Sunset, LLC

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EN ERAL PERMIT
Previous permit #
,New ❑Modification ❑Complete Reissue El Partial Reissue Date previous permit issued Kw
As auth rued by the State of North Carolir�a, Department of Environment and Natural Resources t
and the Coastal wources Commission in an environmental concern
pursuant to I SA NCAC ((
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Applicant Na` ,. 'E '�� t _ P r..?
r R ❑.RulesAttached.
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Pro'ect Location: County +.
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Address `r - t,' �.. ; ry":- i
Street Address/ State Road/ Lot #(s)
City ` State i i j ZIP l
�.` If i '; z� `Y A k
.._...
Phone # (a---,. - --� "'"_' E-Mail """�`—'
Subdivision .�_•
Authorized Agent ", +..l Imo, 1 J w,..
City "i ZIP ) i
❑ Cw El ❑ PTA ES ❑ PTS
Phone # (""") ' ~-- --- --" River Basin. '•. ` ? " F (i I
Affected
❑ OEA ❑ HHF ❑ IH f❑"h1BA El N/A
AEC(s):
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Adj. Wtr. Body nat .%man /unkn)
❑ PWS t
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Closest Maj. Win Body ; I
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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:
El Tar- Pamlico River Basin Buffer Rules ❑ Other:
0 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 howto comply with 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.nccoastaimanagement.net/
Revised 08/27/ 14

AGENT AUTHORIZATION FORM FOR PERMIT APPLICATIONS
Name of Property Owner Applying for ermit ~
Mailing address:
Telephone Number: iaag7
i
certify that I have authorized ���' (�.rc ��
(agent/contractor),
to action my behalf, for the purpose of applying and obtaining all CAMA permits
i
necessary for the proposed development ofy f--Kf-I�f�17
i
at my property located at 3 1 (5- '5 U 0sf:
This certification is valid through
(Property Owner Information)
Signature -
Print or Type Name
i
Title,
, o. owner or trustee for property
"7 -- (/6,
Date
1 Telephone Number
i
Email Address
(date).
RECEIVED
JUL 14 2016
®CM- MH® UTY

T- RfPRIitAfJ,f`ROf+rL Ty ER INFNT /'r
r horby Cef ity ihtrt 1 Own propoorty Adjacrr.t to C \
ProP� rty ;ocated at l t 5- 5 u ri alit" Ts Noma of Property Owner)
on Cit�,b�t� (Address, 4Bioek Rosd,ete.t
(Watettrarly} n CAPVl t'� N.C.
(Cityi F OWn ndtod r County)
The l
i>p+ t has dtrscrlbe d to mc, as shown below, the development prOp0,,*d lit the above
iEN a
I have no Ot>je,;Rian to this Dropvsal.
--_T_ 1 have objections to this proposal.
t UESCRIPTION ANWOR DRAWING OF PROPOSED DEVELOPMENT
ttndAstduaf P+'eF-1-9 developmant rrtusf OR in description bsdow or e,ttach a stte draavtng)
f
WAIVER SECTION
undgrVand that ,a pier, d(%rlt, movra-Lq pilings, boat ramp, breakwater. Do;,ttt wsa, GR, ar •rJTDin
T.u;l 09 set back a nvnlmum distance of 15 from my yryy of riparian access unless waived try
me- (if Yore wish to wane the sotbacx, you must initial me appropriate, 64"nk be),,w,)
i
I do wish tv waive the 1F setbyk reouireme^I,
I
t do not wish tO vrawe the 15' setback r?quiresnent. ./ / (Prop rty Oymor Information) o ' a / 1A p
? [Adjacent Property OvmmlnformaliJn�/Jy;t,�a S %�/h• . �" -
I
"J Aid for ore Calendar year utter fr;m turn'
�� t � �7 iS1JSc 1 / ��' 1 ✓✓
.%40ng Ad�dr
r�aeprrwwA4rtr,L�r;'u:rs:,d»d,?�rs5 ,
jHevsed &q 204)
RECEIVED
JUN 2 3 2016
DCM- MHD CITY
RECEIVED
JUL 14 2016
DCM- MHD CITY

ADJACENTRIpARIAN PROPERTY OWNER 3TATE67Es+T
her by Certify that I own Property adjacent to �l3 p+S�(„ LG
prop rty located at 3 {� Surl3gr- (Name of Property Owner)
on v (Address,(tlo�,t,QBlock Road, etc.)
(Waterbody') in N.C.
(CitylTown dndlor County)
The iapplicant has desoribed to me, as shown below, the development proposed at the above
loca
I have no objection to this proposal.
_ I have objections to this proposal.
�Qvrar I ivry ANVIOR DRAWING OF PROPOSED DEVELOPMENT
proppsing development must fill In description below or attach a site drawling)
42
�J
WAIVER SECTION
I and rstand that a pier, dock, mooring pilings, boat ramp, breakwater, boathouse, Ilft, or groin
must a set back a minimum distance of 15' from my area of riparian access unless waived by
me. (I 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
'Valid for one calendar year after signature'
City/State/Zip
Telephone Number/small address
Date•
(Revised Aug. 2014)
RECEIVED
JUN 2 3 2016
DCM- MHD CITY
RECE!VED
JUL 14 2016
CM- MHD CITY
i