Paylor, Richard

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CAMA i �,ppFtEDGM & FILL
N`161 6680A B D
ENERAL PERMIT 7 Previous permit #
W,GxtNew ElModification ElComplete Reissue ElPartial Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environment and Natural Resources
and the Coastal Resources Com is•sion in an area of environmental concern pursuant to I SA NCAC
[9,Rqles attached.
Applicant Name j Proect Location: County
Address Street Address/ State Road/ Lot #(s)
State
City e J ZIP
Phone # i F-Mail Subdivision
Authorized Agent City ZIP
Affected 0 CW _�-EW *U [D ES 0 PTS Phone # River, Basin v�
0 OEA 0 HHF 01H 0 USA 0 N/A
AEC(s): Adj. Wtr. Body (kn)
natt) un
0 PWS:
Closest Maj. Win Body
ORW: yes'/ w' IPNA yes/ no
"T
Type of Project/ Activity
4Ffr (Scale:
Pier (dock) length
Fixed Platform(s)
Floating Platform(s)
Fingerpler(s)_ ..... ... . . .. .. ... ... ...... ... ........ ... .. ...... .... . ... ... .... .. ........ ......... . .......... .... . ... .......... ... .... . ... .... ... . ....... . .... ..... ....... .. . ........ .. .......... . .......... ........... ........... .......... .......... ... ... ........ . .. .......
Groin length
number
.... .... ... ........ .
Bulkhead/ Riprap length
fie f
avg distance offshore P
......... ...... ... ....... .. ........... .... .. .. . . . . . .............
:4
max distance offshore
Basin, channel
.. . ...... . ........... .......... . ......... ......... .. ...... . . ....... . ... ....... ... ......... ... .... . ... .. .. ........ .. ......... . ........ ...... .. ... .... .. . ....... . ...... .... .......
cubic yards r
Boat ramp
Beach
Other
Shoreline Length
SAV: not sure yes no
Moratorium: n/a yes no
Photos: yes # no
Waiver Attached: yes 11.,no
A building permit may be required by:
,.,t(N9.t9,,Local Planning jurisdiction),--,
k-pplicafi-Phpied me
"Please read compliance statelnent on back of pei
11 Fee(s) C
ommmixww.mm
INNEEMNIO
OWN= 011
ONE MENOME111
ENNOOMMONE111
4
....... . . ....... ......... ........ . ....... ... .. — -- ------- 7­­
EJSee note on back'regarding River Basin rules.
J

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
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 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
400 Commerce Ave
Morehead City, NC 28557
252-808-2808/ I-888-4RCOAST
Fax: [phone]
(Serves: Carteret, Craven, Onslow -
North of New River Inlet- and Pamlico
Counties)
Elizabeth Ci�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

CAIVIA / l7{DRERGE &FILL:
q B,mD
G FU ERAL PERMIT
Previous permit #
New ❑Modification ❑Complete Reissue El Partial Reissue Date previous permit issued
ij
authorized by the State of North Carolina, Department of Environment and Natural Resources
d.the Coastal Resources Comynission in an area of environmental concern pursuant to I SA NCAC
4 rr
R les attached
Thdant Name �' C. i 4
Project Location: Countyu
Idress �1� t t�' I ' f/j'�
Street Address/ State Road/ Lot #(s) ; 1A' a /`
fd-1"4•ti �•� State � "'� ZIPa`rY �✓+• ` �
..r _i -.� � j
lone*'� - t f E-Mail -�
jA`
Subdivision
rthorized Agent
City ZIP
fected ❑ CW - EW �A El ES ❑ PTS
Phone # ( ) yRiver Basin y R
❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A
C(s):
��
Adj. Wtr. Body .- l _`" aat man unkn
❑ PWS:"
RW: es PNA n9
Closest Maj. Win Body
y ( yes .
Ype of Project/ Activity.''';_
(Scale: f'
■■■■■■■■■
■■
■
��'
■■
■Io1■11011
Platform(s)
■■■■■■■■..
ONNEINMEMEN
MEN
a
WEENEENINE
IMENNESS...■®....■■■■■■....�.�■■■.■■....NEEN
n umber
■■■■■■■
■■■■■■
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■
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11111011111■■1■■D
4
also■11
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■■■■■.Nmax
■
■
■
11
Fwg distance offshore
■■■■■■■■■■
■■■■■■■■■
■
■
distance offshore
.■■■■■■■..■..■.■■■.�1■.1:1:1■■::111111
■■■■■■
■■■■■■■■■.■■�n�■■�■■■■■■■■■■�►■■■■■■
111■1'J■1■11■1111■®■
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■■1■1
SEEN
1
yards
ra MD
■■■■■■■■■■■■■■■■■■�['1�■■■■■■■■���
■■SEEN■■■■■■■■■■■■■'�■■EI■■■■■■■■■r■■■■
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ierAttached: yes
building permit may be required by: �. El See note on back regarding River Basin rules.
All Planning Jurisdiction)
IeSpecial nditions�' e f , t�"
A"..1. 17 �•, s,f t ,.
F
0 1QJ Uld-
a
e orApplica ted a Permit Officer's Printed Na
(Mature Please read compliance stat ent on back of permit j Signatures
o// (c
,_plicatlon Feels) Check# Issuing bate f Expiration. Date
nta,.,ti(`u�,..._n.n....._....�.t _,...__... .....�. ...._.�.,w _„s ___., r..�.�.:i.�,i ...�.,._i.> .�.�.�.tt�,u.r k,.,.:.tr/.a .�_.�..., ... ........�_._...,�..,....��;,a.u....,.�u_G:r.�.,.d ..c_,<,,..., ,...,..z.,.._. ,,s.....,.,.y__. •.. ..,._ �... .,.. .,.... ,...�_ ,.

