Humphrey, Cliff

1
OJCAMA / ❑ DREDGE & FILL
GENERAL PERMIT Previous permit# A B OC D
ElNew ❑Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environment and Natural Resources % f -o
and the Coastal Resources Commission in an area of environmental concern pursuant to I SA NCAC / /8
iRules attached.
Applicant Name r .: `t " ° d, 9 �� � t�`� Project Location: County
.•- i
I Address a f) jl,'�' Street Address/ State Road/ Lot #(s) ._
v , _
City `j j ai /� �► f State r -f ZIP .) ` 16 1 F b � �
Phone # ( +) >c ) 1. E-Mail Subdivision
Authorized Agent /' ! ` r j .> / - %` City ZIP
��t ' t`i
Affected ❑ CW p EW PTA ElES ❑ PTS Phone # ( ) River Basint
'
❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A
AEC(s):
❑ PWS:
ORW: (yes no PNA yes
Type of Project/ Activity
Shor
SAY
Mor
Phoi
Wai,
Adl. Wtr. Body _ t! >�(naC /man /un n)
Closest Maj. Wtr. Body
t
Y ( ki 00 '0 f 1:4 1
(Scale:`'
IMEENIMMEME
MiNIM
MEWM
IMENIMEMM
■
i length
number
No
ONEENNNE
MEMO
lead/ Riprap length
MERM1111mmso
avg distance offshore
MEMWEMEMEMI
max distance offshore-----,--
MOMMEMEM
MENE
,channel
cubic yards
211VIMOMMONMEN
ram
M
2.0
M
M
ME
HEM
:[Bulldozing
MEN
IMEMEEM!
ME
Maim
Jine Length
not sure yes
A building permit maybe required by: c c'r "t ' ElSee no/ote on back regarding River Basin rules.
( Note Local Planning jurisdiction) Notes/ Special Conditions'
r.;
1f
Agent or Applicant Printed, Name PermitCffi
Signature �I Please read compliance statement on back of permit" Signature
Applica�(s) -;Check# lssuingDp
=r<i Printed Name
' Expiratioh 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 [)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 comply with these buffer rules.
Division of Coastal Management Offices
Morehead City Headquarters
400 Commerce Ave
Morehead City, NC 28557
252-808-2808/ I-888-4RCOAST
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

f
f
r�
N.C. DIVISION OF COASTAL MANAGEMENT
AGENT AUTHORIZATION FORM
Date j0), /t I +
Name of Property Owner Applying for Permit:
el I +W I M Upkr-C V(
Mailing Address:
Po 9ox it13
_SV3 0-In C 55 5L
I certify that I have authorized (agent)0� to act on my
behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to
install or construct (activity)
j
at (my property located at) _ % /T$A
This certification is valid thru (date) 6 --31 4
Property 4 Signature
RECEIVED
JUN 0 2 2015
k04 4, -kWhW k: 4
Date

DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION FORM
CERTIFIED MAIL - RETURN RECEIPT REQUESTED
I hereby certify that 1 own property adjacent to
property located at
sqrle
cal r� .s
(Name of Property Owner)
nn Ovid (Address, Lrot, Block, oad, etc.)
eav- Pit N.C.
(Waterbody) / (City/Town and/or County)
Agent's Name #: G-S Mailing Address: 5pp p�arsa•� Gr�t�
Agent's phone#: •252 IWO 32�2- AhWP e4—A%L za'S%
He/She has described to me as shown below the development he/she is proposing at that location,
and I have no objections to the proposal.
-------------- ------------------ ------------------------------------------------------------ -------------------------
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(individual proposing development must fill In description below or attach a site drawing)
�1ct S�r� 1
u
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 www.nccoastalmangement net/contact dcm.htm or by calling 1-8884RCOAST. No
response Is considered the same as no objection If you have been notified by Certified Mail.
(Property OwngpWormati
Signature
Print or Type Name
Pb 9
Mailing Address
��ansbvb, u, $4
City/Statwzip
�)6 - 33b �33�
Telephone Num er
1 I � I I �
Date
(Riparian Pro rty eerr`Information)
v
0- -
- &--4" l
aY�t
Print orr`S pe Name
6 lblQ r)b r' &Z,' /'I& RECEIVED
Mailing Address O � . SUN 0 2 201
5
/Y"0 9 I+y
City/State/Zip
Telephone Number
Date

DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION FORM
CERTIFIED MAIL - RETURN RECEIPT REQUESTED
all rb ,
adjacent to � s
I hereby certify that t own property �
(Name of Property Owner)
property located at;
t#1 1h) Vj (Address, Lot, Block, oad, etc.)
on in ',Wad" p�1 44— , N.C.
(Waterbod) // (City/Town and/or County)
Agent's Name #: k IGS Mailing Address: 57J"� Pears=.•t
Agent's phone #: 252,li�G 3Z42
He/She has described to me as shown below the development he/she is proposing at that location,
and I have no objections to the proposal.
--------------
-----------------------------------------------------------------------------------------------------
-- DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(individual proposing development must rill in description below or attach a site drawing)
w
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 infonnation for DCM offices is
available at www.nccoastaimangemenbnet(contact dcm.htm or by calling 1-888 4RCOAST. No
response is considered the same as no objection if you have been notified by Certified Mail.
(Property Owner infgrmati
Signature
4
Print or Type Name.
P6 dux 1113
Mailing Address
6 W � (� <,l b
City/StatwZip
� b 330- $332k
Telephone Numb r
I � q I I �,
Date
(Riparian Property Owner Information)
RECEIVED
Signa re
JUN 0 2 2016
Print or Type Name
1417 h'
Mailing Address
City/StatelZip
Telephone Number
Date

Y
Goode earth feet 300
meters 100
RECEIVED
JUN 02 2015
We -lkvi lvArlw W-Ex