Ormond, William

4.
C A DREDGE & FILL
1A B IN 67795
D
?ENERAL PERMIT
Previous permit #.:
New 11 Modification ElComplete Reissue
El Partial Reissue Date previo4s permit issued
As authorized by the State of North Carolina, Department of Environment and Natural Resources 14
and the Coastal Resourcps C mmission in an area of environmental co'cern pursuant to I SA NCAC
Rules attache
Applicant Name
Project Location: County
Address, ct ii -Y
Street Address/ State Road/ Lot #(s)
0 f
i City tate ZIP
Phone #
Subdivisio
Authorized Agent
City zip
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yl�
Phone # 4A'vqr Basin-
Affected
i .
D OEA 0 HHF El 1H 0 UBA 0 N/A
AEC(s): -1
.
Adj. Wtr. Body (natVman Junkn
E PWS:
ORW: yes Alno PNA yes /ono
Closest Maj. Win Body
Type of Project/ Activity
(Scale:
Pier (dock) length
Fixed Platform(s)
Floating Platform(s)
Finger pier(s)
Groin length
number
Bulkhead/ Riprap length
avg distance offshore ill",
max distance offshorer"w"
Basin, channel
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4 N
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, certifythatthis project is consistentwith the North Carolina Coastal Management Program.
River Basin Rules Applicable To Your Project:
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 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 comply with these buffer rules.
Division of Coastal Management Offices
Morehead City Headquarters
400 Commerce Ave
Morehead City, NC 28557
252-808-2808/ 1-888-4RCOAST
Fax: [phone]
(Serves: Carteret, Craven, Onslow -
North of 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 - South of New River Inlet -
and Pender Counties)
http-//www.nccoastaimanagement.net/
Revised 08/27/ 14

WN
iew
MA / DREDGE & FILLNERAL PERMIT Previous permit #A B c
❑Modification El Reissue ❑Partial Reissue Date previo s permit issued
As authorized by the State of North Carolina, Department of Environment and Natural Resources V�4
a �—
and the Coastal Resour s C mmission in an area of environmental c tern pursuant to 1 SA NCAC. �„b`
ti 3 Rules attache .
Applicant Name Di ► Project Location: Countyt�"
Address
(,,li, AIJU I { "
Street Address/ State Road/ Lot #�
City e
.Y!U
tate;
Phone # ( i
U
" �'
-Mail �—
Subdivisio 1,
_
4,
Authorized Agent
3
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f
City1.Z�
j` ZIP
.
❑ CW
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El PTA )(ES ❑.PTS
Phone # (
ver Basin
r ... �� i
Affected
°
OEA
AEC(s):
❑ HHF
❑ IH O USA O N/A
r
Adj. Wtr. Body ,
kc
!
nat man unkn
El PWS:
ORW: yes /\no
PNA yes / no d f—
w
Closest Maj. Wtr. Body
I U (;
Type of Project/ Activity
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Agent or Appli Printgo Name
in
Signat re a P read compliance statement on back of permit
App ication Fee(s) Check #

N.C. DIVISION OF COASTAL MANAGEMENT
AGENT AUTHORIZATION FORM
Date A & % 70
,a
—
Name of Property Owner Applying for Permit:
Mailing Address:
Z � � 0 JA
I certify that I have authorized (agent) • C �en� to act on my
behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to
install or construct (activity) S fa.- L. )O -
at (my property located at) 2- 3 2 0(0(,C OJ S'-e
RECEIVED
This certification is valid thru (date) j!�,�� 2 (7 AUG 2 2 2016
Property Owner Signature
DCM- NAND CITY
Date
RECEIVED
AUG 19 2016
DCM- MHD CITY

.)s
Blo k, Road ditc..
N.C.
(City/Town and/or County)
The applicant has described tome, as shown below, the development proposed at the above
I have no objection to this proposal.
I have objections to this proposal.
DESCRIP1
-(Individual proposing
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hey by certify that I own property adjacent to
(Name of Property Owner)
property located at 00( NV5e11)0-1
(Address,
on in
(Waterbody)
AN.D/OR.DRAWING .OF.PROPOS8DDEVELOPMENT.
elop-mentmust fill in description below or attach a site drawing)
19
(ace- A Z
4V
j0d pa
A
4
WAIVER. SECTION
I understand that a pier,rdock, mooring pilings �.breakwAtbr, boathouse, lift, or groin must be set
J
back a minimum distance of 15'. from* r-Ry area of .riparian access unless waived by me. (If you
.Wish to waive the.setback, you i-nust.1hitial the. appropriate blank below.)
REC'EIVED":, A
I do wish to waive.the 15'setback requirement. z!
AUG 2 2 2016
.1 do not wish to waive thO.15 setback requirement.
cent Pro PerAy Owner InfoenWV - M;,, H D CITY
(Property Owner Information): (Ad'
ii
1 1A )/A f ?fl/1
Sign9tur nature re
64-
Print or. Type Nam Print or Type Narpe
RECEI
Old I
M Address M 'lin Aqdj
I v
AUG 19 2016j:
Cfty%Stat@30p city, te,
DCM- MHD
CITY
Telephone Number Telephone Number
?
Date Date
(Revised 611812012)

