Seitter, John

` CAIIVIA / ❑ DREDGE & FILL
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GENERAL PERMIT
Previous permit#
❑Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued
//New
As authdrized by the State of North Carolina, Department of Environment and Natural Resources
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and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC (f
1 1 i7t
;Applicant Name 1�1 (`fit v 7 1
Rules atta ed.
Project Location: County CO. 1 `t
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ddress err 11 e
Street Address/ State Road/ Lot #(s)
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City
State) ZIPS 7 �
Phone # ( j r�)1 'T_T) Fax # (_)
Subdivision — # ) {. `i j(
t4uthorized Agent tf" C ) 1, ! " ° ` ?,1/ i (
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City. - .�-A (�_ZIP
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❑ cw ..���w�.3 TA ❑ ES ❑ PTS
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7 ! River Basin ! r
Phone # `�
Affected
O ❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A
AEC s :
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Ad'. Wtr. Bod � f'- (: -( .{, f �%�✓ �
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❑ PWS• ❑FC•
Closest Maj. Wtr. Body r`I
ORW: yes / fio� PNA yes / q Crit.Hab. yes / no
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Type of Project/ Activity `'i I o�-
Pia,' /1
_ (Scale:
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number
■■■■■MNEWME■■■■■RIMMr-�"Wat01!
■■■■■■■/211
ONE
■■■■■
■■■■■■■■■
■■■
■■■■
avg distance offshore
■■■■■■■■■■■■■■■■
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max distance offshore--
■■■■■■■■■■■■■
■■■■■■■■■■■■■■■■■■
■■■,■■■■■e■■■■■■��■■■
cubic yards'
■■■■■
■■■■■■■■■■■■■�i/■■■�■■■■■■■■■■■tl■■■
■■■■■■■■■■■■■■■■r►■■■■■■■■■■�■■�■■■s�■■
ramp
Bulldozing
MEMEMEMMEMEMEM
Rol
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dine Length
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71
A building permit may be required by: ❑ See note on back regarding River Basin rules.
Notes/ Special Condition !(i 1 i(^% r I : ) i �' 1 /i t \ -i -� i���/ J ! / ! E �" )(f - t %C
' � /i ' �"L �'� t ►, r ;'�"' (:.1.,1. , l r ��� r L `� (i;'^ � 1 � / l l 1 E � j �',� l t � i � l r•4 i (• '} z ! I ,,� a c ;_;_
•
Age t or Applicant Printed Name Permit Officers Signature
rr;
Signatyr* IPleasg read compliance statement on back of permit Issuing Dace Expiration Date i
Application Fee(s) Check# Local Planning jurisdiction RoverFile Name

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:
❑ 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 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 howto complywith 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/ I-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

T" s/��7 LIia1,3f:c `� r - -
Applicant:
Date.
g4a 5�ym'
Describe below the HABITAT disturbances for the application. All values should match the name, and t3units o easurement
found in your Habitat code sheet.
Habitat Name
DISTURB TYPE
Choose One
TOTAL Sq. Ft.
(Applied for.
Disturbance -total
includes any
anticipated
restoration or
temp, impacts)
FINAL Sq. Ft.
(Anticipated final
disturbance.
- Excludes any
restoration
and/or temp
impact amount)
TOTAL Feet
(Applied for.
Disturbance
total includes
any anticipated
restoration or
temp impacts)
FINAL Feet
(Anticipated final
disturbance.
Excludes any
restoration and/or
temp impact
amount
Dredge ❑ Fill ❑ Both ❑ Other
Dredge ❑ Fill'[] Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both* ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ .Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑ .
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both [I Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ _ Fill ❑ Both ❑ Other ❑
Dredge ❑. Fill ❑ Both ❑ Other ❑
MAR 2 8 ' 2014
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N.C. DIVISION OF -COASTAL MANAGEMENT
AGENT AUTHORIZATION FORM
Date �,PR— Zd / C4
Name of Property Owner Applying for Permit:
Mailing Address:
2 Z 2 /(JD/c'C//
/V/ocv c�r�.r hoc
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I certify that I have authorized (agent) (:7 'pb N �to act on my
behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to
install or construct (activity)©�
at (my property located at) 2
This certification is valid thru (date) / 2 0 % T
Property Owli+er Signature Date
MAR 2 g 2014

