Dixon, William & Sarah

CAMD A / O REDGE & FILL s ~'
"� `� N s e,� .�,. A g t C p
ENERAL PERMIT � Previous permit # ``—
iNew ❑Modification ❑Complete Reissue []Partial Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environment and Natural Resources j
and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC
t p Rules attached.
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Applicant Name U ! ; ! 'r } ' ' ? Project Location: County
Address (� ^~' a a L I, 1 Street Address/ State Road/ Lot #(s)
City rl I t State (J- ZIP
Phone # �__ 1 _(.� `� # Subdivision
(') E-Mail
Authorized Agent "— City I ZIP
r I _-I
! .�� i, River Basin
Affected d C] EW d PTA El ES ❑ PTs Phone # ( ')
AEC(s): ❑ OEA ❑ HHF d IH ❑ UBA ❑ N/A Adj. Wtr. Body j ` ' ' ` ' (. iat /man /unkn)
❑ PWS:.
Closest Maj. Wtr. Body
ORW: yes / no ; PNA / yes ` no _�
Type of Project/ Activity
Pier (dock) length A 'TI ,
Fixed Platform(s)+
Floating Platform(s)
Finger piers)
Groin length
number
Bulkhead/ Riprap length
avg distance offshore ----
max distance offshore
Basin, channel .�
cubic yards -
Boat ramp
Boathous%Boatlift) . i X
Beach Bulldozing
Other 5� �( P''yf
Pic £4,E:l.'.,
Shoreline Length
$AV: not sure
yes no
Moratorium: n/a
yes �o "
Photos:
yes ino;
Waiver Attached
es no `
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A building permit maybe required by: j i 'a.; t. .i.; �• i a_ 1 ❑ See note on back regarding River Basin rules.
• ( Note Local Planning jurisdiction) jj , ;� �}} + r / !
�f.
Notes/ Special Conditions
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3 Agent on Applicant Printed Name ! Permit Officer s`Printed Name
E
ignature ",Please read compliance statement onbackofpermit Signatur
ApplicationFee(s) Check# Issuingbate Expiration 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, certifythatthis 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 complywith 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 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

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/MOORING PILINGSIBOATLIFTIBOATHOUSE) �51rwxl_Ii N
cam. � �o�� -��93
I hereby certify that I own property adjacent to W I 1\ .�(� � D;x'�/U
(Name of Property Owner)
property located at 113 Ca r?_ Ni vQ' W tS7—
(Lot, Block, Road, etc.)L
on i�Q at3,Vl , in it �,Q oCL C� , N.C.
aterbody) (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.
y I da wish to waive that setback requirement.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
RECEIVED
MAY 14 2015
E'1R.'M*n0 blt#
C/l
Signature /34th-a0 ce,t.Q 4 waf—
&q/,t'dCoifV
Print or Type Name
Telephone Number
Date:—

%a n -15 01:49p' ' Sarah Dixon
■%oe
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252-622-4131 p.1
ADJACENT RWARMN PROPERTY OWNER STATEMENT
(FOR A PITsR/MOORING PILINGS/ilOA,TUFIYBOATHOUSFs)
I hereby certify that I own property adjacent to L, X�.( 1,.1,_i._'.: '
) d-�
(Name of Property Owner)
Property located at Ca CZ? b r , W �
(Lot, Block, Road, etc.)
Aon A, inLt , N.C.
�-{ aterbody) (Town and/or County)
He has described to me, as shown below, the development lie 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 dQ wish to waive that setback requirement.
DESCRIPTION AND/OR DRAWING Or PROPOSER? DEVELOPIMENT:
(To be filled in by individual proposing development)
RECEIVED
MAY 14 2015
p�RM-la ;114 V,11T
----------------- ----------- -------------- ----------------------------- — --------_-----------�
Signature
• �1t�i>��� W �P��1t
Print or Type Name
Telephone Number
Date: l� t5

N. leT
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3:60'
RECEIVED
MAY 14. VIS
pCM.IVIHD CITY