UNITED STATE VICE First -Class Mail
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der: Please print y ur name, address, and ZIP+4® in this box•
cox c� 1c�
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= ;s �� �fr>>��f�i��l fill
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9590 9403 0112 5077 9642 94
2. Article Number (Transfer from service label)
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D. Is delivery addre"iferent from item 1? 0 Yd:
If YES, enter delivery address below: No
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PS Form 3811, April 2015 PSN 7530-02-000-9053 Domestic Return Receipt

UNITED STATESper, ERVICE
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First -Class Mail
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Postage & Fees--Paid
USPS
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• Send lease print your n addreps, and
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MAR 2 8 2016
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4.11 -4-1
■ Complete items,, 2, and 3.
■ Print 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. Article Addre d to:
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13 Addressee
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D. Is delivery address different from Rem 1? 0 Yes
If YES, enter delivery address bel : ❑ No
3. Service Type
❑ Priority Mail Express®
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Delivery
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7 015 0640 0004 6357 0051
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Restricted Delivery
=r $500)
PS Form 3811, April 2015 PSN 7530-02-000-9053
Domestic Return Receipt

Richard Paylor
250 Gatsey Ln
Beaufort, NC 28516 25 FED `15-
PM 2- L
?015 0640 0004 6357 0099
— RECEIVED
MAR 2 8 2016
DC,'iVl- MHD C
.cholas Rodriguez
) Box 1153
-ean City, NJ
,es P%.
14-9'f j
--PITmry oowEs
02 1P $ 006.740
0001821324 FEB 25 2016
MAILED FROM ZIP CODE 28579
NIXIE 176 75,
1 0003/02.13-6
RETURN TO
SE14DER
NOT DELIVERA81 ;E
AS
'WARD
Ll NAS L E fd
F OF
C
Z �1- 1,r a - Z -3 S.'a - 0 JLl
Alt

Richard Paylor
250 Gatsey Lane
Beaufort, NC 28516

Mr. Rodriguez,
Per CAMA requirements, would you please complete the enclosed form and
return it in the included, stamped envelope.
Thank you for your time and prompt response.

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to Richard Pa for is
(Name of Property Owner)
property located at 321 Gatsev Ln, Beaufort NC 28516 -- Dock Lot 6
(Address, Lot, Block, Road, etc.)
on Core Creek , in Carteret County , 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)
It is my plan to have a boat lift installed on the south side of the T dock at 321 Gatsey
Lane, dock lot #6. 1 co-own this lot and dock with Jerry Johnson. This job will require the
installation of pilings.
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.
(Pro erty Owner Information)
M pa,
Signature
Richard Paylor
Print or Type Name
250 Gatsev Ln
Mailing Address
Beaufort, NC 28516
City/StatelZip
252-241-5114
Telephonp Nurpber
(Adjacent Property Owner Information)
Signature
Print or Type Name
Mailing Address
City/State/Zip
Telephone Number
Date

For 10uc RCCods
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to Richard Pa IOC is
(Name of Property Owner)
property located at 321 Gatsey Ln, Beaufort, NC 28516 -- Dock Lot 6_
(Address, Lot, Block, Road, etc.)
on Core Creek , in Carteret County 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)
It is my plan to have a boat lift installed on the south side of the T dock at 321 Gatsey
Lane, dock lot #6. 1 co-own this lot and dock with Jerry Johnson. This job will require the
installation of pilings.
h,
x�r
v �
i
L v
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)
(Adjacent Property Owner Information)
J4JPhMk
Signature
Signature
Richard Paylor
Print or Type Name
Print or Type Name
250 Gatsey Ln
Mailing Address
Mailing Address
Beaufort, NC 28516
City/State/Zip
City/StatelZip
252-241-5114
Telephone bTelephone
Number
tamly
Date
Date

