Sullivan, Joyce

Y,CAMA / ❑ DREDGE & FILL
QENERALPERMIT„µ

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:
M Tar- Pamlico River Basin Buffer Rules )! Other:
El 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 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/ I-888-4RCOAST
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

Applicant:
Date:
Describe below the HABITAT disturbances for the application. All values should match the name, and units of measurement
found in your Habitat code sheet.
Habitat Name
DISTURB TYPE
Choose One
TOTAL Sq. Ft.
(Applied for.
Disturbance total
includes any
anticipated
restoration or
tem im acts)
FINAL Sq. Ft.
(Anticipated final
disturbance.
Excludes any
restoration
and/or temp
impact amount
TOTAL Feet
(Applied for.
Disturbance
total includes
any anticipated
restoration or
temp impacts)
FINAL Feet
(Anticipated final
disturbance.
Excludes any
restoration and/or
temp impact
amount
'�(Lw�yywv)Dredge ❑ Fill ❑ Both ❑ Other—�—
Dredge ❑ Fill ❑ Both ❑ OtherA
Dredge ❑ Fill ❑ Both ❑ Other ❑
f
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
252-808-2803 -- 1-886-4RCOAS :: revised, 02/03/10

DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM
Name of Property Owner: Joyce Sullivan
Address of Property: 1005 Edgewater Place, Morehead City
Applicant phone #: [phone] Mailing Address: same as
above
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 I proposing. A description or drawing, with dimensions, must be provided with this letter.
�/ I have no objections to this proposal. I have objections to this proposal.
if you have objections to what is being proposed, you must notify the Division of Coastal
Management (DCM) in writing within 10 days of receipt of this notice. Contact information for DCM
offices is available at www.nccoastaimangement net/contact dcm.htm or by calling 1-888-
4RCOAST. No response is considered the same as no objection if you have been notified by
Certified Mail.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boathouse, or lift 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.
(Property Owner Information)
Signature
Joyce Sullivan
Print or Type Name
1005 Edgewater Place
Mailing Address
Morehead City, NC 28557
City/State/Zip
252-726-9525
Telephone Number
8/26/ 13
Date
flan Pr er Information)
ure
Print or Type Name
Mailing Address
City/State/Zip
c5�:U-714.68SGR
Telephone Number
"4-.-26 -/�
Date

C&ENR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
Pat McCrory Braxton C. Davis John E. Skvarla, III
Governor Director Secretary
Date 5—
Applicant Name ��.�� �fe -:���� A./1�
Mailing Address
I certify that I have authorized (agent) to act on my behalf, for the
;urpose of applying for and obtaining all CAMA Permits necessary to install or construct (activity)
leg0'57. 4�5 4 g � &, �� /- , at (location)
U
This certification is valid thru (date)
100,
Signature Qae'411-7
��� ►�
400 Commerce Ave., Morehead City, NC 28557
Phone: [phone] FAX: [phone] Internet: www.nccoastalmanagement.net
An Equal Opportunity 1 Affirmative Action Employer
NorthCarolina
Naturally

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to
property located at �---
T Ean
,,rr
(Address Lot Block
on ea4lce �_� , in
-
(Waterbody)
and/or County)
The app ' ant has described to me, as shown below, the development proposed at the above
locat.
I have no objection to this proposal.
I 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)
Sk"I" ZW10"14314
WAIVER SECTION
I understand that a pier, dock, mooring pilings, 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.)
I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
Owner Information)
Print or Type
City/State/Zip " I
.1y - ?- e,s->
Telephone Number
Date �®
(Adjacent Property Owner Information)
Pn'S,T—r Tye Name
-d,<ter"//,)?/ ST
Cit /State/Zip
Teleph-one Number
Date
(Revised 611812012)

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to ]E&kk � ��, 's
(Name of Property Owner)
property located at le('2S' dy'��
(Address, Lot, Block, Road, etc.) ,4
on t✓ @ t'�i�- , in /YI 'D.P,/s-`" —1►16 � r , N.C.
(Waterbody) (City/Town and/or ounty)
The Vo.
ant.has described to me, as shown below, the development proposed at the above
loca
I have noobjection to this proposal.
I 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)
A�'11'119xlkj 'T i/tm rVAA7'94W(
WAIVER SECTION
I understand that a pier, dock, mooring pilings, 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.)
I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(Property Owner Information)
ivianuiy AUUTUs
CiV ta�ipG�j�
Telephone Number
Date '-f0+ j h
(Adjacent Property Owner Information)
S" nature -,
-O J s c e�,f-Lt) L 1
Print Qr, T�ll ame I I'
U I
Mailing 0 d- e- s
=rn-,o�e�'er�
City/S t.6 � _
Telephone Number
F-/ 5-1.3
Date
(Revised 611812012)

■ am ■%6 A V a ■ ■
as authorized by the State of North Carolina
Nd,
. Department of Environment and Natural Resources and the Coastal Resources Commission
in an area of environmental concern pursuant to 15 NCAC' ,
Applicant Name j lr Phone Number rr
Address+
city ' ' State` Zip f/
Project Location (County, State Road, Water Body, etc.)
Type of Project Activity
PROJECT DESCRIPTION SKETCH
Pier (dock) Length
1
Groin Length �.
number
Bulkhead Length 14
r ..max. distance offshore �
Basin, channel dimensions
cubic yards
Other -,ice-- t
(SCALE: f /
This permit is subject to compliance with this application, site drawing
and attached general and specific conditions. Any violation of these terms e' '" applicant's signature
may subject the permittee to a fine; imprisonment or civil action; and
may cause the permit to become null and void. f
This permit must be on the project site and accessible to the permit of- rm t officer's signature
ficer when the project is inspected for compliance.'The applicant certi- (;
fies by signing this permit that 1) this project is consistent with the local issuing date expiration dace -
land use plan and, all local ordinances, and 2) a written statement has
been obtained from adjacent riparian landowners certifying that they
have no objections to the proposed work. �' 1 s*� ,,, attachments
In issuing,this,permit the State of North Carolina certifies that this project ' J f t ' *
isconsistent with the North Carolina Coastal Management Program. application fee

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