Howell, Michael

tl
❑, AMA / ❑ DREDGE & FILL � ` �.<,�d 4tz f 1
GENERAL PERMIT J� Previous permit# A B D
QNew ❑Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environment and Natural Resources f {
and the Coastal Resources Com fission in an area of environme tall concern pursuant to 15A NCAC 78 i
` f _ •0Rules attached.
Applicant Name 1 �� l , �" r + Project Location: County
,r �� Street Address/ State Road/ Lot #(s)
Address r ^,t �t3 'k"-�1- ,t ur t': �, _ -
City State Al 5'ZI P �� ` �� —7 (1)
Phone # (_)
E-Mail//
Authorized Agent
< f `� ►—, N f ZrA 4 ,,i t­li
Affected El,_DEW
._
- 3.kA ❑ Es
O PTs
AEC(s): ❑ OEA
❑ HHF
❑ IH ❑ UBA
❑ WA
❑ ws:
ORW: zes /o
PNA
yet o ,
f
Type of Project/
Activity
Pier I
Fixed
Float
Finge
Groh
BUM
Basin
Boat
Boat
Beac
Othe
Shor
SAV
Mon
Phot
Wan
Subdivision . z
Cityfi�Kof"per ZIP Fy?) /%1
Phone # ( ) River Basinr C`r
Adj. Wtr. Body r(nat/man /unkn)
Closest Maj. Wtr. Body -''�''`"''�'
(Scale:��} p ) I
i
MENME
MENEM
MENMEMEMMENEEM
ME
number
avg distance offshore-
ENNENEM
max distance offshore
M
MEMENEEMEMEM
Rai
M
M
MEEN
cubic yards
MENOWERNEMEMEM
NEEMMENEMEN
MEMMENEEMEEME
oil
MEN
MIN
MOMENNEMEN
ME
MINE
�MEMENNEEMEEMENEEME
�E■
sline Length-
MEMMEEMEMMIN",
IINNOMME
�n?�
'torium: n/a yes
NMI
0111111111111111
No
M
MEMO
Y.
PrAvre!"i VPC
MENOMONEE
MENNEEN
A building permit may be required by: "s ' t" : ❑ See note on back regarding River Basin rules.
( Note Local Planning jurisdiction) ,
Notes/ Special Conditions
fjgent or Applicant Printed Name r`
Signature Please read compliance statement onback ofp re mit*
Application fee(s) Check #-
Permit Officers Printed Name 1 {
Signature /
Issuing Date x 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, 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 Resources. Contact the Division of Water Resources at the Washington Regional Office (252-946-648 1 ) 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 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 -
(Serves: Beaufort, Bertie, Hertford, Hyde,
North of New River Inlet- and Pamlico
Tyrrell and Washington Counties)
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)
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

cubic yards
Boat ramp .{ f
Boathous Boatlift i+ t
r—
Beach Bulldozing
Other -�
Shoreline Length . la
SAV: not sure yes io f
■■■■■■■■■■�■■■■■■■■■e■■■■'■■■■■ten■!��!®■■■

e
i
REC VED
n o-j'�s

N.C. DIVISION OF COASTAL MANAGEMENT
AGENT AUTHORIZATION FORM
Date vd
Name of Property Owner Applying for Permit:
Mailing Address:
v
� I certify that I have authorized (agent) O In M !V Lakl f6n C-G to act on my
behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to
install or construct (activity)
at (my property located at) Z ��©Sti �p fl c� �� ± /V l,oc r-5 &+A6eCq �G
This certification is valid thru (date) _
Property Owner Signature
RECEIVED
JUN 112015
fat. M•IFl?•dy P:43;
Date
RECEIVED
MAY 2 9 2015

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
hereby certify that. l own property adjacent to -w.
(Name of Property:Owner) ;.
I
r9medy.locatedLgt,
�, (Address, Lot, Block, Road, etc.) 2
on 0846 5' k,A�- . in iMA�.SWi��4�4 � � Q.1~E EI' . N.C.
t b d (Cityrrown and/or County)
(Wa er o y)
The applica as described to me, as shown below, the development proposed at the above
locatio
rj
have no objection to this proposal.
have objections to this proposal.
DESCRIPTION ANDIOR DRAWING OF PROPOSED DEVELOPMENT
(individual proposing a evelppment must fill in description below or attach a site drawing)
RECEIVED
JUN 112015
WAIVER SECTION
1 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
wis o w 've the setback., you must initial the appropriate blank below.)
RECEIVED
do wish to waive the 16 setback requirement. MAY 2 9 1015
do not wish to waive the 16 setback requirement.
Maili Address
c`t���ta2 p�3�� 5533
Tele hone Number
Date .
2�9 GooS� �nn� �d
Mailing Address
M 6ASAAL 3 ed2 G.
City/State)Zip
Aix - A4f1- 375-2
Telephone Nuipber
Date
(Revised 6/1 &2012)
•

t ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
1 hereby certify that. I own property adjacent We / A G �� s
(Name of roperty Owner)
.Zurp-located.-located.-At
f��F . p y� (Address, L BI k, g�' a c.
on C CJ , in 1�1 { N .C.
(Waterbody) (City/Town and/or County)
The applicant has described to me, as shown below, the development proposed at the above
locatio .
x _ I have no objection to this proposal:
I have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF.PROPOSED DEVELOPMENT
(individual proposing development must till in description below or attach a site drawing)
E7EtiST i ��
WAIVER SECTION
understand that a pier, dock, mooring pilings,. breakwater, boathouse, lift, or groin must be set
back a minimum distance of 1 v' from my: area of riparian access unless waived by me. (If you
wish to waive the setback, you must initial the appropriate blank below.) RECEIVED
k I do wish.to waive the 16 setback requirement. Jl1N i 1 1013
-
do not wish to waive the 16 setback.requirement.
m
(Prop rty owner_ Info .anon).
is (Adjacent Property Owner Information) RECEIVED
: P-A-1-t
J
0-
MAY 2 9 1015
9'4
SI a
She DC-,K _J!/PH H
Prin,�pr Type Nape,
)
Prinf or Type Name Z� �6
Mailing
9 dress
-
MaiJi� Addre s -
City/State/Zip
2sz - 23� -��33
C' /Stafe
A,�s lL� �' . /V. C 29 S-/j�
Telephone Number
S-a 7.
Telephone Nup7ber. .
Date
Date Z -7
(Revised 6(10012)

turn) elk".D NM
9UI I I Nnr
Page 1 of i
Parcels - Updated 05/21/2015
Centerlines
NC Railroad Right of Way
13
County Boundary
[I
other County
,. _ : <all othervalues>
Cart
1e<
http://carteret.connectgis.com/DownloadFile.ashx?i=_ags_map55039dda6al54c4e9al aObf5... 6/4/2015

CERTIFICATE OF EXEMPTION
,
FROM REQUIRING A CAMA PERMIT CIAl
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 15 NCAC Subchapter 7K
Applicant Name n.i t 1, 4 1 f i1t-k--- Phone Number
Address
' City t W it State V1 Zip rh .5`"a
Project Location (County; "State Road, Water Body, etc,)
r:.• 'L. i ',.i.,. � ...�� i "._t.�;(�?-s v L 1< �'rsc � 'f .c-�• klc..
Type and Dimensions ofroject n rr I t
The proposed project to be located and constructed as described This certification of exemption from requiring a CAMA permit is
above is hereby certified as exempt from the CAMA permit valid for 90 days from the date of issuance. Following expiration,
requirement pursuant to 15 NCAC 7K . This exemption a re-examination of the project and project site may be necessary
to CAMA permit requirements does not alleviate the necessity of to continue this certification.
your obtaining other State, Federal or Local authorization.
SKETCH (SCALE:
w
e , E
i
£ E 9 F
i
! i _ NO .0_2015
\
DCIUi HD CITY
E
_E
1
f _
e ,
E
t
x
,
s
J,I
i
i
t
4 9
+
4 r .
Any person who proceeds with a development without the con-
J ul/ ' -�0 ✓%j "t C
F ' sent of a CAMA official under the mistaken assumption that the
Applicant's signatu e "
development is exempted, will be in violation of the CAMA if there
` I "
is a subsequent determination that a permit was required for the
' development.
'
LAMA Office Is si neture
The applicant certifies by signing this exemption that (1) the ap-
Issuing d fe
' plicant has read and will abide by the conditions of this exemp-
#ro�adjacer►t
Ll f :�
tion, and (2) a-written•statement-#ras beec�obta+ned
,)
landowners-certifying-that-the}r-have-no-objeet+ons-to-the
Expiration date
proposed-wark"
Attachment: 15 North Carolina Administrative Code 7K