Johnson, Leonard A

CAMA /`7 DREDGE & FILL t/ • "'
GENERAL PERMIT Previous permit#
New ❑Modification El Complete Reissue ❑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 15A NCAC ?
-- — © Rules ched.
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Applicant Name = ' f�" i)? ` # ' �'' r } Project Location: County ( ��� -
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Address` �� � , �, � �. ti, � � j �t� I :.�s� ' Street Address/ State Road/ Lot #(s)
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�Agent orAp�;� Al
plicaht rented Name Permit Officers Signature T
Expiration Date
Ex iDate Issuin
Signature' _�` Please read compliance statement on back of permit"8 p'
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Application Fee(s) ! Check # Local Panning Jurisdiction " .. Rover File Name

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
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 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 Headquarters
400 Commerce Ave
Morehead City, NC 28557
252-808-2808/ I-888-4RCOAST
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

Name: L.A. Johnson Permit #: 64172C
Date: 8/21/14
GP Habitat Sheet
Address: 545 Deer Creek Drive
Habitat
SF of Disturbance
SF of Disturbance
LF of Disturbance
LF of Disturbance
Open water
338
338
N/A
N/A
Shoreline
N/A
N/A
100
100
AUG 212014
3DCMMHD CITY

4
ADJACENT RIPARIAN PAPERTY OWNERS A' Ei' MENT
1 hereby certify that I own property adjacent t •e-o J-6 H ry f o „> s
(Name of 3roperty Owner)
property located at Jr S e-4-, D 2, po
( ddres 3, Lot, Block, Road, Md.)
onQ'Ie, i �'�� p.�'� , N.C.
(Waterbody) (City/ o n .and/or County)
The applicant has described to me, as showri below, the develo ment proposed at the above
location,
have no objection tot iis prop sal.
.�.�. I have objections to this propo al,
DESCRIPTION AND/OR DRAWI 4G OF PROPOSED DEVELOPMENT
(Individual proposing development must f ! In description bel 7w or attach a site drawing)
o r
I understand that a pier, dock, mooring pilin(
back a minimum distance of 15' from my ar
wish to waive the setback, you must Initial t
I do wish to waive the 1 setba
I do not wish to waive the 15' s
Owner Information)
Print or Type Name
Mating Address
"s'f y
Tole hone Number
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Pate
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AUG 21 2014
i)CM M10 CITY
t SECTIQN
, breakwater, boath use, lift, or groin must be set
i of riparian access unless waived by me. (If you
: appropriate blank eiow.)
requirement.
back requirement.
(Adjacent Pro arty Owne-rInformation)
Signature
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Print or Type Ns me
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Date
(Revised 6/1W012)
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(Perty Owner Information)
:rop,-7 A n
e
QJACENT -Rip
I hereby certify that I own property
property located at /� (Name of roperty Owner)
on
(Addres , Lot, Block, Road, etc.)
i ��� , N.C.
(Waterbody) ity/To n and/or County)
The applicant has described to me, as sho below, the develot rnent proposed at the above
IOC
have no objection to this prop sal.
I have objections to this propo al.
DESCRIPTION AND/OP DRAM 4G OF PROPOSED DEVELOPMENT
(Individual proposing development must f ri In description bel w or attach a site drawing)
G
e
•
AUG 2 Z 2014
DVA MM MY
1AIAIVfE
ECTION
I understand that a pier, dock, mooring pilinbreakwater, boath u:se, lift, or groin must be set
back a minimum distance of 15' fro my aof riparian access unless waived by me. (If you
wish to waive the setback, you must Initial tappropriate blank Blow.)
10 1 do wish to waive the 1 ' setba requirement.
1 do not wish to waive t�te 15' sback requirement.
(Adjacent Pro perty Owner Information)
22i,�1
IPA,,I
Telephone Number
D - , I t_1 i
Pate
or Type
(Revised 6/98/2012)
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