■■
■erne■e■�e■■®■�■rr■®ei®■■
�w■�■■■■�■ewe■■■■■�■��®®■
Moratorium: n/a yes
/
f
Photos: yes ' o
—
:'
Waiver Attached: es
A building permit may a required by:
'�
See not on
i5 c regar i g"Rive"rtasin rules.
( Note Local Planning jurisdiction)
r
Notes/ Special C ndition
y
1
{ �I
Agent or `ffplicant Printed ame '
Permit Officer's
rioted Name
Sig ure Plehse read compliance statement on back of
Sig4ture
io
Check#
�,1 Issuate
expiration Date'
1„� 9g
!M, ,�.•.

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 howto complywith these buffer rules.
Division of Coastal Management Offices
Morehead City Headquarters Washington District
400 Commerce Ave 943 Washington Square Mall
Morehead City, NC 28557 Washington, NC 27889
252-808-2808/ I-888-4RCOAST 252-946-6481
Fax: [phone] 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)
(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

ding permit may -re- required by: See note on a rig v" er Basin rules'_

Alan G. Bailey
PO Box 93, Morehead City, NC 28557
504-0737 9 726-5443
04�" SllareaQ oe®ek 9) 22 e>s-; 2303G j6 r ms S;". /�-GJ
1 • ee
r4Ph� /Ocs4- Pixy., dock S pc.M e p k� W t'-a q,tN r
Q(oc.lc fig rift
dar lc
je Zv c-ecase k,, ,% leaf /a b awvL
�J
tOfde4Y 44aT,4 ol'oc k /,l f /y6avI5(e,,-,v silos A- lq6 eo ss �ro�.► �j'
pRo 6
>�S % 6%a�tc� J ry l0✓'0�o sed0o,��►c�wi��
/" + h oi�7 .s A ec i t4qoo f1 5 �aOpc- & 4- 14cafe--S sf✓�i Nt r�`s�
�� ` f�CGK1N t00 �'�5 i �` W, it tee �rLta,'^, /Ire S'c`-Ke—
J v
pp ''rr
N o4trc+k
JAN 2 3 2017
JAN 0 9 2017
r �r
r

3.
CERTIFIED MAIL - RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM
Name of Property Owner: / "1 0 1 1_(l (.,. �) d V761 e-
Address of Property
Agent's Name #:
Agent's phone #:
(Lot or Street #, Street or Road, City & County)
Mailing Address:
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. R 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 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 http.//www.nccoastaimanagement.netlweblcmistafi-listing orby calling 1-888-4RCOAST.
iVo response is considered the same as no objection if you have been notified by Cedified Mail.
WAIVER SECTION
I 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.)
Mb5
I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
Wrope Owner Infor ation) I Z- 2 K 2 o (Ri r' n P rt O I f t'
,W�. ��
SignaiVre J'
-v I L-1 CSaa�a
Print or Ty Name
,7114 Gary Y'0 5-e S
Mailing Address
City/StatelZ'
��_-_ ��3- 4
Telephone Numberl Email Address
Date
-A.
p ra ropey ner n orma ron)
{
,&gnature
WL-e 7
Print or Type Name
,Z 12 `- 6& m br y� /?-J
Mailing Address
2' Ccl'yl� ly� � EIVED
City/Sf tel CityZip
gl�- 66i- 3k6 -BAN 232017
Telephone Number/ Email Address
� ._...................._®C M - M H ® CITY
Date
RECE ed Aug. 2014)
JAN p 9 2017
DCM- r`VIHD CITY

