Stallings, David

0 F Ati
A [DREDGE & FILL NO* 6`7046 A a D
ENERAL PERMIT Previous permit #
New ElModification 0 Complete Reissue ❑Partial Reissue Date u permit issued
iz
Asauthor authorized byl 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 15A NCAC f 441(f
EJ Rules attached.
J
Applicant Name Project Location: County -
Address Street Address/ State Road/ Lot #(s)
City State zip - eL,
"I' U A -Mal allw.
Phone # �utdivision
ZO, Authorized Agent 0. city-
E-1 Cw S 0 PTS Phone # River Basin
Affected
OEA 0 HHF 011H tUBA 0 N/A Adj. Mr. Body (nat /�an
El
AEC(s): /unkn)
0 Pws:
Closest Maj. Wtr. Body
ORW: yes PNA yes/ ono
Type of Project/ Activity k..
(Scale:
Pier (dock) length
Fixed Platform(s)
Floating Platform(s)
Finger pier(s)___:::
Groin length
utnb er
yklkk!!q/1R1prap length J
ayg distance offshore—.
max distance offshore
Basin, channel
cubic yards-
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing.-.-
Other —
Shoreline Length U 4!L
SAM not sure yes no
Moratorium: I n/a yes (no
... .. . .. .....
Photos: yes �o)
Waiver Attached: yes 0)
A building permit may be required by:
Note Local Planning Jur
isdiction)
Ix,•
Notes/ Special Conditions� t.
ij
An
A
t v
Agent or Applicant Printed Name 6 Pen
*tP n bJ otpermit Signature' Aease readcompliance' statement o Sigr
Iss
Checkf, A�plicationFeels)
tte
❑ See note on back regarding River Basin rules.
V"

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 consistent with the North Carolina Coastal Management Program.
River Basin Rules Applicable To Your Project:
0 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/ 1-888-4RCOAST
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

AGENT AUTHORIZATION FORM FOR PERMIT APPLICATIONS
Name of Property Owner Applying for Permit:
Mailing address:
Telephone Number:
zjqj9 795 5375
0-
l certify that l have authorized (agent/contractor),
WnVI
to act on my behalf, for the purpose of applying an obtaining all LAMA permits
necessary for the proposed development ofloraas4r,.11
lk -% _ a .. .
at my property located at
This certification is valid through ,� 2-5 ~�_ (date).
(Property Owner Information)
Signature ci
cl S 4a / 11,
-<i
Print or Type Name
d
Title, co. owner or trustee fo roperty
q / / (P
Date
! lCiS- 95
Telephone Number
Email Addrlhn
OCT 01 2015
DCNI- MHD CITY

PIACENT RIPARIAN PROPERTY gliVNi , ER STATEMENT
.
i hereby certify that l own property adjacentto__ ,4✓1 xs
property located at
Name of Property Owner)
�°�� � .Y �' � �� �f�f
onPDa�,5 {Address, Lod, hock cc�dtc.}
(Waterbody) (Citytrown andlor County)
he applicant has described to me, as shown below, the development proposed at the above
ocatio
1 have no objection to this proposal.
1 have objections to this proposal.
®ESORIP110N AND/OR DRAWNG OF PROPOSED DEVELOPMENT
(individual proposing development must fill in description below or attach a site drawing)
RMA / e e P, 74 J- /- Alevkl 6 P,4.4< #,#X -fw_� Afe,<�I'Z I—
YwyvG-� rxc� dadl—
INKI 1ER SECTION i�i r ad
S understand that a pier, dock mooring boat ramp, breakwater, boathouse lift, o "�°
P pilings, g
must be set back a minimum distance of 15' from my area of riparian access unless waived by ®� 2�15
me. (if you wish to waive the setback, you must initial the appropriate blank below.) OCT
l do wish to waive the 15' setback requirement. DC M _ M H D CITY
l do not wish to waive the 1a' setback requirement.
%dsle-_re17.:kr1.Cet
(Revised Aug. 20M)
Walid for one calendar year after signature*

A J;h AGENT RIPAR1AN PROPERTY QVU IER STATEMENT
1 hereby certify that I own property adjacent to Da 11 � ' i 's
•� ') ► i t n s (Name of PropertyOwner)
property located at J OU J W C D D
4 (Address
on � PQ� 1..'L , in
(filaierbody)
N.C.
The ap .Want has described to me, as shown below, the development proposed at the above
iocaii
I have no objection to this proposal,
I have objections to this proposal.
DESCRIPTION AND/OR DRAINING OF PROPOSED DEVELOPMENT
(Individual proposing development merit ftil in description below or attach a site drawing)
l � �CJ�-c.J� �'L �C_.Lr �ci�.� - YZ.tZ.t�., ��-t.�.•�i.�'l.�`.G.�71_
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.)
f do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(Propett,y Owner Information) (Adjacent Property Owner Information)
0
or
RECEIVED
TelephoneJVumberl email address Tele hone Number/ email address O C T 01 2015
Date Date* DCM- MHD CITY
(Revised Aug. 2014)
Valid for one calendar year after signature'"