Mays, Roger & Virginia

Iw dy. 2712C,
'LAMA /, ❑ DREDGE & FILL 'G.i'
dENERAL PERMIT Previous permit#
qRlew ❑Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued
As As
rized 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 /.
x
YRu es attach d. I
'Applicant Name ' 1 -- ' ( r r - ? �(,t, Project Location: County
Address ?' )4 1 i Street Address ,State. oad/ Lot #(s) r-
C' �
itY
ME
fe
Phone
Ul'JaX # (_)'
Subdivision
Authorized Agent
City
❑ J"�"
PTA ❑ ES
❑ PTS
Phone # (> % ?
d),River Basin
Affected
ElOEA ❑ HHF
AEC(s):
El IH ❑ UBA
❑ N/A
Adj. Wtr. Body )
o nat; man Junkr
' ❑ PWS• ❑ FQ
Closest Maj. Wtr. Body
ORW: yes / no J P
esNA / no Crit.Hab.
yes / no
_
Type of Project/ Activity.
r , C
1' Y
.( i' (►"�fr� ) �d 1 1�
�- Vi� .l��lG' )
• a.- --
""►• (Scale:
MENEWA
i LID'�'_W"I
"I
OEM ■ ■ 'I
■■■■■�ON
■■■ WOi■■ I
_ - ■■■lilt �' �Il�/�1�■I
■■■■�`� �. !!N■■■!
cubic yards MERN.0
Boat ramp ■E
®LBoathouse/ Boadift
�%l�
®r,
Beach.. a J■I fib
ll
cx 9111 OW,
'Shoreline Length
SAV: not sure yes
Sandbags: not sure yes }
r�
Moratorium: n/a yes o
Photos: ye no
`Waiver Attached: es no
A building permit may be required by:
Notes/ Special Conditions
ie
See n to on back regardin River Basin rules.

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, certify that this 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 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/ 1-888-4RCOAST
Location: Fax: [phone]
2728 Capital Blvd.
Raleigh, NC 27604
919-733-2293
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

ti
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
hereby certify that I own property adjacent to 2'OcA-r C-'N4 N r c 0-%"" �k -5 's
(Name of Property Owner)
property located at � J � a Av e.r S�' ,
(Address, Lot, Block, Road etc.)
on � A « C.C'�e 1� , in 1Mc.rekQ-c.� E , N.C.
(Waterbody) (City/Town and/ r County)
The applicant has described to me, as shown below, the development proposed at the above
location.
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)
S
ro: R$CBNEn
•rY
JUN 2 7 2013
DCNI M. CITY
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.)
I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(Property Owner Information)
ture
Print or Type Name
15 � a A- ej Cyr ,
Mailing Address ,
City/ tate/Zip
C, ^7
Telephone Number
2s 2- '7 Z3 1 \ Z
Date 2 (.a"
(Adjacent Property Owner Information)
Signature
Print or Type Name
Mailing Address
City/StatelZip
Telephone Number
Date
(Revised 6/18/2012)

'4 t
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REFERS
1
1
DEMO= 1404 PAGE 322
I
DEEDBOOK 1092 PAGE 166
PIN / 636614329937 LOTS a & 10
AND EAST PART OF LOT a BLOCK G'
1
PIN / 63a - LOT 7 # 9
1
PW9907
AND 1MEST PART of LOT a BLOCK 'C
I
ACREAGE
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1 ORAPM SCALE FEET
RECEIVED
JUN 2 7 2013
DCIT y'Im CITY

ADJACENT RIPARIAN PROPERTY OWNER
STATEMENT FOR CAMA MINOR PERMITS
I hereby certify that I own property adjacent to 'Z-`A n
fr � \ n��� %CLu 5's
(Name of Property Owner)
property located at J 10 A �1 , S� ! �-� OA2rQI��
Address, Lot, Block, Road, etc.) I
on �. `i cA C C ;L , in 1�t �JQ�l2�.� �t� r tkLC4CD, N.C.
(Waterbody) (Town and/or County)
He has described to me as shown in the attached application and project drawing(s), the development
he is proposing at that location, and, I have no objections to his proposal.
(APPLICATION AND DRAWING OF PROPOSED DEVELOPMENT ATTACHED)
.Q
Print or Type Name
'2s2• zab , 68V8
Telephone Number
6 •ems 1:3
Date
RECEIVED
JUG 7 zui�
ACM-nff.W CUy

Receipts for
Certified Mail
(Staple Here)
ate
Adjacent Property Owner
Mailing'Address
f
City', State, Zip Code
A
r'
,J
Dear Adjacent Prope
This letter is to inform you that I, have applied for a CAMA Minor
Property Owner
Permit on�4property atc in COUNTY
�Fed
PropertyAddress
County.'As CAMA regulations, I have enclosed a copy of my permit application and project
drawing(s) as notification of my proposed project. No action is requited frotut
or you may sign and return
the enclosed no objection form. If you have any questions or comments aby proposed project, please
m,r
contact me at f ,or by mail at the address listed below. If you wish to
Applicant's Telephone
file written comments or objections with the LOCAL GOVERNMENT CAMA Minor Permit Program, you may submit
them to:
f LPO NAME
Local Permit Officer for LOCAL GOVERNMENT
LOCAL GOVERNMENT ADDRESS
'CITY, STATE,<ZIP CODE
Sincerely,
Property Owner
Mailing Add/drdss
City late, Zip Code
�t

A
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
4
1 hereby certify that I own property adjacent to P1;11qe—r �4 +s: C �1�., c, �'� S 's
(Name o Property Owner)
property located at
(Address, Lot, Block, Road, etc.
on _(` .A < < co C('-e-e. k , in e. or . , 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/OR DRAWING OF PROPOSED DEVELOPMENT
(Individual proposing development must fill in description below or attach a site drawing)
S "i CD
j <r- IIXCEIVBD
4�
JUN 2 7 2013
L�CA r-"?ii'J Cay
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.)
I aive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(Property Owner Information)
Signature
1ZZZ, �Ak s
Prin or Type Nam
+ S 10 A-t ¢1-1 c Jr
Mailing Address
City/State&ip
2SZ 723
Telephone Number
Date
(Adjacent Property Owner Information)
(Revised 611812012)

for Recor,
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1
I
1
I
REFERENCES
1
1
DEEDDOOK 1404 PACE 322 I
DEEOBOOK 1092 PACE 106
PIN tor - LOTS a 1c 10 1
AND EAST PART ov LOT a BLOCK a
PIN / e3aa14329907 . LOT 7 & 9 1
AND HEST PART OF LAT a BLOCK •C- I
_ 1
ACREAGE '
IN
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to to . eoonoo s - ntt we •.
POT a tat o - mama W. - as At ,
mm . ttm00At1 tr. - om
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30.00. ( me Log)
1�v to0.00• — �01.
"burl to.01' tx w� N li 21'091U X"Lpr
N 83.29 40,
AVERY STREET
( 60' R\W — pUBUC )
1Z 30 0 30 60 90
GPAPW SCALE _ rErr
REaIVET)
JUN272013
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