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E3 Agent
❑ Addressee
by (Printed Name) C. Date of Delivery
D. Is delivery address different from Item 1? 0 Yes
If YES, enter delivery address below. ❑ No
UiGL
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ssO
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7 015 0640 0004 6357 0099 5Mall Restricted Livery Restricted Delivery
Ps Form 3811, April 2015 PSN 7530-02-000-9053 Domestic Return Receipt

UNITED STATES POSTAL SERVICE
First -Class Mail
Postage & Fees Paid
USPS
Permit No. G-10
17der: Please printeur name, address, and ZIP+4® in this box•
1 C C� I0'r-
C-k�e� LY\
111111111111111111111111111111

0,+Vj A s
-Darle', -or
14c
71.711F; PM -1
. ........ .
Richard Paylor MAR 2 8 Z016
250 Gatsey Lane ClTy
Beaufort, NC 28516 DCM- MHO

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to Richard Paylor 's
(Name of Property Owner)
property located at 321 Gatsey Ln, Beaufort, NC 28516 -- Dock Lot 6
(Address, Lot, Block, Road, etc.)
on Core Creek , in Carteret County , 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)
It is my plan_to have a boat lift installed on the south side of the T dock at 321 Gatsey
Lane, dock lot #6. 1 co-own this lot and dock with Jerry Johnson. This job will require the
installation of pilings. °$F
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.)
g I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(Property Owner Information)
P J4.q�B3k
Signature
Richard Paylor
Print or Type Name
250 Gatsey Ln
Mailing Address
Beaufort, NC 28516
City/State/Zip
252-241-5114
Telephon Nu ber
Oiit
Date
(Adjacent Property Owner Information)
Qa�
nature
gay" 1 iJ-�-1043
Print or Type Name
33oo barieq c-
Mailing Address
/Pale; ( o 7
City/Sta /Zip
Telephone Number
Date
6- i

Robert & Marilyn Jansen
93 Forest Dr
Pittsboro NC 27312-7116
ARAU'EIG;�i-I MA-". 5
v Z�
ml��H
. ...... igo
6
Richard Paylor MAR 2 2016
250 Gatsey Lane
Beaufort, NC 28516 DCM- NIHD CITY
2 a S I. G -7 6 3 S

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to Richard Pavlor 's
(Name of Property Owner)
property located at 321 Gatsey Ln, Beaufort NC 28516 -- Dock Lot 6
(Address, Lot, Block, Road, etc.)
on Core Creek , in Carteret County. , 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)
It is my plan to have a boat lift installed on the south side of the T dock at 321 Gatsey
Lane, dock lot #6. 1 co-own this lot and dock with Jerry Johnson. This job will require the
installation of pilings. 9_ FTa._._
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.
c�L7� I do not wish to waive the 15' setback requirement.
(Property Owner Information)
uLj
Signature
Richard Pavlor
Print or Type Name
250 Gatsey Ln
Mailing Address
Beaufort, NC 28516
City/State/Zip
252-241-5114
Telephon Nu ber
.7.1
Date
Property Owner Information)
Print or Type Name
-Po ivL ,-,2 -721,Z
7i 7-7.>> -EV.-
Telephone Number
Date
�crzv�l �2
, 36_ 1615 C'��

04 * 01
PROPERTY OWNER STATEMENT
I hereby certify that I co-own property with Richard Paylor is
(Name of Property Owner)
property located at 321 Gatsey Ln, Beaufort, NC 28516 -- Dock Lot 6
(Address, Lot, Block, Road, etc.)
on Core Creek in Carteret County , 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 rill in description below or attach a site drawing)
ED
It is my plan to have a boat lift installed on the south side of the T dock at 321 seeyE IV
Lane, dock lot #6. This job will require the installation of pilings. MAR 2 8 2016
t L l FT DCM- MHD CITY
(K
(Pro y Owner I formation)
yjatl� &A
Signature
Richard Paylor
Print or Type Name
250 Gatsey Ln
Mailing Address
BeaufortNC 28516
City/State/Zip
252-241-5114
TelephoAn�as {� �
Date /'
r
k ,' o`n.
APR 01 2016
DCM- MHD CITY
(Property Co -Owner -information)
Print or T3(pe Name
Mailin Address
City/State/Zip
5 �©� 441 a �- 2
Telephone Number
7 -_-� 3 V /""'
Date