King, Tony

k I
Affected _'i CW ,E]EW .,01PTA _JbES WPTS
El OEA [I HHF El 1H El UBA /El N/A
mt%_ksy E] Pws- DFC:
ORW: yes fno%PNA eW no
J
Type of Project/ Activity
Pier (dock) length _/0
Platform(s)
Finger pier(s)
Groin length
number
This facility is located within a Primary Nursery
Area, and is not for boating use. No slips are
permitted for vessels -motorized, sail, or other. An)
kicking or prop wash will be considered a violation
of this permit, and of the CAMA and D&F Act,
jou st pub
A= _mN %a=F_d powoq S1 141l!---U ST
Boat ramp . . ..... ..
Boathouse/ Boa tlift
Crit.Hab. yes,/__n'8'>
Street Address/ State Road/ Lot #(s) �, *.- / ), 2 0
r
Subdivision
City ZIP
Phone# River Basin
Adj. Wtr. B
(J t (inat /man /unkn)
Closest Maj. Wtr. Body VK
Beach Bulldozing
Other
,Shoreline Length
;SAV: notsure yes 0
iSandbags: not sure yes .0
Moratorium: n/a yes rioMMOMMEMMENNOMMIN
Photos: yes no
WaiverAttached: s (Jno
yes 0)
NMI
M
MMMIEMIN■I
I'm
EMENEMENEEMENE
MEMEMMEMMEEMEM■0
NOMMONEEMENOMENN
.l -
(Scale:
A building permit may be required by 0 '1 C, I
r) T
I See note ?n back regarding ver Basin rules.
Notes/ Special Conditions
4
f
t
Agent or 4 11 p icapt Printed N e
Permit Officer's Signature
A
irea8 —compliance statement on
W
Df permit Issuing Date ExpirationDate
7
(4)
Check # Local PlanningJurisdiction Rover File Name

a
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:
0 Tar - Pamlico River Basin Buffer Rules 0 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 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
Morehead City Headquarters
Mailing Address:
400'Commerce Ave
1638 Mail Service Center
Morehead City, NC 28557
Raleigh, NC 27699-1638
252-808-2808/ 1-888ARCOAST
Location:
Fax: [phone]
2728 Capital Blvd.
(Serves: Carteret, Craven, Onslow -above
Raleigh, NC 27604
New River Inlet- and Pamlico Counties)
919-733-2293
Fax: [phone]
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

c �
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
Pat McCrory Braxton C. Davis John E. Skvarla, III
Governor Director -. Secretary
Date
Applicant Name ON
Mailing Address - 40
C
/ 4 w
AJje�,J rDaJ- AJ C,
I certify that I have authorized (agent) l� `'� �'-�''''�cS to act on my behalf, for the
purpose of applying for and obtaining all CAMA Permits necessary to install or construct (activity)
c E: 2 , at (location) ": ; . RBCEWM
MAY 2 8 2014
iDCM MHD Cy
This certification is valid thru (d te) �Iqy
Signature
*"D
400 Commerce Ave., Morehead City, NO 28557 One
Phone: [phone] FAX: [phone] Internet: www.nccoastalmanagement.net NorthCarolina
An Equal Opportunity l Affirmative Action Employer Naturally

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to 1 VIA) 's
� (Name of Property Owner)
property located at 4- M �/_ L"')Dod L.n/
144
/
(Address, Lot, Block, pad, etc.
on 144RAOC.� CE45c< , in IN cw'0o2- , 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.
I have objections to
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(Individual proposing development must fill in description below or attach a site drawing)
1
M425�-( RMENED
t
MAY 282014 M4 2014
Ge�Nc�
WAIVER SECTION
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
wish -to waive the setback, you must initial the appropriate blank below.)
I do wish to waive the 15' setback requirement. j
I do not wish to waive the 15' setback requirement.
(Property Owner Information)
r--Z,
Signature
o/v.�
Print �r Type Name
� of
Mailing -Address
t��ybzi , d'�- ZSfS'7o
City/StateZZ 9
Telephone Number
Date
(Adjacent P;)4:
Owner Information)
Sig46ture
J-mtt 4. ltl�rf�i�a
Print or Type Name
l/3 044,4W
Mailing i jew s
AG
ar
City/Statelzi
lflt25'2-726 -;2 FsT
Telephone Number
611ill Z/
Date
(Revised 611812012)

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to 's
q(Name of Property Owner)
property located at o /VIAL i..Jaod t-4
(Address, Lot, Blo,c�1, Road etc.)
on t4APJow� G4 4G , in NewQoal , 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.
I have objections to this proposal.
DESCRIPTION AND/ RAWING OF PROP
u e opment mus t in escription below or attach a site drawing)
WER
MAY 2 8 2014
DcM mm crry
•V
WY 2014
WAIVER SECTION pMh
understand that a pier, dock, mooring pilings, breakwater, boathouse, lift, or groin must be sett
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.)
do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(Property Ow7 Information)
Signatt
/0NH
Printor q p Maq� WDo L At.
Mailing 4ddress
EWVoV4 , AL ZSfs7 �
City/State/Zip
ZT2-- 531- ? Z�
Telephone Number
Date
(Adjacent Property Owner Information)
ignature
Print or Type Name
Wo /v I'M6 w 0 a
Mailing Address
Iy-w pc) e i { A)C Z S3-70
City/State/Zip
lrzy- 77'7-q3��
Telephone Number
5-i7--.nly
Date
(Revised 611812012)