u -vio-iuii yr toOA,6 AL WAm-AuxEw En i
ADJACENT RIPARIAN PROPERTYOWNER NOTIFICATION FORM
CERTIFIED MAIL - RETURN RECEIPT REQUESTED
I hereby certify that I own property adjacent to a,� �r 's
,(ap{i!!{-i Lf i i{If.IYt c9 4s�aaavar
property located at 3 z (' i
i n, ae rern xsr ewg-�{f4'.r+i,{ iail9�'9 4�_
onin - Wit£ c , N.C.
14AXa�taA+...l..� �t�e4�tFir►�sere ar�r�inrf if"ne£%St=vi
Agent's Name#: r''
Agent's phone #: L- 't Z- L-. 0A
Mailing Address �.;azrs�
n61h_-ti.. r-ri:--s•-
r r rrtr r r •F.. r, i - o- r rr_'. .� �..,:_..�tt:.r.:
-Y'7CIJIIC iidD UC4i J:1iJt%U iU 1£iG Cte!-JMYi I iUi UG£UMM if va.UGYC'1UPJ fivi:£1. I IG/Ji i-- IJ.J+>�t.+vw+:aa�.:u�.auui:wvuuy.y
and I have no objections to the proposal.
---------------------------- ----------------------------------------------------------------------------------------
a �r►azas r � e�� a poryi io n1aA+.mmsft- nr: PR'irli nQr-n r9pvpi ( ]PMFMT
(individual proposing development must rill in description below or attach a site drawing)
�.
`j JS} �e� viva i.c.rP G doted e,,.
If you have objections to what is being proposed, you must notify the Derision of Coastal Management
(DCM) - in writing within 10 days of receipt of this notice. Contact information for DOW offices is
available at http://www.nccoastaimanagementneilweblcm/staff-listina orby calling 1-888-4RCOAST.
No response is considered the same as no objection if you have been notified by Certified Mail.
(Property Owner Information)
Signature
Print or Type Name
2-3
Mailing Address
B(", r<.
City/State/Zip
Telephone Number/Email Address
Date
(Riparian Property Owner Informati—j- E M E D
Signature �;' AUG 2 2 2016
-a
Pent or Type Name'
Madrng Address £ RECEIVED
AUG 19 2016
CitylStatelZip
-u E 'y ®CM- MHD-CITY
Telephone Number/Email Address
1-2
Date 4� f
ft7.,_....,,.7. A.,.,. I)Al A\ -

21
■ Complete items 1, 2, and 3.
■ 1 Pent your name and address on the reverse
so that we can return the card to you.
■ Attach this card to the back of the mailpiece,
or on the front If space permits.
1. Artibb Addressed to:
T e� (:0�- Part-(
D
so_ N C_ 'Z � i b
13 Agent
'FFecei by (Printed Date of Delivery
is aeuvery aaaress amerem4rorrmem rr 1-J T67
If YES, enter delivery address below: ❑ No
3. Service Type
❑ Pdortty Mail Express®
❑AdultSignature
❑ Registered Mall -
III
IIIIII
I'll
IIIIIIIIII
III
Il IIIII
I II II
III
II III
El Adult Signature Restricted Deiivery
❑Registered Mail Restricted
❑ Certified Mail®
Delivery
9590 9402 2061 6132 5737 43
❑ certified Mail Restricted Delivery
❑ Collect on Delivery
❑ Return Receipt for
Merchandise
2. Article "'
�stricted Delivery ❑ Signature ConfinnatiprM .
7 016 0910 0002 0546 7620
❑ Signature Confirmatio n
rid Delivery
Restricted Delivery
(over $500)
Ps Form 3811, July 2015 PSN 7530-02-000-9053 �,
Domestic Return Recei a

''k'W&MCKlNG#
�} First -Class Mail
Postage & Fees Paid
USPS
Permit No. G-10
9590 9402 2061 6132 5737 43
United States
Postal Service
• Sender: Please rint your name, address, and ZIP+4® in this box*
Zo � �'090' �r c
fp Ccff C�i�et �
'ijllfit 1111111'11''li'1'1'.111'i111117lfi1III)'�1iR'lllrlerl�1��11�

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AUG 22 2016
AUG 19 2016