"lY
CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM
Name of Property Owner: Ja ol"A es A 46-(7 h Avv q
Address of Property: ZZa� ClJOnS SJOCe,f /hc.AeAea C,±r Z 8'5"3-7
(Lot or Street #, Street or Road, City & County)
Agent's Name #: 4 i(Ae U-Qr- - 04&,A;►+{— Mailing Address: /0 o r60)e q3
Agent's phone #: 2SZ - Say- o7J3 `7 Ci I~+ /4.G.
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 `descriiption .or drawing, with dimensi6psmust be provided with this' ietter.
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 http://www.nccoastaimanaaement.netlweblcnilstaff-listing orby calling 1-888-4RCOAST.
No response is considered the same as no objection if you have been notified by Certified Mail.
WAIVER SECTION
I 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.)
I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(Property Owner Information) (Riparian Property Owner Information)
Signature Signature
EGEIV
Print or Type Name Print or, Type Name
JAN p 9 2017
Mailing Address Mailing Address .
DCM- fA� -JD CITY
City/State/Zip City/State&ip HE EIVED
Telephone Number/Email Address Telephone Number/Email Address j N! 2 3 2017
DCM-- MHD CITY
Date Date
(Revised Aug. 2014)

CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM
Name of Property Owner: 3-c+-t-,eS /)oK Q fo/-/
Address of Property: 27-0S ,6U'?H5 sr✓'t-e-� 1-4•G 291-5-7
(Lot or Street #, Street or Road, City & County)
Agent's Name*
/91uc t0o4r, 1V-&-;,.e
Mailing Address: PO d oy
9.3
Agent's phone #:
Z S2 S-OLf-073%
G.tY N.c.
2 85-s7
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 areproposing. A description,or drawing, with dimensions.must be provided with this lette
%r.
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 http://www.nccoastalmana_aement.netfweb/cm/staff-listing orby calling 1-888-4RCOAST.:
No response is considered the same as no objection if you have been notified by Certified Mail.
WAIVER SECTION
I 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
h t ' th tb k t' 'f 1 th ' t bl k b I )
you wis o waive a se ac , you mus r11 ra a appropna a an a ow.
I do wish to waive the 15' setback requirement. RECEIVED
I do not wish to waive the 15' setback requirement.
JAN 0 9 2017
CITY
(Property Owner Information) (Ripari Property Owner Information)
Signature SKnature
-Dck�� �i rrk, C .t_,
Print or Type Name
�T-
Mailing Address
City/State/Zip
Telephone Number/Email Address
Dat
�J4vt� {S W. /✓OwgLi�a'�f
Print or Type Name
2724 60CA6;w
Mailing Address - oad-1 i I?tA .
2-3�°F ECEIVE®
C y/State
IN- 669 — 3 �706 JAN 2 3 2017
Telephone Number/Email Address
/)L ®CM— MHD CITY
Date
(Revised Aug. 2014)

0
sAbt
R
Po.e.s.-Pe 4—fe-
FVl©,Q;! F� c4 �;vN
------------------------
Sc•�� \1 ---
�QuS� �M "
� ,ro�, p,�oli'•
S0
3
7
o
r C
�4A
r
M
ISM ILI ; 210
2,4 ys = I -to
6�6
sl �•+�sc
RECEIVED
JAN p 9 2017
DCM- M"69'&
Sd'
JAN 2 3
�vED
2017 Hxw

�41
H.
rylO-iml boc-l<
NtfW
JAN 2 3 2017
DCM- MHD CITY

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit:
Mailing Address:
/
Phone Number: 01t q- w- s � U b
Email Address: bloc A h
I certify that I have authorized
ko 9
44dlc-
/ Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: '094&
tr.�
03e- S-
22m
at my property located at 2 2
S-
in Ge-,-f-z,al, County.
I furthermore certify that 1 am authorized to grant, and do in fact grant permission to
Division of Coastal Management staff, the Local Permit Officer and their agents to enter
on . the aforementioned lands in connection with evaluating information related to this
permit application.
Property Owner Information:
Signature
J v»e1_ I U
Print or Type Name
Own C4
Title
! I I��
RECEIVED
��
Date JAN 2 3 Z017
This certification is valid through P2 l/_I 261