Dean, Lindsey

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pCAMA/❑DREDGE &FILL
iGENERAL PERMIT Previous permit#
0New ❑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 environmental concern pursuant to I SA NCAC 11
EZI Rules attached.
Applicant Name f rr ' .�f `' ' Project Location: County �=
h
Address l �' �'a £f +c ; = :� Street Address/ State Road/ Lot #j(s)
City t' State Aff ZIP x,'r +1 } �-4;• a r� 1�4 �
Phone # (7,') a/i ,Pax # O Subdivision
uthorized Agent i I �l� �'" ° City i C , r ZIP ) �?�
f i
];3 C N OEW „1; P"A DES ❑ "S Phone # ( ) 1 River Basin c' 410, Ir 04Affected
AEC s ❑ OEA �❑ HHF ❑ IH ❑ UBA ❑ N/A Ad'. Wtr. Body �-� +{ "i+�+d�� r r `� nat man unkn
O ❑ PWS: ❑FC: i y i s
ORW: yes no PNAfs / no Crit.Hab. yes / no Closest Maj. Wtr. Body
Type of Project/ Activity
f si (Scale:/i f i )
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Finger pier(s)
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Groin length
number
Bulkhead/ Riprap length■■■
distance offshore
max distance offshore
Basin, channel
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ZONE
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cubic yards
Boat ramp
Boatlift.
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■■■
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■■
■■■■■■■■■■i■■■
■■■■■i■■■■Boathouse/
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Beach Bulldozing_
Other
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!Shoreline Length—J"t■■�2■
iSAV.'; not sure yes .
,.Sandbags: not sure yes •
(no),
Photos:�■■■■
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A building permit may be required by: C G e See note on back regarding River Basin rules.
Notes/ Special Conditions f EJ i J a i' n« ? C 4 1 s r
i
f
Aicant.Printed Name PermitOfficer Signafd a
f r
Please read compliance stateme tnt on back of permit" Issuing Date Expiration Date j E
` Appiication F�ee(s) . Check # Local Planning Jurisdicti

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 consistentwith 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 Quality. Contact the Division of Water Quality 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
Raleigh Office
Mailing Address:
1638 Mail Service Center
Raleigh, NC 27699-1638
Location:
2728 Capital Blvd.
Raleigh, NC 27604
919-733-2293
Fax: [phone]
Morehead City Headauarters
400 Commerce Ave
Morehead City, NC 28557
252-808-2808/ 1-8884RCOAST
Fax: [phone]
(Serves: Carteret, Craven, Onslow -above
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 -below New River Inlet- and
Pender Counties)
Revised 08/09/06

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MA►/ El DREDGE & FILL 8.30
ENERAL PERMIT Previous permit#
P1CIew ❑Modification:: ❑Complete Reissue El Partial Reissue Date previous permit issued
uthorized by the State of North Carolina, Department of Environment and Natural Resources '
d the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC
ules ttached
pplicantMm C Project Location County
r,t�}
ddress - �. s = Street Address/ State Road/ Lot #(s)
.Subdivision
uthonzed Agent ' :`t%frJF r` F City. ZIP'%�
Affected r" �F�PTA - ' Offs ❑ PTS Phone # ( ) River Basin 1./4
❑ OFA ❑ HHF -❑ IH ❑ UBA . ❑ N/A I t' 1 ir fT na man unkn
AEC(s) Adj. Wtr. Body �•./
❑ PWS: ❑FC:
:ORW yes no PNA / no Crit.Hab. yes /_ no Closest Maj. Wtr. Body
MGI�i :oilllr■■■®\�7
MEMO
MEMO
(Scale:
sm ON �®
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El Sep note on back reg�roing River Ba'sin rules.

1�
0
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/MOORING PILINGSIBOATLWIBOATHOUSE)
I hereby certify that I own property adjacent to Lil N 45t''D&rAr-� 's
,( (Name of Property Owner)
property located at
(Lot, Block, Road, etc.)
on %� C , in (0,l 44bC,�J �(�R� , N.C.
(Waterbody) (Town and/or County)
He has described to me, as shown below, the development he is proposing at that location,
and, I have no objections to his proposal. I understand that a pier/mooring
pilings/boadift/boathouse must be set back a minimum distance of fifteen. feet (15') from my area
of riparian access unless waived by me.
I do not wish to waive the setback requirement.
t�✓ I dQ wish to waive that setback requirement.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
RECEIVED
MAR .11 2015
Signature
idyl,( /tl 14ar(607
Print or Type Nam
3� - 3 4/-5 Lf 9�I�'
Telephone Number
Date: 2( ho /

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/MOORING PILINGSIBOATLIFFIBOATHOUSE)
I hereby certify that I own property adjacent to.. 1_
(Name of Frdpert.y Owner)
I
property located at ' 2-0_J X 4A)d/ Xl ar R .
'�\ (Lot, Block, Road, etc.)
on �J �`� Vl(,t�(�ja �f i✓�, in (ITS-/t:�cdw+p N.C.
(Waterbody) (Town and/or County)
He has described to me, as shown below, the development he is proposing at that location,
and, I have no objections to his proposal. I understand that a pier/mooring
pilings/boatlift/boathouse must be set. back a minimum distance of fifteen. feet (15') from my area
of riparian access unless waived by me.
I do not wish to waive the setback requirement.
I d4 wish to waive that setback requirement.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
RECEIVED
MAR 31 1015
Fs'!tRml 1pona ►!ft#
---------------------------------------------------------------------------------
Signature
Print or Typ6 Name
Telephone Number
Date:

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RECEIVED
MAR .11 2015
Plgm-M"q GIN

i North Carolina Department of EWronment and Natural Resources
Division of Coastal Management
t3etr * am Perdue. Qovamor .i8f�3 H. Grrgtaa, Din for oee Freea+ae. 5eaetary
Date �b
AppliawtName 1-n
Mailing Address 0203 oL/g
X certify that f have authorised (agent) to act on my
behalf, t'or the purpose of applying r, and obtau,iug all CAMA permits accessary to
install or construct (activity)
at (Wcation) .
This certificadw is s► lid thm (date)
Signature
RECEIVED
MAR 31 % )s
ytetw,►#+.nw L-rt4
400 Commerce Marehead Cilyy. i OM Carolina 2&W
Phone: 252408 M I FAX: 252W-M l intemet:
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