Robinson, David

.d CAMA / 3 DREDGE & FILL
' GENERAL PERMIT Previous permit#
©New ❑Modification El Complete Reissue &eissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environment and Natural Resources
and the Coastal Resources Commission in anareincif environmental concern pursuant to 15A NCAC ("
' ❑ es attached.
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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:
0 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 (252-946-648 [)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
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

*SEP. 16.2013 2:42PM WELLS FARGO ADVISORS NO.361 P. 3
N.C. DIVISION OF COASTAL MANAGEMENT
AGENT AUTHORIZATION FORM
Date 'R, f L ct 1 13
Name of Property Owner Applying for Permit:
b o- '?JL TA l a s \ S ,, a-,
Mailing Address_
VL G a. r) k j t u
I certify that I have authorized (agent) to act on my
bebaK for the purpose of applying for and obtaining all CAMA Permts necessary to
install or construct (activity)
at (my property located at)
This certification is valid thra (date) l 2 + 10 — /3
af��tjt3
Property Owner Signature Date
MAY 2 3 2014
'flOWY. 3 CITY

Froc koresville Fire Admin 7046623842 09/16/2013 11:38
SEP. 16. 20131 8 j34 So?LIS FAROO ADVISORS36 N0.329
#145 P.001/001
P. 2
• ADJACENT RUARIW PROPERTY OWNER STATFMRNT
(FOR A PIEWNOORING FILINGSIMAIVIFTIBOATHOUSE)
I hereby certify f that I own property adjacent Jov,�l awcQ Si t
(Name of Property Owner)
property located at 6
(X,ot, B1oW Road, etc.)
on 01A*� wl'3 f C&AIA in , N.C.
(Waterbody) (Town and/or tounty}
He has described to nit, as shown below, the developrtient he is proposing at that location,
and, I have no objections to his proposal. I understand that a pier/mooring
pilings/boatlift/boathouse must be set back a minimum distance of fifteen feet (IS,) from my area
of riparian access unless waived by me.
I dp n t wish to waive the setback requirement. [
I sQ wish to waive that setback requirement.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be fdUd in by indivUual proposing development)
Rep�Ae-a 26W6,Ae
VOc ;"�' 2,6A-- 3-0 f , f-9'4
T _ E
MWED
MAY 2 3 ' 2014
DOM m ary
ignature
Print or Type Name
--Io4 - (,m 377 d
Telephone Number Date: 9 -- t L -- IS

o.
SEP.16.2013 2:42PM WELLS FARGO ADVISORS
NO.361 P. 2
.ADJACENT FJPARM PROPERTY OWNER STATE T
(FOR A NERIMOORING PILINGS/B0ATLIFr1BoATj76USQ
I hereby certify that I own property adjacent to --- " Wfft Re�, Is
(Name of property Owner)
property located at
Block, Road, etc.)
on wrs G� , in q f4!TVCAd40-r-A, N.C.
(Waterbody) (Town and/or ounty)
lie has described to me, as shown below, the development he is proposing at that location,
and, I have no objections to his proposal. I understand that a pier/mooring
pilings/boatlift/boathouse must be set back a minimum distance of fifteen feet (15') from my area
of riparian cress unless waived by me.
I do not wish to waive the setback requirement.
I da wish to waive that setback requirement.
DESCRIPTION AND/OR DRAWING OF PROPOSED MVELOPMENT:
(To be filled in by individual proposing devetopment)
MAY 2 310 `4
Daf.y'rz CITY
2
Signa & v
Print or Type Name
2 S72- - 7 z rr Or 0 2 I
Telephone Number
Date: 9 / t

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MAY 232014
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