Saunders, Rick (2)

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GENERAL PERMIT Previous permit #
,(New . ElModification ElComplete Reissue ElPartial 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 15A NCAC %a
gRules attached.
r, C, Project Location: C —V
County ("I elr(,
Applicant Name
A!
Address— Street Address/ State Road/ Lot #(s)
r-7
°City ZIP _77�,4
'Phone #
Fax # (
Authorized Agent
Affected El CW Y h6V �FPTA DES El PTS
AEC(s): 0 OEA El HHF DIH 0 UBA 0 N/A
0 PWS: OFQ
ORW: yes no) PNA yes o Crit.Hab. yes ICnw n
Type of Project/ Activity
Pier (AdcwkUPnLPih_
Platfr,
Fing
Groi
Bulk
(Bai,
Bow
Bow
Beac
Othi
Sho
�SAV:
Sand
'Mor,
Phot
aWaiv
A bu
no,
Subdivision
A I iP J , 52 —7, le,i.
7,
City ZIP y V i,
Phone# ir�River Basin
Adj. Wtr. Body 0 -,'t t nat A_a`n')/unkn)
Closest Maj. Wtr. Body
(Scale:
e
Notes/ Special Conditions
a-k
cefs Signature Permitpwl
Agent �r�t Panted Nan*
Id,
-Signature Please read compliance statement on backofp`ermit Issuin
g Date Ex irit lonDate_
Application Fee(s) Check # Local Planning jurisdiction Rover File Name'
I

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 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
landowners).
The State of North Carolina and the Division of Coastal Management, in issuing this permit under the best available
information and belief, certify that this project is consistent with the North Carolina Coastal Management Program.
River Basin Rules Applicable To Your Project:
Tar - Pamlico River Basin Buffer Rules FI 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
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/ 1-888ARCOAST
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

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to
(Name of Property Owner)
I
property located at
(Address, Lot, Block, Road, etc.)
on , in , N.C.
(Waterbody) (City/Town and/or County)
The applicant has described to me, as shown below, the development proposed at the above
location.
_ 4 1 have no objection to this proposal.
have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(individual proposing development must fill in description below or attach a site drawing)
Dredging under existing boat lift to allow use at low tide
RECEWED
JUL 18 2014
WAIVER SECTION 37CM-1VIoc"
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.)
do wish to waive the 15' setback requirement.
wish to waive the 15' setback requirement.
Print or Type Name d L
M ' 'ng A ress
°-a
Ci4o/State2ip
n-16
Tel phone Nu/ brh er
i// 2 // u
Date
(Adjacent Property Owner formation)
01
Signature
Print or Type Name
Mai' g Address
�1� Z851Z
City/S-tall Zip
Telephong Number
Date
(Revised 611812012)

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to 's
(Name of Property Owner)
property located at
(Address, Lot, Block, Road, etc.)
on , in , N.C.
(Waterbody) (City/Town and/or County)
The applicant has described to me, as shown below, the development proposed at the above
location.
X 1 have no objection to this proposal.
I have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(Individual proposing development must fill in description below or attach a site drawing)
Dredging under existing boat lift to allow use at low tide
• MCI i �1!
JUL 18
DCM Y-M 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 waive the 15' setback requirement.
to waive the 15' setback requirement.
r w er ormation) (Adjace t Property Owner Information)
Si ture Signature
_Ralph Passino. POA for J H Passino
rint or Type Name Print or Type Name
2/'1'r d A/ 341 Harbor Dr.
Mai ' AddFess Mailing Address
Old Hickory, TN 37138
City/StaterZip City/State/Zip
/d -f- -2-fA4 X 252-51"744 _
Telephone Number Telephone Number
_J
uly July 11, 2014
Date Date
(Revised 6/18%2012)