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ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to J 0 H N SE .T ! '% E JR is
(Name of Property Owner)
property located at 222 tyo12' N SMOAK DA, 6�-,Wt4mQ Pock It enow"40'Or **-
(Lot, Block, Road, etc.)
UA,49,0
on A100W R E in 13 �4ll �� T ` >?P�'.% , N.C.
aterbody) (Townfind/or County)
Applicant's phone #: 2 5j2-8i 3 —2 7 2 7 Mailing Address: 222 NC•? r 42 LMIle 04
6S4meeR o- )r C. a fps/6
He has described to me, as shown below, the development he is proposing at that location, and, I
have no objections to his proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be, filled in by property owner proposing development)
.b�N S� lrr�� w2cva.�dlrY
APB,-00,t 13 a•
,;(,f
a JOILJW&G --T Z)
ot) 5fx
P A OW
(Information for Property Owner Applying (Riparian Property Owner Information)
for Permit)
as NaI?rx 5Pat- Of
Mailing Address Signature
A/C 8 8 5f6 `° �9 e. 215
City/State/Zip Print or Type Name
212- 813-2227 Sa —505e--60? /90
Telephone Number Telephone Number
Signa a Date Date
MAC •L g c01�
'ACM-WD C1Ty

ADJACENT RIPARIAN PR. -PERTY ONVNER STATEMENT
I hereby certify that I own property adjacent to J a H lr/ 3.4- 1 7-,r E -4 's
(Name of Property Owner)
pmpertY located at 2 2
(Lot, Block, Road, etc.)
&C.
on AbQM aferiwdy) �
(— (Town orCounty)
AppiiegnVs phone #: - t 3 -7177 Mailing Address; - 2 a ti0-4 r R SIr*dllE �?/i
7844rre: d k tt" u- C 351
He.has described to me, as shown below, the development he is proposing at that location, and,1
haw no objections to his proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED.DEVELOP1MM:
(To U f `rued in by property owner proposing development).
J01W Se l rreje pdR0,041"JeTY
(information for -Property Owner ApPlYing
for Permit)
22 a *01?tr $ e �$
Mailing Address
awstate/Zip.
25-7- $13-2777
Tele . e Number
4 !
Si Date
*ApRax t eS If.
Jqt
Owner
signa=e
" ! LEE 601 5
Print or Type. Name
eacm�250-51S--.2q1
Telephone Number
-7 ly
Date
e a�
2
1)cmNmCITY

gthomas3
From:
gthomas3 <[e-mail]>
Sent:
Sunday, March 23, 2014 8:15 PM
To:
Dr. Jim Lewis [e-mail])
Cc:
[e-mail]
Subject:
Dock Permit Form for Signature
Attachments:
scan0001.pdf
Dr. Lewis,
Hope this finds you and Carol doing well. As you may recall John Seitter applied for and obtained a dock
building permit last year and due to unforeseen circumstances the permit lapsed prior to the dock being
constructed. With my help he is in the process of re -applying for another permit. As with the previous
permitting process the adjacent property owners are ask to sign an "Adjacent Riparian Property Owner
Statement". I have attached a PDF file with the completed form of which John is requesting your signature
and date. Please email the PDF form back to me with signature and date at your earliest convenience.
Thanks and see you in a few weeks.
George Thomas III
OLSV5D

athomas3
From: Lewis, James <[e-mail]>
Sent: Thursday, March 27, 201410:15 AM
To: [e-mail]
Subject: FW:
Attachments: 20140327071531926.pdf
attached signed form _
Dr. James G. Lewis
Associate Dean of Basic Sciences
Professor of Pathology
-----Original Message—
From: saba.u.admin.officeAsaba.edu f mailto:saba.u.admin.officepsaba.edul
Sent: Thu 3/27/2014 8:15 AM
To: Lewis, James
Subject:
This E-mail was sent from "RNPA07060" (Aficio 3045).
Scan Date: 03.27.2014 07:15:31 (-0500)
Queries to: saba.u.admin.office asaba.edu
_. i�CEIVED
MAR 2 S 2014
DCM-MHDC rY
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