Sea Spray, LLC

LL
INKIIA El DREDGE& FILL-S
N
N) 66710 A B C D
ENERAL PERMIT Previous permit #
ew ElModification ElComplete 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
Mules at
tached. h
Applicant Name Project Location: County
Address Street Address/ State Road/ Lot #(s)
N,
City Stat ZIP
Phone # i Subdivision
J
J Authorized Agent City ZIP LLZi
0 Cw IkEW N�!PTA DES 0 PTS Phone # River Basin i a % a t r'r=
Affected
El OEA 'D HHF 0 lH El UBA El N/A
AEC(s): Adj. Wtr. Body__iv 0 at` Iman /unknj
0 PwS:
ORW: yes /�no lPNA yes /(no Closest Maj. Win Body
Type of Project/ Activity ,-f
Pier (dock) length
Fixed Platform(s)
Floating Platform(s)
Finger pier(s)
Groin length
number
Bulkhead/ Riprap length
avg distance offshore
max distance offshore
Basin, channel
cubic yards
Boat ramp
Boathous.xBoh if "
Beach Bulldozing
<1" t '
Other � 1' "" : ( I i.'
Shoreline Length
SAV-. not sure yes j / no,
Moratorium: n/a yes kno
Photos: yes
Waiver Attached: yes no
A building permit may be required by:
Note Local Planning jurisdiction)
Notes/ Special Conditions
J
7�
7
4
—br Applicant Printed Name
PermitOfficer's Pr'
Signature Si n t ,*,016ase read compliance statement on back of permit" g a
t
4.
I%& Aoplicatiqn,Fee ' (s) Check# issuing
pEENNEMMMM
MMMM
IMEMEEMMMM
INEWINEMMMM
IMMINMEMOMM IME I
to on, back regarding River Basin rules.

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 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 complywith these buffer rules.
Division of Coastal Management Offices
Morehead City Headquarters
Washington District
400 Commerce Ave
943 Washington Square Mall
Morehead City, NC 28557
Washington, NC 27889
252-808-2808/ I-888-4RCOAST
252-946-6481
Fax: [phone]
Fax: [phone]
(Serves: Carteret, Craven, Onslow -
(Serves: Beaufort, Bertie, Hertford, Hyde,
North of New River Inlet- and Pamlico
Tyrrell and Washington Counties)
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)
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://vvvvvt.nccoastaimanagement.net/
Revised 08/27/ 14

Y
AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
StIA- s PRI)Y 1-6c C)
Name of Property Owner Requesting Permit: ti'mr-0
Mailing Address: / / 2
Phone Number: �2,52-- 2 2 ~- V 6 e
Email Address: �✓D�: �/ i % �I c G-�
I certify that I have authorized /'R/C
Agent / Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: 0"
Aq T G/f %
at my property located at �,�'4 /N 4— i D� , �i /v(f ASS 7,
in 41/%e'eFT� County.
l furthermore certify that 1 am authorized to grant, and do in fact grant permission to
Division of Coastal Management staff, the Local Permit Officer and their agents to enter
on the aforementioned lands in connection with evaluating information related to this
permit application.
Property Owner Information:
RECUVED
zz'&'�L L &VMAY 10 2016
Signature
/-, %w DCM- MHD CITY
Print or Type Name
Title
Date
RECEIVED
SEP 0 6 2016
This certification is valid through
DCM- PAHD CITY

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to 5` °/ '`
(Dame of Property Owner)
property located at 6 �1✓ l--�i Q� ��1 r��?Er�r� f r �T �
on ir�Pd�►: 1 WA(Address, Lot, Block, Road etc.)
014 y , N.G.
(Waterbody) . (CityJr'own andtor County)
The applicant has described to me, as shown below, -the development proposed at the above
i have no objection to .this proposal.
I have objections to this proposal.
DESCRIPTION ARID/OR DRAWING OR PROPOSED DEVELOPMENT
(Individual proposfng development must fill "in description below or attach a site drawing)
T► ' X .I.S l vL l
iVEwpo 47^ L�
4S14 6A? JrvF
WAIVER SECTION
I understand that a pier, dock,. mooring palings, 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. appropriateblank below.)
i do wish to waive. the 1`5' setback requirement.
l do riot wish to waive the 15' setback requirement.
(Property Owner information) (Adjacent Properly Owner Inform ion
g99CEIVED,'
Signature Signature MAY 1 0 2016
i,Jfi.tI ^6arci"7' ;Lf% ;;.,l.l -
Print or T pe Name Print br Type Name
glot DCM- IVIH.® CITY
MalbngAddress , Mailing Address
CffylSfa ./Zip City/state/Zip
Telephone Number Telephone Number ° i
Date, Datel" SEP 0�6 2016 -
(ReviDQW MH