Spooners Creek North Marina

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rJCAMA / ,Q DREDGE & FILL 4 C D
GENERAL PERMIT ALL! S Previous permit # A B ( ( +
QNew ❑Modification El Complete Reissue ❑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 ursuant to 15A NCAC
©-Rules attached
Applicant Name ;(,` `�� i ( 'ro ect Location: County
t tir �' I
! I;
Address i + s_ ` ft�- K Street Address/ State Road/ Lot #(s)
City t t �.1 State ZIP
Phone # O _ E_M�I Subdivision
Authorized Agent j �Z l"'.� �,j'�_l (`:i City a, �� ;i`.t_ ZIP
fj
Affected ❑ CW E ❑ EW f£r ] PTA ❑ Es ❑ PTS Phone # (�Rover Basin(
AEC(S): ❑ OEA ❑ HHF I`_71H ❑ UBA ElN/AWtr. Bod
N/A j y � t , ' �t I � � `� nat /man /unkn)
❑ PWS
ORW: yes / no PNA yes /o
Closest Maj. Wtr. Body r
Type of Project/ Activity
(Scale:"
Pier (dock) length ----
Floating Platform(s)
Finger pier(s)
Groin length ----
number--
Bulkhead/ Riprap length-�
avg distance offshore —
max distance offshore--
Basin, channel 4 1
ME
MEN
MENEM
NONE
M
ME
MMEM
M101
I
Mw
MEN
M
No
MEN
MEN
ME
ME
MEN
IMM
EE�MME11111
MEMENME
Boathouse/ Boatlift
MEN
MINIM
ON
Other
M
IBM
MOM
ONE
M
NONE
SAV: not sure yes no
Moratorium: n/a yes
Waiver Attached- es ��no
I
mom
WMIMMOMMEMM
ON
MEMMEN
NNE
A building permit may be required by: y,t i `� ,`` '• ( ❑ See note on back regarding River Basin rules.,- t
(SNote Local Planning Jurisdiction)'
Notes/ Special Conditio s � % t( /` j ; , i �`?; ` #' ,j ,fit j�(f� 10 ��l f ;�( i �r►! , '� : t f} �'-r r�! ( Jc' �1. � f��"'
Fcrl i
t;..� � � ,� �� �,� r _r � � ', !E,i` l,., � r � 1�f� �i,�'t i'��'�'� . ��*•-. n i �y }'� � �� � `.:, �, f.% r<._..�.�t .r�
i y r
AgentOr Appligant Printed Name Permit Officer s Printed 1`I ' e '
3 .r f
t r
Signature aPlease read compliance statement on b `ckof permit Signature
(
Application Fee(s) Check # Issuing Date Expiration 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
landowners).
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 ❑ 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
400 Commerce Ave
Morehead City, NC 28557
252-808-2808/ 1-8884RCOAST
Fax: [phone]
(Serves: Carteret, Craven, Onslow -
North of 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 - South of New River Inlet -
and Pender Counties)
http://www.nccoastalmanagement. net/
Revised 08/27/ 14

N.C. DIVISION OF COASTAL MANAGEMENT
AGENT AUTHORIZATION FORM
Date //- 2 /- /.ri,J
Name of Property Owner Applying for Permit:
Mailing Address:
I certify that I have authorized (agent) ,_a A A11A E-aaycft—Ly aaa2 - , ( t
behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to
install or construct (acti,
at (my property located
This certification is valid thru (date) � �b (I
- - -r-- -✓ - .. --- --a- -- -
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GO
RECEIVED
DEC 21 2015
DCM- IMHD CITY
/l- /I l.'
Date
RECEIVED
DEC 10 2015
DCM- Mf-,Ifs CITY

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
pa�n�' Cr-�-t-� Na►Zd-h m�r1Ne
hereby certify that I own property adjacent to -4 's
S 3 (Name of. Property Owner)
property located at 1 109 N4 E,- saw
(Address, Lot, Block, Road, etc.) ,
on S �o a n�c� S Ga �e-lL , in r n a r -21z-e ,a-ci L�j , N.C.
(Waterbody) (City/Town and/or County)
The applicant has described to me, as shown below, the development proposed at the above
location.
I .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)
�l1D V '-4,,) T—
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I
J,
RECEIVED
o'ZI 9 DEC 10 2015
WAIVER SECTION D C M - MHD CITY
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 un 1��®
me. (if you wish to waive the setback, you must Initial the appropriate blank belo .
_ I do wish to waive the 15' setback requirement. DEC 21 2015
V, I do not wish to waive the 15' setback ®cM
requirement. - MHD CITY
/�
(Prope Owner information) (Adj Prope ner Information)
ig
.4i#namm re
Ig
Print or Type JVame , t Print or Type r
rg
fling df1r(�� �� Mali �Address� / / G
�ty/5tate/Zip a c�� L7 !3l Z�3� City Stat ip
elephone Numbeerlemail a Te%one Number
j-1=! 2 Zz
D ee 3
Date.
- A-e,�(Revised Aug. 2014)
*Valid for one calendar year after signature*

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
S p YJ.Q/7g L PLIJ 6fL+,* (Ak(I
1 hereby certify that I own property adjacent to is
'S I n 3 (Name of Property Owner)
property located at t: <aw Co v- a-1-
(Address, Lot Block, Road, a c.)
on �j P�� n�e�S_ Cr'-c�� , in ipl' or�-WV41 C-t' -L , N.C.
(Waterbody) (City/Town and/or County)
The applicant has described to me, as shown below, the development proposed at the above
location. RECEIVE®
I .have no objection to -this proposal.
DEC 21 2015
have objections to this proposal.
14) -- -- --- --- - — - CtTY-- —
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPM
(in ividual proposing development must fill in description below or attach a site drawing)
4")
� 3
to
'ctu 'ti)5
RECEIVE®
9 DEC 10 2015
WAIVER SECTION
1 understand that a pier, dock, mooring pilings, boat ramp, breakwater, b0 ; IMbt&QITY
must be set back a minimum distance of 16 from my area of riparian access unless waived by
me. (If you wish to waive the setback, you must Initial the appropriate blank below.)
Date
I do wish to waive the 15' setback requirement.
1 do not wish to waive the 16 setback requirement.
9
--'.Jn ny"% l:> .. -
Print or T pe 1mUame
1 S'� �
Mailing Address 2 $
G r- "V l I � N • c,
3 City/State --
Telephone Number
Date
--- (Revised Aug. 2014)
*Valid for one calendar year after signature*