Rathsun, David G.

lCAMA / ❑ DREDGE & FILL
GENERAL PERMIT Previous permit#
lbNew ❑Modification ❑Complete Reissue El Partial Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environment and Natural ResourcesT"I�
and the Coastal Resources Commission in an area of environmental concern pursuant to I SA NCAC. /
11
-ES Rules attached.
4pplicantName Project Location: County
1 t,
Address '/� _ ! 1 f i*' f) +°t t ~. a �� , �' Street Address/ State Road/ Lot #(s)
r..
;City State', ZIP "� s
Phone # ( lf�) r) ��6— >` , Fax
Authorized Agent
Affected ❑ Cwr ❑ EW ❑ PTA )qES 411TS
AEC(s): ❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A
❑ PWS: ❑FQ
ORW: yes f/ro. PNA yes / no; i Crit.Hab. yes /01'
Type of Project/ Activity �' {iv f
1
Pier (dock) length
Platform(s)
Finger pier(s)
Groin length
number
Bulkhead/ Riprap length?O,;'
-• avg distance offshore
max distance offshore
Basin, channel y
cubic yards _
Boat ramp
Boathouse/ Boatlift
'
Beach Bulldozing
Other
�77 -
'Shoreline Length
SAV: not sure
_
yes o
?Sandbags: not sure
yeso
(no/
Moratorium: n/a
yeso
;Photos:
yes
Waiver Attached: Yes
Subdivision
City ZIP
Phone # ( ) River Basin
Adj. Wtr. Body .¢' s �, ' = / r(nat;/man /unkn)
Closest Maj. Wtr. Body
tt err}
(Scale: )
A building permit may be required by:
Notes/ Special Conditions Z )
*! See note on baIT regarding River Basin rules.
AU6 12 20m
v
d
(Agent or Applicant Printed Name 1' s P`e`+rg�mitofficer/ s Signature
Siignature Please read compliance statement on back of permrc'r*`. IssuinglDa e 9 r f / Exlpiration Date
Application Fee(s) Check #" Local Planning jurisdiction' 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 [)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:
QTar - Pamlico River Basin Buffer Rules F1 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 Morehead City Headquarters
Mailing Address: 400'Commerce Ave
1638 Mail Service Center Morehead City, NC 28557
Raleigh, NC 27699-1638 252-808-2808/ 1-888-4RCOAST
Location: Fax: [phone]
2728 Capital Blvd.
Raleigh, NC 27604
919-733-2293
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
A4j';AW
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management -
Pat McCrory Braxton C. Davis John E. Skvarla, III
Governor Director Secretary
Date —7 —Jr—
Applicant Name I o,, ; ir>
Mailing Address 26h % �w,Z,,,,� /ZJ3 -
G� C 2 s/
y
I certify that I have authorized (agent) �� �,�.,,� �a�i wSo•.J to act on my behalf, for the
purpose of applying for and obtaining all CAMA Permits necessary to install or construct (activity)
at (location)
Zoe � )/ L- ..a ,3J/L ,. RECEIV I►
JUL 2 Q 2014
Dr 1,111 "�'.. C;TY
'This certification is valid thru (date) l 2
Signature r 9 i Lam_
e
pa,
CEit
AUG .1.2 2014
DC&r MHj CITY
400 Commerce Ave., Morehead City, NC 28557 One
Phone: [phone] FAX: [phone] Internet: www.'nccoastalmanagement.net NoiffiCarohna
An Equal Opportunity 1 Affirmative Action EmployeraturaL`

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at
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For delivery information visit our:website
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Certified Fee
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Return Receipt Fee
(Endorsement Required)
to {{
-Postmark
Here
(Endorsement Requ red)
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PO Box No.
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or
PS Form 3$00 Au ust 2006 '""'''� rx" r
See Reverse for Instruction

■ Complete items 1,.2, and 3. Also complete"~�
ite►»' lf,Restricted Delivery is desired..-:.
■ -rint your name' and address on the:reyerpe
so'that we can return the card to you:
■ Attach.this card to the back of the mailpiece,r
or on the front if space permits.
1. Article Addressed to:
Asa'4, /4- VZIZIF'X�
�-
❑ Agent
C. Date of Delivery
N delivery address different from item 1? ❑ Yes
If YES, enter delivery address below: ❑ No
JUL 2 �j 2014
%-,alc!;' 4 / M(_ _ 2Zo3
2. Article Number
(Transfer from service label)
li PE Forrh'3811, July 2013
17914110510
tt4e Type
Certified Maila ❑ Priority Mail Express'"
❑ Registered ❑ Return Receipt for Merchandise
❑ Insured Mail ❑ Collect on Delivery
4. Restricted Delivery? (Extra F
013112 (1588.9572,
Return Receipt
❑ Yes

UNITED STATES AMRVICE
275
First -Crass Mail
Postage & Fees Paid
USPS
Permit No. G-10
• Sender: Ple se print yoq)4atfie, ,and ZIP+4® in this box•
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ADJACENTRIPARIAN PROPERTY OWNER STATEMENT
(Adjacent Property wrier InfoWMMW'Cffy
Si ature
Print or Type Name ,, „
R
hereby certify that I own property adjacent to 1DAUTO' M{ --7 lz eY-Xi E %�s�-t 's
(Name of Property Owner)
property located at- 20e - �- --' - .._.• ... .
(Address, Lot, Block, Road, etc.)
on p'Aw1 s C n ��,� , in '�Z,4 u-. / , N.C.
(Waterbody) (City/Tow and/or County)
The applicant has described to me, as shown below, the development proposed at the above
loc tion.
l/ fJ'- I have no objection to this proposal.
have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(Individual proposing development must till in description below or attach a site drawing)
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RECE
WD
JUL 29 2014
DCMMHDCITY
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.)
I do wish to waive the 15' setback requirement.
AUG 12 2014
I do not wish to waive the 15' setback requirement.
(Property Owner Information)
�(?�c-
Signature
' Av',Q G, "' RAT 1413u..J
Print or Type Name
Zoo
Mailing Address
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City/Sta e/Zip
t -- `�J3
Telephone Number
it /V
Date ate --
UVJ, l f'0 Jrs (Re
2,9r16
8/2012)