Renfrow, Hilton

❑DREDGE & FILL
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GENERAL PERMIT
Previous permit#
New ❑Modification ❑Complete Reissue El 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 JH ! t j
4pplicant Name '�' E ''' f� -r / ,' )
Ef Rulesattached.
Project Location: County_✓
*ddress.' l%.. y?
Street Address/ State Road/ Lot #(s)
City, State P ZIP
Phone # (� t Fax # ()
Subdivision
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Phone# ( ) River Basin "it,
Affected
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Type of project/ Activity /
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Pier -+
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Fing
Groff
Bulk
Bash
Boat
Boat
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A building permit may be required by. f'�') 1J, ; . I l� ❑ See note on bac regarding River Basin,rules.
Notes/ Special Conditions i `, . t ; E•1,: i t �' r �" r� + �, v i- r i; [ ^l J�
r
'
Agent or Applicantp_rinted Name '
r,
PermrcOffiters
S' ature a ..
' Si nacre!`Please r6dcompliance statement onback ofpermit
Issuing Date
r E} Expi tion ate
J
Application Fee(s)
Check #
Local Plannmgjurisdiction
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 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, certifythat this 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 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

APR-13-2015 12:21 From:DCM MHDCTY
4'
Date
To:93936146
!v C-40
J OF COASTAL MANAGEMENT
'AUTHORIZATION FORM
Paee:2
Name f Pre rty Owner ( pplying for Permit:
ftq
Mailing Address:
f
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 (activist*) .' ek SRC, i,
at (my property located At)I
RECEIVED
This certification is valid thru (date) APR X 71015
Property Owner Signature Date
RECEIVED
SG Y APR 15 20b
�}� `-DCM-MHO CITY

(Name of Property Owner)
rppertX-IQQatJP(
/� (address, Lot, Block, Ro
on ad, etc.
��� , in 45 , N.C.
(Waterbody) (CitylTown and/or County
The applicant has described to me, as shown below, the development proposed at the above
locati n.
have no objection to this proposal.
1 have objections to this proposal.
DESCRIPTIONIANDIOR DRAWING OF PROPOSED DEVELOPMENT
(Individual proposing devolopMent must flll In description below or attach a site drawing)
Sw« LA
i
i
WAIVER SECTION
I understand that a pier, doick, mooring pilings, breakwater, boathouse, lift, or groin must be set
back a minimu ;stance of 15' from my area of riparian access unless waived by me. (If you
Wish to wai a setback, you must initial the appropriate blank below.)
I do wish to ive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(Property Owner Information). (Adjacent Pro Own Information)
• c '
Signature Ir Sig
,✓ �«J 1.�Si � A �f2 5 0
Ptin[ or Type Name PrintAr LYp� Name
�M ����
6 --
Ma Ifi Addres Mailing Address
84ty fate/Zip City a e/li RECEIVE[)
Telephone Number Telephone Number OR 17 2015
Date Date
(Revised 6/182012)
RECEIVED
F
APR 15 1015
DCM-MHO CITY

r
APR-13-2015 12:21 From:DCM MHDCTY To:93936146 Pa9e:1
.Division of Coastal Management
I
AM
(Zt0Z1gt/9 pesIAaa) I WDENR
North Carolina iDepartment of Environment and Natura Resourcesviva
awQ
Pat McCrory, Govemor Braxton Davis, Director Donald . van der Wart, Secreta
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Morehead City Office
400 Commerce Avenue
)rehead City, North Carolina 28557
Phone: - 252-808-2808
FAX: [phone]
www.nccoastalmanaaement.net
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APR-13-2015 12:21 Frgm:DCM,MHDCTY
To:93936146 Paee:3
• I hereby certify that 1 own property adjacent to E 's
- T + r• .:: _ I �O a,,., .. _ ...`••��... (Name
o� operty Owner)
At
(Address, Lot, Jock, Road, etc.)
on o S O in „�r le ;� �Si�l, N.C.
aterbody) (City/Town and/or County)
The applicant has described to me, as shown below, the development proposed at the above
local
1 have no objection to this proposal.
I have objections to this proposal.
DESCRIPTIONJANDIOR DRAWING OF PROPOSED DEVELOPMENT
(Individual proposing development must fill In description below or attach a site drawing)
SV'�
':--'
Rgulvp)
APR 17 2015
DCM-MHD CITY
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 ive the 15' setback requirement.
1 do not wish to waive the 15' setback requirement. --
(Property Owner Information)
Print or Type Name
Mailing Address J _
Telephone Number
(Adjacent Property r Informati n)
& G
si r,.,'NL t v�
Pri t or� e �r►le �v "tCA f
Telephone Nu�
Dare
RECEIVED
APR 15 2015
DCM-MHD CITY
z.,7,- 110
(Revised 61182012)
i

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❑ .
Omer Courty
<all othervalues>
Cart
PIN
Acreage
Parcel Dimensions
Lot Number
7
RECEIVED
APR 17 1015
Sew"Ria Wl?V
http://carteret.connectgis.comIDownloadFile.ashx?i=_ags_mapcd4b7l ee3e l74e2783fcf2f6... 4/16/2015