Segrave, Anne & Ryan

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CAMA / ❑ DREDGE & FILLn 67557
�iEN ERAL PER �64Previous permit # rE ;-
rrrized
PW Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued
As auth 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 1— 'k'{
pRules att?Ehed.
Applicant Name t ; `" ; a '
.'; '``,Project Location: County ' sp-
:,
Address `. s , t, ,t
t t'
Street .ddress/,.State Road/,Lot #(s)
Cifr.'' `i ti._`.k °; i.. f
ttt".
State' ZIP"`
Phone # ()�)S j M E-Mail - ..--
Subdivisions • ...
Authorized Agent --- - - -
City ZIP
.f
F ❑ ❑ CW A
.Affected
❑ ES ❑ PTS
Phone # (' l -
�. " <'� "r Basin !
�
OEA HHF ❑ IH
s :
UBA ❑ N/AEl
❑AEC
r •, ,.
Ad . Wtr. Body + � nat /man /unknl
❑ PWS:,
E ORW: yes /{�o .{ PNA yes /
,,
r
o+r
Closest Maj. Wtr. Body—
.._
j
Type of Project/ Activity
c'
t�
Pier (dock) length-�
Fixed Platform(s)'"'---f
Floating Platform(s)­
Finger piers) =
Groin length
number
Bulkhead/ Riprap length
avg distance offshore
max distance offshore `—
Basin, channel
cubic yards:�
Boat ramp ---_Y_O 1
Beach Bulldozing
Other '
Shoreline Length
SAV: not sure yes
no
Moratorium: Va yes
I o,'
Photos: yeso}
Waiver Attached: yes
i no
A building permit may be required by:
( Note Local Planning Jurisdiction
Notes/ Special Conditions
(Scale: j )
❑ See note on back regarding River Basin rules.
i
ti ent or Applicant Printed Name r'` PermitO, cer's Prii
Signature P.Je-ase read compliance statement on back of permit" Sigpatur'
Jame
Application Fees) Check Issum Date " . E
cpiration Date

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:
0 Tar - Pamlico River Basin Buffer Rules El 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
Washington District
400 Commerce Ave
943 Washington Square Mall
Morehead City, NC 28557
Washington, NC 27889
252-808-2808/ 1-888-411COAST
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://www. nccoastaimanagement.net/
Revised 08/27/14

Y�'=

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to vt 4.- 4. � 's
(Name of Pro erty Owner)
property located at A VJQ
(Address, Lo , Bloc , Road, etc.)
onin , N.C.
(Waterbody) (City/Town andkir County)
The applicant has described to me, as shown below, the development proposed at the above
location.
I 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)
13'0'r�t s, t
,k 'i s14
WAIVER SECTION
I understand that a pier, dock, mooring pilings, boat ramp, 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.
t.� I do not wish to waive the 15' setback requirement.
(Property Owner Information) (AAacent Propofty Owner Information)
Vtt
Signa re2-u (n
Si a tr
Print or Type Name Prrn o T ame
Mailing Address Mai Ad s
C,44 o IQ C ;��fis �: ,7 RECEIVED
City/Statelzip �� C lS to i �
Telephone Numberl email address Telephone Ntimber/email address
Dale 1)afe
(Revised Aug. 2014)
*Valid for one calendar year after signature*

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to N l' �° �dc��, `
�r�1`vJ jL (, --4�'t�- 's
(Na e o Property Owwr er)
property located at o4c, C
,C,
(Address, Lot, Bloc� Road etc.)
on e: CCc _,in_ A: A_ x u , N.G.
(Waterbody) (City/Town and/ r 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.
I have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(individual proposing development must rill in description below or attach a site drawing)
v9c' 1,
/,I Ile,
WAIVER SECTION
I understand that a pier, dock, mooring pilings, boat ramp, 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.
I do not wish to waive the 15' setback requirement.
(Property Owner Information) (Adjacent Property Owner Information)
l i•L^.i l :.,-. 4r'E4 l`� v'fr� r � ��,. i:�/. � -- ,gin.... ♦ i „/ t...� .r.,�f
Signature ' St m lure
{
Print or Type Name` Print or Type Name :!
Mailing Address Marling Address
v �.� ,�-:�''� � " - f ,.=_,1 1 i• '�»; t„-3 �+..�, is �., v.. .
City/Statelzip City/State2ip
Telephone Number/ mail address Telephone Numbed oma# address
-- __ ........................................... .........
........_ _
Date I)ate*
(Revised Aug. 2014)
*Valid for one calendar year after signature*
RECEIVED
JUL 2 4 2015
"*Ih y f;g+'

I . .
The outer pylon dimensions of lift will be a maximum of 12.5 feet, based on the
width of the current slip.
RECEIVED
JUL 2 4 1015