Parrott, Donald Spooners Creek North

"A v 4l2e.+l
CAMA / El DREDGE &6465
FILL r(5„) N ~'
ENERAL PERMIT Previous permit#
ew ❑Modification ❑Complete Reissue El Partial Reissue Date previous permit issued
As auth rized by the State of North Carolina, Department of Environment and Natural Resources
and the Coastal Resources Commission iq; an aredW environm ntal concern pursuant to I SA NCAC
( IN P41es attache
Applicant Name.,, `. „ Project Location: County
Address ��} Street Address/ State Roa / Lot #(s)'
City ��...�'. ; (i l Mate ZIQ'
Phone # ("" f' "". --M ail Subdivision
Authorized Agent t, X ?,i `) City 1 t' ; � Ic ZIP
❑ Cw FW n �A ❑ ES ❑ PTS Phone #^(—`) --~�^ "'" River Basin',
,
Affected ❑ OEA ❑ HHF ❑ IH ❑ USA ❑ N/A ,
l ;
AEC(s): " " Adj. Wtr. Body Anat Iman nkn
❑ P(WS
, �' j Closest Maj. Wtr. Body
ORW: yes / •�o ,� PNA yes / o
Type of Project/ Activity
(Scale:
distance offshore
IL
Jill
InIlMMM
NEI
or
cubic yards
Boat ramp
uu��e
Boathouse/Bo
MEME
0
IMMENSE
Beach BuIldozin
Other —
Shoreline Length
SAV: not sure yes n
Photos: yes
N
Ali
A building permit may be, required by:
1
!
❑See note
on back regarding River Basip rules.
( Note Local Planning Jurisdiction)
Notes/
8
'
is
i� 1i °
%
`,. #1
i i
�� �'
70
E.
Agent plicAnt Print ame
Permit Officer' �Prikecl Name
Si",Ure,-- Ple1aseread compliance statement onb
kof Permi a
Signature
Application Fee(s)
�. Check#• -
Issuing Date
Expiration Date

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 I) 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
landowners).
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 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 howto 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/ 1-888-4RCOAST
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.nccoastalmanagement.net/
Revised 08/27/ 14

N.C. DIVISION OF COASTAL MANAGEMENT
AGENT AUTHORIZATION FORM
Date
Name of Property Owner Applying for Permit:
Donald ?0,rr©tt
Mailing Address:
I certify that I have authorized (agent) �Q PCB v\ to act on my
behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to install or construct (activity) _ —t>/? dC,� R m C+— 5, I ' P- *- ` ¢
at (my property located at) "9 I ,
This certification is valid thru (date)
Property Owner Signature
.1�-3 1 _ ) ,-o RECEIVED
DEC 21 2015
t i- I t --;-o t <DCM- MHD CITY
Date
177
n d,
R00 Y 4.
RECEIVED
DEC 10 2015
DCM- MHD CITY

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
Atl
1 hereby certify that I own property adjacent to off6 tv va L, D �� * f a 'fit 's
"S' l ' P T (Name of Property Owner)
property located at i a '4 vVZi
(Address, Lot, Block, Road, etc.)
on 1�� nee in I'� �2.a-►n'e-�t
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.
1 have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(Individual proposing development must fill in description bel w or att ch a e drawing)
tR to- 1A r-94. je� a'*ewf
Vu'Kq- f —4C�
2'
WAIVER SECTION
I understand that a pier, dock, mooring pilings, boat ramp, 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.) C F-N EID
do wish to waive the 15' setback requirement.
R
I do not wish to waive the 15' setback requirement.
pEC 21 2015
i�
(Property Ow;V14
r Information) Adjacent Prope Own In orn M.
/p
a cd G a �
S*gre
PHIor Type N"e �- Print or Type Name
O �►C&XV 1L 1,0,2 TZaCL RECEIVED
Malt
Ad � 6 t fJ Mailing Address
K
cityistat�;r-�O G�> ►��, >� N .� 2� DEC 10 2015
C 2S2'�
1,4
0
Telephone Nu ber/email addrese 1 fll(s _ �/] ® ''�'Y
Telephone Number
Date I Z - 10^ l S
Date
(Revised Aug. 2014)
*Valid for one calendar year after signature*

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own grope!y adjacent to _I -� o r L 0 �� � r o � is
`F (Name of Property Owner)
property located at o`-) 1A11E r.. 10 r4 Lo -
(Address, Lot, Block, Road, etc.)Ilk
on 2 n Yl 8J' C P �� , in j''1'1 o r�� .e c� �t !fl , 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 be►p�w or a ch are drawing)
tq Cam.
= SOD : 27 = pg4-,, kf 05
RECEIVED
DEC 21 2015
WAIVER SECTION DC M- M H D CITY
I understand that a pier, dock, mooring pilings, boat ramp, breakwater, boathouse, lift, or groin
must be set back a minimum distance of 15' from my area of riparian access unless waived b
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.
I do not wish to waive the 15' setback requiren
(Property Ow r Information)
Id r�®-
ature
V-
Pn'nlor Ngme v�
MaI A67ns ' �,
City//Z Staf " (� ` �
Telephone N—u,mber/email address
zli
Telephone Number
DEC 10 2015
Owner Information)
- MHD CITY
Date
Date �—
�.,�Z7��-
`Valid for one calendar year after signature* (Revised Aug. 2014)