M Best & Son, LLC

tAMA / ❑DREDGE & FILL
5472A A B CC")
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G111ERAL PERMIT Previous permit#
❑New ❑Modification ❑Complete Reissue El Partial Reissue Date previous permit issued Y
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 I SA NCAC'k ' c
} ,m ules attagbed.
Applicant Name 4 �� ' `' Lf.* Project Location: County w
City ") f x- StateAA" ZIP
"fi
Phone # £ E-1
Aail
Authorized Agent
Affected ❑ Cw pew p41A ❑ ES ❑ PTS
AEC(s): ❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A
❑ PWS:
ORW: yes /(no) PNA yes /
C. I Type of Project/ Activity
Pier (dock) length %
Fixed Platform(s) a
Floating Platform(s)
Finger pier(s)
Groin length
number
Bulkhead/ Riprap length
avg distance offshore
max distance offshore
Basin, channel
cubic yards
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing w.
Other
Shoreline Length a+'
SAV: not sure yes i--4 °
Moratorium: n/a yes
Photos: yes
Waiver Attached: yes
Street Address/ State Road/ Lot #
'125 a ,`
Subdivision 144 r°
City` er4 t ' ZIP
Phone # ( ) River Basin
Adj. Wtr. Body )''.y" na man unkn
Closest Maj. Wtr. Body
- Y 14 ' Vie, J r. ,a '�Y '01%
(Scale:�e� )

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:
El Tar - Pamlico River Basin Buffer Rules El 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 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/ 1-888-411COAST
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.nccoastaimanagement.net/
Revised 08/27/ 14

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AGENT AUTHORIZATION FORM FOR PERMIT APPLICATIONS
M u,v aac, Be, �-�. 3 A
Name of Property Owner Applying for Permit: e, ri i L
Mailing address:
-9 d q M'-1/ 0,4 c)
Telephone Number: 11 9 9 a 0 ! 9 9 9
OIq
I certify that I have authorized A/, J fi `; - R 13 y (agent/contractor),
to act on my behalf, for the purpose of applying and obtaining all CAMA permits
do
` � necessary for the proposed development of C A �J� � 1
at my property located at ..5 114 f71t K h ® iZ I a , 1v Q I Nq
S +R 4; - - S ----' 4f, f C, F- C-f'
This certification is valid through �/ 31� / (date).
(Property Owner Information)
rVl
���rature RECEIVED
� e> S��d LL-- �-'
JUN 15 1015
M 01J R a e-
Print or Type Name
Title, co, owner or trustee for property
(01 5 / / , RECEIVED
Datel JUN 0 51015
01 - 191.0 ~ ( ! i Y q O 'CM-MHD Ctty
Telephone Number
Email Ad ress

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that. I own property adjacent to i►i., t: e� 1� 'VQAl 5 LL e 's
:propert5l.locatodm-. ��. -in, - - '�.� N')` ._....__....
( e of Prope Owner)
-.. - - - - � (Address, Lot10 tc.) ,_... .....�_,� .._..s._....�._...�
on .5 + )Z >'t- z , in S ��� /} )2,- 2. �.. , N.C.
(1Waterbody) (Cityliown and/or County)
The applicant has described to me, as shown below, the development proposed at the above
Ipcation.
C� I have no objection to this proposal.
I have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(individual proposing development must rill in description below or attach a site drawing)
WAIVER SECTION
I 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.)
RECEIVED
I do wish to waive the 15' setback requirement.
MAY 2 8 1015
I do not wish to waive the 15' setback requirement. DCM-MHD CITY
(Property Owner Information) (Adjacent Property Owner Information)
S-e( _ RECEIVED
4---
Signature m ;3 c, 5 t- � o ry L. LLL Signature JUN 1 1015
M a nl R Q P--., f� N 5 -1- . Utz ►
Print or Type Name Print or y e NALPIT
me n
g D 9' yo e I l J�. y - 1'ti
Mailing Address r Maifi g Address
�7�7
0 3 Y y 1Z, h A a:x 176 -1
City/St�afe1Zi� Ci- � � $ zs Cam`/ 1 t� e/ZI p" 9 2
Telephone Number Telephone Numbe
a
Date —� Date
(Revised 6/18.,2012)

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
'I hereby certify that. I own property adjacent to
'N ne of Property Owner)
pro12 y.loc. t Cl: t /-� ✓I t� o f _ �.i.N f o >4c�
(Address, Lot, Block, Road, etc.)
on
(Waterbody) (City/Town indlor County)
The applicant has described to me, as shown below, the development proposed at the above
lo�ca�tipn.
(JfL- I have no objection to this proposal.
I have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(individual proposing development must fill in description below or attach a site drawing)
WAIVER SECTION
I 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.)
RECEIVED
1 do wish to waive the 15' setback requirement.
JUN / 5 1015
I do not wish to waive the 15' setback requirement. PQIV VM
(Property Owner Information) (Adjacent Property Owner Informs tion)
/" f r WV/✓
Signaturp i ature
M- 13e. ,4 4 Soap US — R le GJ�<►z .
Print or Type Name Print r Type ame
AIn- MO)) RJ I �q" C'nLe1 P©rid
M ill Address L i A - C 7
g, t 5 3
Citl y/State ip l Y
9 ao
Telephone Number
a. to JIS
Date —
(Revised 611812012)

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