Sanderford, Larry

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CAMA / ❑DREDGE &FILL��
A B D
r'.CAGENERAL PERMIT Previous permit#
mfNew ❑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 Res urces Commissi n in an area of environ riental co tern pursuant to I SA NCAC
! ! �( ule attached
Applicant Name ; �• L. d Project Location: County
A
ddress . a " �,.:�.k i ` Street Address/ State Road/ Lot #(s) x
City ` , , , o- f State ZIP j3 'i ; j
I Phone # l` t o.kelivie;,.,. f
Authorized Agent
Affected ❑ Cw Ew PTA
❑ OEA ❑ HHF kl
AEC(s):
❑ PwS:
ORW: yes / IPA'\ PNA yes /
Type of Project/ Activity
cubic yards
Boat ramp `'""`
Boathouse/ Boatl
Y
Beach Bulldozing ��##
Other
a
❑ ES ❑ PTS
❑ UBA ❑ N/A
city
Phone # f _; ) J.
Adj. Wtr. Body, !' i f
Closest Maj. Wtr. Body
Shoreline Length I
I f P
SAV: not sure yes I' no
Moratorium: n/a yes t no
Photos: yes '•no
... .... ... ....._.................... ..... ........._..........................._...........
Waiver Attached: yes ''no
A building permit may be regTred by:
1 'f ''• i I �w
(Note Local Planning Jurisdict n ✓
''� /
T.
Notes/ Special C nditions�
f'V, i.. .1�i 1 A �Jc .
fl
»
Agent or Applicant Printed fa
Pe
Signature' .* Please read compliance statement on back of permite
Sid
ApphcationFee(s)
Check#
a
'�'1fio_ ., .,i ..?.ti..n �r b ,�. � >>, .�:. .�„i.^
'ice: �C �., n. a�•N
y .T.���., fi ZIP
River Basin. I `,
f
I I I I I I I I I I I I I I I I I I I I I I I I y
❑ See note on ba�k regarding River Basin�rules.
mrtOfficer's�Printed Name.
nature
ling ate I dxpirati,6n bat .'
Vv...w s. ,.gib � ,. ..,. ...., a u . +�f^, i*.•. ;N

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, certifythatthis project is consistentwith the North Carolina Coastal Management Program.
River Basin Rules Applicable To Your Project:
Tar - Pamlico River Basin Buffer Rules 0 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 how to comply with these buffer rules.
Division of Coastal Management Offices
Morehead City Headquarters
400 Commerce Ave
Morehead City, NC 28557
252-808-2808/ 1-8884RCOAST
Fax: [phone]
(Serves: Carteret, Craven, Onslow -
North of 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 - South of New River Inlet -
and Pender Counties)
http://www.nccoastaimanagement.net/
Revised 08/27/ 14

AGENT AUTHORIZATION FORM FOR PERMIT APPLICATIONS
Name of Property Owner Applying for Permit: I-AW
Mailing address: �?��j On U/1tw i3�rD
C-
Telephone Number: -ra
I certify that I have authorized -6j5 (agent/contractor),
to'act on my behalf, for the purpose of applying and obtaining all CAMA permits
necessary for the proposed development of __�`C.ajq-G//J6 ?jack -
at my property located at 2 q S ;F>19� 4 ICt,.� fff 4 itrL1 rL W c t'(
This certification is valid through (date).
(Property Owner Information)
RECEIVED
JUL 2 8 2015
ignat—U4
-- Print or Type r
Title, co, owner or trustee for property
Date
Telephoofe Number
Email Address
RECEIVED
NOV 0 4 2015
DCM- MHD CITY

DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION FORM
CERTIFIED MAIL - RETURN RECEIPT REQUESTED
I hereby certify that I own property adjacent to J-. C RIN -56 OXRt ab 's
(Name of Property Owner)
property located at 6M 4115W W,W'o
(Address, Lot, Block, Road, etc.)
on dIRP i(Y W c-A144 4 - , in A- 4A A-rIC. WC9 . c4ggI/tl =- , N.C.
(Waterbody) (Ci y Town and/or Coun y)
Agent's Name Mailing Address: V / L3 &-V-D
Agent's phone Q5a►i
He/She has described to me as shown below the development he/she is proposing at that location,
and I have no objections to the proposal.
-------- ------------------------ ; ---------------------------------------------------------------------------------
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(Individual proposing development must fill in description beelow or attach a site drawing)
RECEIVED
Ar , o 4k' Q t L,10 JUL 2 8 1015 ItG
6e
Pt/f you have objections to what is being proposed, you must notify the Division of Coastal Manag ment
(DCM) in writing within 10 days of receipt of this notice. Contact information for DCM offices is
available at httn://www.nccoastalmanagement.net/web/*m/staff-listing orby calling 1-888-4RCOAST.
No response is considered the same as no objection if you have been notified by Certified Mail.
(Property Owner Information)
Signature
Print or Type Name
Mailing Address
City/State/Zip
Telephone Number/Email Address
Date
(Riparian Property Owner Information)
ignature
CA49+tqg�- 6 f �lLl
Print or Type Name
Mailing Address ®C C E t 0 E D
City/State2ip
NOV 0 4 2015
Telephone Number/Email Address ACM- MH® CITY
Date
(Revised: Aug. 2014)

Jul.07.2Q15 01:15 PM ha.b 9195571946 PAGE. 1/ 1
.07--JLL-2015 12:07 From.,Guw C Lee Morehead 125e726022i To:19192821300 PAeeoi011
dF
" 11*0 DIVISION Op COASTAL MANAGEMENT
4 X,.1AgJACENTRIPARIAN eftiorCMUt
401, CERTII"IED MAIL, RETURN RECEIPT REQUESTED
1A I hereby certify that I OWn property adjacent to L &egl 1i Qgsnm's
(Name or Property Owner)
propsrt ca ted at oZ L15
1 "
'L (Address, Lot, Black, Road, etc.)
'To
'
� '"J °n4 , in ,��i1 -i0
mef!1*1111*7" , N.C.
(Waterbody) (01tylTown andior County) RECEIVED
Agent's Name Meiling Address; �----. � i2 E�
JUL 2 8 1015
Agent's phono #A$P.
He/8hs has described to me as shown below the development he/she is proposing at that location,
and I have no objectlons to the proposal.
-------------------------------------- ------ ---............................. _...—---- —--------- ---...............
QEBCRIPTION AND/OR DRAWING OF PROPOSED DEV91.0112MENT
(individual Proposing development�must fill in description below or attach s .site drawing)
AM
STt11
6�
v have objections to What Is bainp proposed, ya rust notify the Division of astsl M►e»sgement
(DCM) in writing within 10 days of receipt of this nOt/96, Contest InformsHen fcr DCM orrice$ is
+IY4iliebie at nee a stAliMl 8 ar. by ceflingr l-888-4ACOAS r.
(Property Owner informatlon)
Signature
Print or Type &eras
Melling Address
Te/aphone Number/ EmaH Address
IJate
(Rlpar Pr a Own In .or atlon)
(nature
-K
Print or Type Name
Mating Address
City/Siete/Zip
Telephone N�umber%Emall Address
�
(Revised: Aug. 2014)
RECEIVED
NOV 0 4 2015
®CM- MHD CITY