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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 consistent with the North Carolina Coastal Management Program.
River Basin Rules Applicable To Your Project:
Tar -Pamlico River Basin Buffer Rules
Neuse River Basin Buffer Rules
0 Other:
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/ 1-8884RCOAST
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

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N.C. DIVISION OF COASTAL MANAGEMENT
AGENT AUTHORIZATION FORM
Date
q- � - lS
Name of Property Owner Applying for Permit:
SCa��
Mailing Address:
Ul/j 0 0 12,
ot,c'j orf- P•& Z��7C7
I certify that I have authorized (agent) ,�oSuL �-kSU►''���'�/e `�"'"�to act on my
behalf, for the purpose of applying for a/nd obtaining all CAMA Pe/rmitss necessary to
install or construct (activity) `�- �G�i1 b�ccl</
at (my property located at) 72 pt '6 6
Z-- -P 5 -s`7
RECEIVED
This certification is valid thru (date) t / APR 17 201S
Owner Signature Date

From: Angela O'Daniel <[e-mail]>(f
Subject: Adjacent Riparian Property Owner Statement
Date: April 14, 2015 4:41:48 PM EDT
To: "jsloan2l @ec.rr.com" <jsloan2l @ec.rr.com>
Cc: "David Johnson Jr @ MSN" <dhcc303C&msn.com>
Mr. Sloan,
The attached is sent per Mr. Johnson's request.
Kindly confirm receipt.
Angela
Angela O'Daniel
CFOI Johnson Management
Johnson Automotive
5839 Capital Boulevard Raleigh, NC 27616
o: (919) 877-19941 f: [phone]
[e-mail]
Lexusl Hyundai I Subaru I Porsche I Honda IMaserati IFiatlAlfa Romeo
AR+*= PJE&W EROEERTI OWNER STATEMENT
I hereby cerdtq that I own properly adjacent to. 1 ,) A, gf ?� ri 's
property located at S� T /3 We66 -'Nm* o O s
Address, Lot, , eto
on ��M%&V's I In N.C.
I (Watwbody) (Cr4mowa anwor co )
The applicant has described to me, as shown below, the development proposed at the above
location.
I have no ot>joion to this proposal.
1 have objections to this proposal.
DESCRWMM ANMR DRAWING U PROPOSED DEVELOPMW
Px#vM W proPoMby devekpimentmust 0todawr40oab *raw or&Mobasrtedrawrng)
31�D Z-
WANER.8,G=
I understand Mat a {ter, dock, MOWN plNngs, braaMWW, boathouse, lift, or groln .must be set
back a minimum dletance of 15 from my area of riparian access unless waived. by me. (if you
wish to waive the setback, you must InWal the appropries blank below.)
do wish to waive the 16 setback requitenvinL
1 do not wish to waive the 19 asAtim* rem*wrAnt
RECEIVED
APR 17 2015
KP-"sue CUY
59 KB

From: Rick Sykes <rickQramjackusa.com>Lf
Subject: Fwd: Scan Doc.
Date: April 13, 2015 8:50:30 AM EDT
To: Jim Sloan <[e-mail]>
Here you golf
Sent from my Phone
Begin forwarded message:
From: Denise Liles <[e-mail]>
Date: April 13, 2015 at 8:49:41 AM EDT
To: Rick Sykes <[e-mail]>
Subject: Scan Doc.
Thank you,
Denise Liles
Administrative Assistant
Ram Jack
919-309-9727
Fax [phone]
I hereby certiry that I own property adjsowAto 11 ! S/oq ►J S
property located at 52 0 klea Crf :(Ni1 e o
on 542M&O"3 << N.C.
fflaftro) (CNyfTawn andlor Cou )
The applicant has described to me, as shown blow, the development proposed at the above
kxwtio
I have no obiedion to this proposal.
I have objecdorw to this proposal.
DEWMPTKM ANDIOR DRAYWNO OF PROPOSED DEVELOPIIIENT
l7hd1vkW PrOPOOV dwakpatentnrtratfl8 In dbwdplfon befowor agesch a aft draw/ngo
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3 1�a Z-14�-'
1 Attachment, 59 KB
RECEIVED
tNANER SECTION
I understand that a pier, dock, mkwrkhg pp'�s, Ir waW, boat no% IHt, or groln mhat be set APR 17 2015
back a n*bnum distance of 16 from my area of riparian socess unless waived by me. (If you
ansh to waive the setback. you must InNta1 the appropriate blank below.)
I do wish to valve the 1S setback requirement
I do notwish to waive the 1V setback regrdrement
(P ovrrrar IMorrrratlon) (Adjacencioperty owner Information)

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