Starling, Samuel

4C A -MA/ 0 DREDGE & FILL
NT 0* 67710 A B cc J D
GENERAL PERMIT Previous permit #
I$New Elkodification ElComplete Reissue El 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 pursuant to 15A NCAC
t h Rules a Ched
Applicant Nam Project Location: County
Address N IJ Street Address/ State Road/ Lot #(s)
City— State ZIP . .....
Phone # Subdivision
f I
city i Authorized Agent Is I 1 E I. 11 —1k , ZIP
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EW PTA 0 ES 0 PTS Phone # (River Basin
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Affected O'EA 0 14HF $I lk 0 USA ❑ WA
AEC(s): Adj. Wtr. Bod (\,r(naii /man /unkn)
El Pws:
Closest Maj. Wtr. Body
ORW: yes o PNA yes/ 0
e of Project/
I X �Nlvl "I c �
(Scale:
Pier (dock) length
Fixed Platform(s) -V Y,
Floating Platform(* —
Finger
Groin length
number__
Bulkhead/ Riprap length■■■■■■■■■�■■■■
avg distance offshore_ ---
max distance offshore
channel
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Boat ramp
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Beach Bulldozing
Other-&"X It, AM, cr-)
Shoreline Lengt
SAV: notsure�,— (i.�/ no.,1
Moratorium: n/a yes
Photos: yes b
Waiver 4V-9ched: ves
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RWOMEMEMMEMMEMEMMEN
A building permit maybe required by:
( Note Local Planning jurisdiction),\
t or Applicant Printed N
Signature **-,Please read
E]See ngtE
imel Permit Officers Printer
:om0 iance statement on back of Signatu
16,
s Ate
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on bTk regarding River Basin rules.
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4

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, certify that this 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 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 howto 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.nccoastaimanagement.net/
Revised 08/27/ 14

CAMA / ❑ DREDGE & FILLNla67710 A B !C ? D
�-- G�IVERAL PERMIT Previous permit#
ew ❑Modification ❑Complete Reissue ElPartial Reissue Date previous permit issued
,s authorized by the State of North Carolina, Department of Environment and. Natural Resources
nd, the Coastal Resources Comm*ssio�t in an area of a vironmental concern pursuant to 15A NCAC U
`> F y. Rules a ched.
t j "
applicant Name Project Project Location: County
address` `; '�1 f �i ` - Street Address/ State Road/ Lot #(s)
y 6 � States � ZIP, f✓ a
hone # -Mail 4 Subdivision ...
I'i a
authorized Agent,+ City ( (i : > > .. ZIPS
effected CW ftEWtip,
A ❑ ES ❑ PTs Phone # �, L.,.
T❑we Basin vt
❑ OEA HHF ❑ UBA ❑ N/A �(7Adj. Wtr. Body �. nat man unkn
❑ PWS: / � f� Closest Maj. Wtr. Body - i JAI
>RW: yes / no PNA yes -.
T e of Project/ Activity,g ; " t
$ r, (Scale: i tit
Rier.(dock) length t
Fined Platform(s) -- cx�:_- -_ .. n
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■I■N 'EM■riIN a Iiif1!■i1111 I �■■■■■■■■■■■i■W■■■■
number
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MEN ■■■■�■■■■�1'■■■■11I■mN111■■■■■■Nmull
max distance offshore - N 0 E WHE t Imam NONNI NAPM—al I ill
6.13asin, channel
cubicyards-
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oat ramp
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5

AGENT AUTHORIZATION FORM FOR PERMIT APPLICATIONS
'Name of Property Owner Applying for Permit: Sarqttd�
Mailing address:
Telephone Number:
orl+vkA C;-hi,"bc -;�a
;�- A(4-0-0 1-6
I certify that I have authorized S% Off` /A6,/ - 6sf. '7,-ye- (agent/contractor),
to act on my behalf, for the purpose of applying and obtaining all CAMA permits
necessary for the proposed development of Co tA*.td- AO,*-k % !_awru .ySc�, c s
at my property located at 2 l 3 4 khn r6keLj L! f
I
This certification is valid through
(Property Owner Information)
C Signature
JCL I�Yt tie, 1 Spa r
Print or Type Name
SON,
Title, co, owner or trustee for property
r�
Date
Telephone Number
s AY<<-C6t.
Email Add ss
(date).
RECEIVED
JUL 2 7 2016
DCM- MHD CITY
RECEIVED
JUN 29 2016
DCM- MHD CITY

WATER
Alan G. Bailey
PO Box 93, Morehead City, NC 28557
504-0737 • 726-5443
1
`p o `
2� �zfl X
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a
RECEIVE®
�O
JUL 2 7 2016 x
� a
DCM- MHD CITY
z RECEIVED;
JUN 2 9 2016
s DCM- MHD CITY
V 3
y

DIVISION OF COASTAL MAjNAGEMENT
AD JAC.NT RIPARIAN PROPERTY OWNER NOTIFICATIONPPIAIVER FORiIAd
Narne of Individual applying -for Per;nit: _Sam wl W . S-ky-If
K ALL
(Lot or S eet #, Street or Road, City & County)
I hereby certify. that I own property adjacent to the above referenced property. The individual
applyi or this. permit has described to me as shown on the attached drawing the development
they r rA description or drawing, with dimensions, should be provided with this letter.
have no objections to this proposal..
If you have objections to what is being proposed, please write the Division of Coastal
Management, 400 Commerce Avenue, Morehead City, NC, 28557orcall(252) 808-2608within
10 days of receipt of this notice. No response is considered the same as no objection if you
have been notified by Certified Mail.
WAIVER SECTION RECEIVE®
JUL 27 2016
I understand that a pier, dock, mooring pilings, breakwater, boathouse, boatlift or sandbags 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.
(Applicant Information) (Ripar' n pe Information)
[ 3 Kt ALA L.
Mailing Address Signature
PIA
City/Stafe/Zip Print or Typ Name
Z"S- Z C 2- Z. �0C1 L
Telephone Number Telephone Number
Date
64-9- l & RECEIVE®
Date
JUN 2 9 2016
®CM® MH® CITY

DIVISION l OF COASTAL nrANIAGEt ENT
AD,,ACENT RIPA,RWI PROPERTY OVINER AMTIFICATIONMA.VER FORM
T lame of Individual applying for Permit; _ 5r�„nnt4me,I W .
rs
C/_ a8551 -lkr-f'tirLt
(Lot or Street #, Street or Road, City FA County)
I hereby certify. that I own property adjacent to the above referenced property. The individual
applying for this permit has described to me as shown on the attached drawing the development
they are proposing. A description or drawing, with dimensions, should be provided with this letter.
I. have no objections to this proposal..
If you have objections to what is being proposed, please write the Division of Coastal
Management, 400 Commerce Avenue, Morehead City, NC, 28557 or call [phone] within
10 days of receipt of this notice. No response is considered the same as no objection if you
have been notified by Certified Mail.
WAIVER SECTION RECEIVE
JUL 2 7 2016
hA BUD CITY
I understand that a pier, dock, mooring pilings, breakwater, boathouse, boatlift or sandbags must
be set back a minimum distance of 15' from my area of riparian access unless waived by me. (If
you wish to waivq 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.
(Applicant Information)
J14r,
Mailing Address
h1.o rt ke-6,J
City/State/Zip
a5'p'- awl-ov--o
Telephone Number
Date
(Riparian Property Owner Informati n)
Signature
_0_o_tZ©!yA.YJ
Print or Type Name
Telephone Number
45'`-�
Date U-1i RECEIVED
JUN 2 9 2016
DCM-. MHD CITY

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