Herbst, Richard

R'CAMA I.,qDREDGE &FILL
Pb
!"�! 0 (3
GENERAL PERMIT
Previous permit #
EINew ElModification ElComplete Reissue
ElPartial Reissue
Date previous permit issued
As authorized by the State of North Carolina, Department of Environment and Natural Resources
1/_'� 1
11 — 7/f
and the Coastal Resources Commission in an area of environmental concern pursuant to I SA NCAC
1
EJ les attafhed.
Applicant Name cl
-k'fl r- "A
Project Location: County
Address f f I
Street Address/
State Road/ Lot #(s) 1'r Art rill-111,
City State 0.1 ZIP i
Phone # %E-Mail
Subdivision
AuthorizedAgent
city
ZI P
Li kw Ew PTA Es "o PTS
Phone #
I
River Basin _J1
Affected
El OEA 0 HHF D 1H 0 UIBA 0 N/A
AEC(s)
Adj. Wtr. Body
(naQi;�a6 lunkn
0 Pws:
tl'Closest
ORW: PNA
Maj. Win Body
- yes J'no) yes
Type of Project/ Activity t4
Pier (dock) length
Fixed Platform(s)
Floating Platform(s)
Finger pier(s)
Groin length
number
(Bulkhead/ Riprap length
ayg distance offshore
max distance offshore
Basin, channel
cubic yards
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing
Other
Shoreline Length
SAV. not sure yes I /no
Moratorium: n/a yes no
Photos: yes no
Waiver Attached: yes nT
--T
A building permit may be required by:
Note Local Planning jurisdiction)--,
Notes/ Specia Conditions
j3
n r i ,, 1Y El See see note on
, �I
1, r
1;6Y)14' 0
�(J
ff - r ! I
(Scale: / . C; ! 0 ) I .,
back regarding River Basin rules.
V
/')p
PermitOfficer's PrintedName
`Agent or Applicant Printed Name Signpture Please read compliance statement on back of permit Signaturpp I
1V
Application Fee(s) Check # Issuing , Date Expiration Date

I
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 consistentwith the North Carolina Coastal Management Program.
River Basin Rules Applicable To Your Project:
❑ Tar - Pamlico River Basin Buffer Rules
❑ Neuse River Basin Buffer Rules
❑ Other:
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
Washington District
400 Commerce Ave
943 Washington Square Mail
Morehead City, NC 28557
Washington, NC 27889
252-808-2808/ 1-888-4RCOAST'
252-946-6481
Fax: [phone]
Fax: [phone]
(Serves: Carteret, Craven, Onslow -
(Serves: Beaufort, Bertie, Hertford, Hyde,
North of New River Inlet- and Pamlico
Tyrrell and Washington Counties)
Counties)
Elizabeth City District
Wilmington District
1367 U.S. 17 South
127 Cardinal Drive Ext.
Elizabeth City, NC 27909
Wilmington, NC 28405-3845
252-264-3901
910-796-7215
Fax: [phone]
Fax: [phone]
(Serves: Camden, Chowan, Currituck,
(Serves: Brunswick, New Hanover,
Dare, Gates, Pasquotank and Perquimans
Onslow - South of New River Inlet -
Counties)
and Pender Counties)
http://www.nccoastalmanagement.netl
Revised 08/27/14

Name of Property Owner Applying for Permit: t le - L / Ai-D-A H ;97 g.R 5
Mailing address:
_24 SvNRISE D9
NK
Telephone Number q k q. %k q b Lvi So
1©Sp
I certify that I have authorized _ �j jtiT (agentteontractor),
to act on my behalf, for the purpose of applying and obtaining all CAMA permits
necessary for the proposed development of _ -FU L 1 < dEA-b
1
at my property located at L-2 -0 A 913 O R\ V ("FA:L D #2 , P K5
This certification is valid through -D!c-.3(date).
(Property.Owner Information)
f
Signature
Print or Type Nacre
Title, co. owner or trustee for property
Date
Telephone
,1 Number
Ll
-Pmoii brir4ro0c,
RECEIVED
OCT 0 7 2015
DCM- MHD CITY

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
i .hereby certify that I own property adjacent to R I Q fAkD t L-1 AJ-oA PEk$3-
(Name of Property Owner)
property located at I Z© Alk Bo Ry ! T A-9 "R-
C Lot, Block, Road, etc.)
on�itA1 �K1+1l�1.1. LAjA 'ER - , in i.&Ng le-AIM4- S►PIORE5, N.C.
(Waterbody) (City/Town.and/or County)
The applicant has described to me, as shown below, the development proposed at the above
location.
_ I have no objection to this proposal.
have objections to this proposal.
—DESCRIPTION ANDIOR DRAWING OF PROPOSED DEVELOPMENT...
1?15P11RC-E SO' BULKHEAD
RECEIVED
OCT 0 7 2015
DCM- MHD CITY
WAIVER SECTION
understand that a pier, dock, mooring pilings, boat ramp, breakwater, boathouse, lift, or groin
must be set back a minimum distance of 16 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 16 setback requirement
do not wish to waive the 15' setback requirement
(Pro ation) (Adjacent Property Owner Information)
7/
S�i nafore F Signs ure*
,46 c.t1'/' )?,D 14 t3 s T Ly-
Piintolfr- Type Name Print or Type Name
2� 5tJ/I,IRISE J>R 11"1 LlrbarydaP TflY2
ftWding Address MarJ{ng Ad`Ld��eess
gb! 2C3 NK . l� `1P- -IU D �- !-fin jF'ho/l �hofPs e 2251 L
?V`01l p jI , / - City/State2i
Teiqh ne N tuber/email address Teleph n Nu berl email address
�V S ,3" S
Date 1 1 Date*
(Revised Aug: 20i4)
*Valid for One calendar year after signature*

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
! hereby cer#ify that i own property adjacent to R-t 444 ft kD i 1 l J b #'1 EA 1?G T—
Na of Property Owner)
property located at 126 AiZi n R V �'�
—Address, Lot, Bioc Ro d, etc,)
nn�/ A.) 9 ,iT rJ61 L �� A f Me- in F/ ArE, � AJ43 �l. rt. 15/45 k�.�' .C.
(Waterbody) VJA-1 (City/Town and/or County)
The applicant has described to me, as shown below, the development proposed at the 'above
loci .
!� 1 have no objection to this proposal
1 have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
/!!i7lVlGJL(ii( �!/L{11(JSl!!L� iJCYGJVtJJJlCJlL JfJb/.7t /IJt !!/ vG.7vllj�uv+♦ r+a�ivrr vi caaauv++ w+w +.+....,y�
RECEIVE,
OCT 0 7 2015
DCNI MHD CITY
WAIVER SECTION
i understand that a pier, dock, mooring pilings, boat ramp, breakwater, boathouse, lift, or Lgroin
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.)
(P
I do wish to waive the '15' setback requirement.
1 do not wish to waive the'16 setback requirement:
FA -
or
ring Address
A -
Telhone Number/email address
6 S
Date
(Adjacent Property Owner Information)
Prin or Type N me
I ein wood
rho "Oi! .S ory�J Z$S"t
. iS , � ,
Tale hone N m%berl email address
Date
(Revised AUg. 2014)
*Valid for one calendar year after signature"