Suiter, Antoinette C.

LAMA / P DREDGE & FILL V t T ��66444.L+ �
�, ��Crr;
ENERAL ERMIT Previous permit# A B D
ew. 1 difi ati ,pComplete Reissue ❑Partial Reissue Date previous permit issued s
As authorized by the State o ort aro ma, Department of Environment and Natural Resources
and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC
itt i� r ules attache I.
Applicant Name 1 1,...� . +' �( "'1-7 ` - ' ' t �� V Project Location: County
City "i ,' ( '
1
State�ZIP,
Phone # ( )
a �,
w` jF-Mail c
Authorized Agent...,_.
M
i.... '
�4-r1W
r
A
6 .
❑ ES ❑ PTS
Affected
AEC(s): ❑ OEA
❑ HHF
❑ IH
❑ UBA ❑ N/A
PWS:
ORW: yes / no
PNA
yes /io
;
Type of Project/ Activity
Pier (dock) length U X 161.4 .-^V• �1y
Fixed Platform(s) ,
Floating Platform(sl-
Finger pier(s)"'
Groin length -
number
Bulkhead/ Riprap length "
avg distance offshore'
max distance offshore -^"`^
Basin, channel "
_ ... .......... � t... . ...............
cubic yards, --
Boat ramp
Boathouse/ Boatlift
Street Address/ State Road/1 Lot #(s) �4
�f1 ,
Subdivision
City ZIP t l
r•
Phone # (� _"1) � River Bas'n
Adj. Wtr. Body ' `',� ��l 11 +�, i i (��•: (nat /man /unkn)
Closest Maj. Wtr. Body
Beach Bulldozing(
Other 1ril
_ 1
Shoreline Length
SAV: not sure C yes , �n°o
Moratorium: n/a yes i n_o,l
Photos: Ye
s
Waiver Attached: ys �no
A building permit may be required by: (� �• f~ ._ {� : t. ( r��..j �..
( Note Local Planning Jurisdiction
Notes/ Special Conditions t :e.i,ks 'Vo I .-.4(y J ,u. Q i
(Scale: I I I .. C.)i
❑ See note on back regarding River Basin rules.
Agent or App i t Printed Name Permit Offic` r"s Printed Name
}
E I
Signature ,y `Pleas' eadcompliancestatement o aackofpermit* Signaturg
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 andvoid.
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:
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 how to comply with these buffer rules.
Division of Coastal Management Offices
Morehead City Headquarters
400 Commerce Ave
Morehead City, NC 28557
252-808-2808/ I-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
Jj
Name of Property Owner Applying for Permit: l�iulDlK �'U�
Mailing address:
L& QL k&U-1 MT;
Telephone Number: z6z - C�'D q— 'Z
1 certify that I have authorized aAAM/c�► (agent/contractor),
to act on my behalf, for the purpose of appl ng and obtaining all CAMA permits
f
necessary for the proposed development of a
at my property located at
This certification is valid through 1 _ 31 -yJ 4—" (date).
(Property Owner Information)
Signature
hAPOWJSTT �` U
Print or Type Name
nJev,= L "�y.1F
Title, co. owner or trustee for property
Date
t6-2- OLoq Zg'3
Telephone Number
RECEIVED
DEC 0 3 2015
DCM- MHD CITY
RECEIVE®
DEC 1 0 2015
Email Address ®C M - M H ® CITY

AQMCENT RIPARIAN PROPERTY nww�eo TATEMEN_T_
1 hereby certify that I own property adjacent to
Property located at Name of Properly Owner
onjj (,U (Address, Lot, Block, Road, - N.C.
t3>v
(Waterbody) ' in -- ? � lk7" IY�
(City/Town and/or County)
The applicant has described to me, as shown below, the development proposed at the above
i cation.
I have no objection to this proposal..
I have objections tg this DroDosal_
(individual proposing de�
N
M
JK DRAWING OF
ent must fill in de
I understand that a pier, do k, mooring pilings,
must be set back a minimu distance i f 15, fro
wrie. (If you wish to waive th setback u m t
_i)
1 Date
y us
I do wish to wa a the 15' tback r
1 do not wish t waive the 5setbc,
ature
iv -,> C
or Type /fame
?g A M
�t ie/Zi
lion& Number/email ad
4-�f�
VSS
*Valid for one calenda year after
ED DEVELOPMENT
below or attach a site drawing)
'7
Nb°Fo F�VFO
OEM �
%F�TI-
at ramp, breakwater, boathouse, lift, or groin l
my area of riparian access unless waived by
Val the aapprropri blank elow.
!� f t
airement
requirement.
(Adjacent Property Owner Information)
5 l
aRECEIV D
DEC 10 2015
o�
(Revised Aug. 2014)
DCM- MHD CITY

AQJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to
(N me of Pro s
Property located at — , Owner,
(Address, L t, B ck, ad, on �
� (UVaterbody} , in {City/'fown dlor Cou ty)
C.
The applicant;h"cribed to me, as shown below, the development proposed at the above
location'
t !nave no objection to this proposal.
I have objections to this proposal.
DESCRIPTION A /OR g)RAWING OP PRO D DEVELOPMENT
1 (frrdlvidual%proposing develo went must rill in descrF below Oraffach a slte drawing)
Ilk
I understand that a pier, do] k, mooring flings, be
must be set back a minimun i distance o 15' from
me. (if you wish o aive the setback, yo i must in
do wish to wai a the 15'sqtback req
I do not wish td waive the Ih' sethan1
Property Owns infc
Signature
)lJ6N - 71 (' �
Pnnt or T pe Name
fling Addre s
Ltw iV
G5 2=
Telephone
Date
'Valid for one calendar y 6ar after
i
RecEeVED
D 06,C 0 3 2015
cMMHO CITE- C
at ramp, breakwater, boathpuse, lift, or groin
ny area of riparian access unless waived by [
Hal the appropriate blank below.)
iirement.
requirement. RECEIVE
(Adjacent Property er Information C
6 vn� SEC 1 0 2015
afore J 7 � l
or Type Name
M- MHD CITY
rR9 Haaress
01
'fState/Ztp
uhone Number/6 it address
(RevisedAug. 2014)
i Jb

ADJACENT RIPARIAN PROPERTY O�i/NER STATEIUlENT
I hereby certify that I own property adjacent to _. (3 is
property located at . (Name of Properly Owner)
(Address, Lok_Wlaf
B' etc.) �..
on , in .� , N.C.
(�1r'aterbody)(City/Town and/or County)
The applicant has described to me, as shown below, the development proposed at the above
t location.
16 „Y�l k", I have no objection to this proposal.
I have objections to this proposal.
DESCRIPTION AND/0I1 DRAWING OF PROPOSED DEVELOPMENT
(Individual proposing development must Hit in description below or attach a site drawing)
I understand that a p'dr�ock, m
must be set back ac um dis
me. (If you wish to i the setb
I do wis waive th
I do not wish to wail
(P perty Owner Inf ation)
mature
u1Ulgar
��� l
P i =rdp
ameiG/4►l
tltn Address
T. lye-
UWStaWmp I
Telephone Num_berlLeit dress
Date
�f
Valid for one calendar year €
4
I pilin s, boat ramp, breakwater, boathouse, lift, or groin
of 15' from my area of riparian access unless waived by
ou m st initial the appropriate blank below.)
15'�setba4k requirement.
15' s4tback requirement.
(Adjacent Property Owner Information)
-:26-4 - yyas
Telephone Number/email address
(Revised Aug. 2014)

ADJACENT RIPARIAN PROPERTY OWNER ST TEMENT
I hereby certify that I own property adjacent to ANMAIL. - (' QV f70,2
'S
property located at _/ ADYwcI kgo)_� (Name of Property Owner)
C (Address, Lod fBlogk R ad, etc.)
on J� , in NFL%,�(t-�'� , N.C.
(Waterbody) (City/Town andlor County)
The applicant has described to me, as shown below, the development proposed at the above
,/ location
�ij/ l I have no objection to this proposal.
I have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(Individual proposing development must rill in description below or attach a site drawing)
<-.. ' , -
I understand that
must be set back
me. (if you,wish b
f do
=- I do not wish to
perty Owner Inf atior
7Wre
'or T pe Name
li
AddressAU
z
'tat ip I
hone Nuerler�► is l addre;
*Valid for one calenlar year s
I pilin s, boat ramp, breakwater, boathouse, lift, or groin
Of 15' from my area of riparian access unless waived by
ou m st initial the appropriate blank below.)
15'�etba4k requirement.
15' s4tback requirement.
(Ad' cent Property Owner Information)
ature
Print or Type Name
Mailing Address -L
City/state/Zip
Telephone Nurriberlemail dd ess
(Revised Aug. 2014)