Purcell, Teresa

2, eo&
CARAA V J DREDGE & FILL
-. GENERAL PERMIT Previous permit #
,New _ Modification ! -Complete Reissue 'Partial Reissue Date previous permit issued
As authorized 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
El Rules attached.
Applicant Name _ Project Location: County
Address _ _ _ _ _ ._ _ Street Address/ State Road/ Lot #(s)
City — -- — .-- — _ _ - State___ ZIP
Phone # (__) t `;Fax # ( ) Subdivision
Authorized Agent City _ ZIP
Affected CW EW PTA ES PTS Phone # ( )_ River Basin
OEA HHF IH UBA N/A
AEC(s): _ Adj. Wtr. Body_(nat /man /unkn)
PWS: FC:
ORW: yes / no PNA yes / no Crit.Hab. yes / no Closest Maj. Wtr. Body- — — —
Type of Project/ Activity
Pier (dock) length
Platform(s)
Finger piers)
Groin length
number
Bulkhead/ Riprap length"
avg distance offshore
max distance offshore_
Basin, channel
cubic yards
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing
Other
Shoreline Length
SAV: not sure) yes no
Sandbags: not sure yes no
Moratorium: n/a yes no
Photos: yes no
Waiver Attached: yes no
A building permit may be required by:
Notes/ Special Conditions
'J . i lA rt yti;�
Agent or Applicant Printed Name
I
(Scale: 4 , j ) I
L_ I See note on back regarding River Basin rules.
Permit Officer's Signature
Signature ** Please read compliance statement on back of permit
Application Fee(s)
Issuing Date
Check # Local Planning Jurisdiction
Expiration Date
Rover File Name

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 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 consistent with the North Carolina Coastal Management Program.
River Basin Rules Applicable To Your Project:
Tar - Pamlico River Basin Buffer Rules
Neuse River Basin Buffer Rules
0 Other:
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 howto complywith 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/ 1-888-4RCOAST
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

II`;9">-� - j°�"i7� �-t� * .w� e1r e�a� a r' iJ'�,'^3L �Ildl'y <'.'•it^., ' ,..-'-� . ny'-•l`L
AppTicant: C
Date:
Describe below the HABITAT disturbances for the application. All values should match the name, and units of measurement
found in your Habitat code sheet.
Habitat Name
DISTURB TYPE
Choose One
TOTAL Sq. Ft.
(Applied for.
Disturbance•total
includes any -
anticipated
restoration or
tempimpacts)
FINAL Sq. Ft.
(Anticipated final
disturbance.
Excludes any-
restoration
and/or te
im actammtem
TOTAL Feet
(Applied for.
Disturbance
total includes
any anticipated
restoration or
im a
FINAL Feet
(Anticipated final
disturbance.
Excludes any
restoration and/or
temp impact
amount
redge ❑ RIX Both ❑ Other ❑
Dredge ❑ Fill'[.] Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑. Fill ❑ Both' ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑ -
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑. Fill ❑ Both ❑ Other ❑
iF. RE
MVED
MAR 2 5 2014
{

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4�
• + if ,..�
NC®EWR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
Pat McCrory Braxton C. Davis
Governor Director
Date 'O f ex
Applicant Name.
Mailing Address P 'q
John E. Skvarla, III
Secretary
I certify that I have authorized (agent) to act on my behalf, for the
purpose of applying for and obtaining all CAMA Permits necessary to install or construct (activity)
This certificatio . valid thru (date) ._. 3 j._ D /!�!
Signature
400 Commerce Ave., Morehead City, NC 28557
Phone: [phone] FAX: [phone] Internet: www.nccoastaimanagementnet
An Equal Opportunity IAffumative Action Employer
R1;CEiVED
MAR 2 5 2014
DCM MHD CITY
ABjua
flue g I Nbw
Noe Carolina
)Mural!
ff

I hereby certify that I own property adjacent to / ��t lam %UGtrt C�L� Is
Property located at _ // , p ,�,t-2 o (Name of Property Owner)
on
(Address, Lot, lock, Road, etc.)
(Waterbody) , in r V N.C.
(CftylTown and/or County)
The applic
location an s described to me, as shown below, the development proposed at the -above
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)
,S �" --_-7 x
AId
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boathouse, lift, roin must be let
back a minimum distance of 15' from my area of riparian access unless waived %yL. (If you
wish -to waive the setback, you must initial the appropriate blank below.)
�P
I do wish to waive the 15' setback requirement.
I do not wish to waive the 15 setback requirement.
(Pr erEy Owner Information) (Adjacent Property Owner Information)
igwture n %_
Pnnf r Typeluame Print or T e Na
Maing Address -WCv 2JL1!g Address
City/Stag /Zip C" /St e)Zi
,� -1a �a3 � i �- 3pz
Telephone Number Telephone Number
Date:. Date
(Revised 61I M012)
'DCM-M MCY[Y

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
1 hereby certify that I own property adjacent toAW-4-29's
(Name f Property Owner)
Property located at _ /3 ( � �..eQ, , /9,,, o _
(Address,
on , in _
(Waterbody)
Road, etc.)
ity/Town and/or County)
N.C.
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 roust till in description below or attach a site drawing)
�5k
AID
WAIVER SECTION
understand that a pier, dock, mooring pilings, breakwater, boathouse, lift, or groin must be let
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.)TED
I do wish to waive the 15' setback requirement.
MAR,1;9H14
I do not wish to waive the 15'-setback requirement.
(P perty Owner formation) (Adjacent Property Owner In ormation)
Si ture
Signature
lzfr,-- :Ure f- RA��Cut'n,C',L-
P 'qt or Typ Name Print r4ype N me
�a `77 �.ti�,
Ma' ing Address Mailing Address
City/State ip City/State/zip
Asa �a3 'T3i6 3S-1-2a-3 -c(6 s�-
Telephone Number - pXCEWM Telephone Number
Date Date
MAR25 "`° -
(Revised 6/1&2012)
M-NED CITY