Nye, Kemp

LAMA / ❑ DREDGE & FILL
WMENERAL PERMIT Previous permit#
ew ❑Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environment and Natural Resources J l J,Y ,
and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC / ! ! V
El Rules attached.
�.. plicant Name +,' �'= — Project Location: County
Address `ti 0 "' t� ` "� fJ r � ' • Street Address/ State oad/ Lot #(s)
City I City StateAJQ ZIP ," .j( >{ •-� �AgCc,/ '')
Phone`# (?�' �) s l' %"') Fax # (_) i Subdivision r
Authorized Agent ~ �.w, «r t e , 1 t / 4 i%� �` ,;zt . ` �f ZIP -�
City y "'+
Affected ❑ CW 'PkW ❑ PTA ❑ ES ❑ PTS
AEC(s): ❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A
❑ PWS: ❑ FC:
ORW: yes / no PNA yes /ti .) Crit.Hab. yes / no
)
Type of Project) Activity IOU' q1
Pier (
Platf
Fingi
Groi
Bulk
Basii
Boat
Boat
Beac
Cahi
Shor
SAV
Sanc
Mor
Phoi
Wain
Phone # ( ) (River Basin (/ i /"r't,/fiA,
Adj. Wtr. Body' +' J G nat man unkn
Closest Maj. Win Body o, ' - "L'''" /�
(Scale:
ON
ME
100191
ONO
r pier(s)
■
number
avg distance offshore
max distance offshore L)
cubic yards
ramp
IOU se/ Boatlift
NNEMENEEMIENW.—
rNES
MMMMMMMMMNMENMMMMMMMM
dine Length
tags: not sure yes
qi.NMNMMMMNM
�torium: n/a yes
is: yes ;no:
MENEM
zr Attached: yes tno,
f
A building permit may be required by: G ^ ' t C
Notes/ Special Conditions () 1; r r�t9 �v�1� 10 f/t-1A,� rA r_.
J .� j^ / V 1� LI/ /
❑ See note on back regarding River Basin rules.
. r ,
Agent or Applicant Printed Name PermitO cer s Signature
r f r r'
-4,
Signature "Please read compliance statement on back of permit" Issuing ate F)c ration D to
i
ApplicationFee(s) Check# Local PlanningJurisdiction Rover File Name

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 andvoid.
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, certifythatthis project is consistentwith 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
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/ 1-888ARCOAST
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

i
r
NC®EINR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
Pat McCrory Braxton C. Davis
Governor Director
Applicant NameRY-jz
Mailing Address
to C.
0
John E. Skvarla, III
Secretary
I certify that I have authorized (agent) 11 to act on my behalf, for the
purpose of ap ing for and obtaining all CAMA Permits necessary to install or construct (activity)
W at (location)
This certification is valid thru (date) /
RECEIVED
Signature
OCT 2 71014
DCM-MHD CITY
RECEIVED
OCT .14 2014
DCM-MHD CITY
400 Commerce Ave., Morehead City, NC 28557 one'
Phone: [phone] FAX: [phone] Internet: www.nccoastalmanagement.net NofffiC jarohna
An Equal Opportunity )Affrrmative Action Employer

10/07/2014 08:13AM 9195838790 BCD PAGE 02/02
ADJACENT RIPARIAN PRQPERT-Y- OWNER STATEMENT
I hereby certify that I owo property adjacent to A-6 Me 's
j� (NAme of P operty Owner)
property located a( .,
(Address, Lot, Elock, Road, etc.)
on , in N.C.
(Waterbody) (City/T n anchor County)
The applicant has described to me, as shown below, the development proposed at the above
locatiory�
�/_ I have no objection to this proposal.
I have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(Individual propos/ng development must fill in description below or attach a joife drawing)
r ,
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.�ECENED
1 do wish to waive the 15'setback requirement. ��� r �. 2VI4
RECEIVED
do not wish to waive the 15' setback requirement. IDr'M.0 D=Ty
A OCT 2 7 2014
(Property Owner Information)
Signature
or TA= Name
Cityatateizrp
Telephone Number 7e eph
Date J�acta \
Owner Information) DCM_MHD CITY
(Revised 6% W012)
— .— .. —^lr,n11n1I11nut -lainll4thniiL•/n11Ll 1n A

1 6.
. �. w. ..w.w. .. ..... w.... w. .... n- —.nn.. n I I n III I nut. oil^ l If1AIJIL./A dl1 0A AI

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
hereby certify that I own property adjacent to IPA4/A �� 's
BCD (N ma a of roperty Own er)
property located
...._....__
(Address, Lot, Block, Road, etc.)
on Cow , in �911 S4"a Axeg , N.C.
(Waterbody) (City/ own arfdlor County)
The applicant has described to me, as shown below, the development proposed at the above
locatio .
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)
�b I
/VeW i
0
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.) RECEI E
I do wish to waive the 15' setback requirement. OCT 2 7 2014
DCM-MHD CITY
I do not wish to waive the 15' setback requirement.
r1mu l
OCT 14 2014
(Adjacent Property Owner Information)
0-0-00
Signature
,'='9,6A H
Print or Type Name
/Do 6a k / �c
Mailing Address
NIAR!5&7 Az.r�Jt ty k e a'Ss-s 3
City/State/Zip
J.. -72:2 -23.9
Telephone Number
lv—`7- 154`
Date
(Revised 611812012)
DCM-MHD CITY

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-- — ` -- RECEIVED
\ OCT r 4 2014
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