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AF / ❑DREDGE &FILL ( ' ji
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G PERMIT Previous permit #�prModification ❑Complete 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 Crom mis ion in an area of environmental concern pursuant to I SA NCAC
t" f+' { les attached.
,.:,
Applicant Name " °" Project Location: County" "' -
Address % tw' 1' Street Address/ State Road/ Lot #t(s)
City ., s ...� ,r` State / ZIP )
,
Phone # O E-Mail Subdivision
Authorized Agent "'' ty �F' ' 3 f ZIP
�� ��< C;;
❑ CW PM* err T A ❑ ES ❑ PTS Phone # ( ) River Basin
Affected ElOEA ElHHF ElIH ElUBA ❑ N/A
AEC(s): Adj. Wtr. Body »>; fs ; �Ana-. man unkn
❑ PWS: '.
ORW yes (' ncp� PNA yes t ni Closest Maj. Wtr. Body
o
Type of Project/ Activity
Pier (dock) length.
Fixed Platform(s)
Floating Platforms)
Finger piers)
Groin length
number
Bulkhead/ Riprap length
avg distance offshore
max distance offshore
Basin, channel
cubic yards
Boat ramp
Boathouse/ oatl f
Beach Bulldozing
Other
(Scale:, ,,,.t/ ' )
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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 consistentwith the North Carolina Coastal Management Program.
River Basin Rules Applicable To Your Project:
0 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 (252-946-648 1 ) 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/ 1-888-411COAST
Fax: 252-247-3330
(Serves:. Carteret, Craven, Onslow -
North of New River Inlet- and Pamlico
Counties)
Elizabeth Citv District
1367 U.S. 17 South
Elizabeth City, NC 27909
252-264-3901
Fax:252-264-3723
(Serves: Camden, Chowan, Currituck,
Dare, Gates, Pasquotank and Perquimans
Counties)
Washington District
943 Washington Square Mall
Washington, NC 27889
252-946-6481
Fax: 252-948-0478
(Serves: Beaufort, Bertie, Hertford, Hyde,
Tyrrell and Washington Counties)
Wilmington District
127 Cardinal Drive Ext.
Wilmington, NC 28405-3845
910-796-7215
Fax:910-395-3964
(Serves: Brunswick, New Hanover,
Onslow - South of New River Inlet -
and Pender Counties)
http://www.nccoastaimanagement.net/
Revised 08/27/ 14
AMA / ❑ DREDGE & FILLS 66805 A B C D
0 N E RAL PERMIT Previous permit
ew ❑Modification FlComplete Reissue ❑Partial Reissue Date previous permit issued
authorized by the State of North Carolina, Department of Environment and Natural Resources7/
d the Coastal R77P
on in an area of environmental concern pursuant to 15A NCAC
les attached.
liaant Name �" �'�7 Project Location: County L�- 6
idrest O r Street Address/ State Road/ Lot #(s)
ty O U Ce°l (I' State Alc. ZIP /
_ l t� �oj�lrr'l
One # O E-Mail Subdivision
ithori ed Agent ' r' i k) - City ( CeJ4,F ZIP
❑ CW ;*a'v ETA ❑ ES ElPTS Phone # (_) River Basin
fected ❑ OEA ❑ HHF ❑ IH ❑ USA ❑ N/A
C(s) Adj. Wtr. Body # �3 na man unkn
❑ PXVS.
tW: yes n PNA yes n Closest Maj. Win Body
ape of Project/ Activity P%
Pier (dock) length
Fixed Platform(s) - - —
Floating Platform(s) -------
Fmger pier(s)
Groin length
number
Bulkhead/ Riprap length_
avg distance offshore
max distance offshore " m
Basin, channel
PermitOffice 'nte
Signatur
(Scale�.j )
North Carole DWarkneM of ulwlro�rrlwlt &W N i PASOurm
wvww of COWN UAL__ emeni
sewdy am Oom w 'JwmKQrdpOm6Okldw lase smxdx r
Dtt 3-23-14e
ApplkastName
M
MaWieg A PO RJR 1 Z5Z
A 112 L- 3 0
X calKy that I have aaathodnd tsg=Q �,e, g. C,& k is act os any
behalf, for the parpow of applybg for read obtabft an CAMA pamits air 10
RECEIVED
MAR 2 4 2016
DCM- MHD CITY
4W Camwa AvWAW iAcraWN tom, *0 C M7
Phone: 204Ma B t FAX 29W.Mn%
AnE*dClpo bftiff=AVMMBMW-SiLRACV"Ieli*%Pmcsowmwpaw
RECEIVED
MAR 2 9 2016
DCM- MHD CITY
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIERIMOORING PILINGSIBOATLIFT/BOATHOUSE)
hereby certify that I own property adjacent to TM (J 5u0t--1-r I
(Name of Property Owner)
property located at I Z 5h6re ! oe. brave
(Lot, Block, Road, etc.)
on in r'-itrd , N.C.
(Waterbody) (Town and/or County)
He has described to me, as shown below, the development he is proposing at that location,
and, I have no objections to his proposal. I understand that a pier/mooring
pilings/boatlift/boathouse must be set back a minimum distance of fifteen feet (15') from my area
of riparian access unless waived by me.
I do not wish to waive the setback requirement.
I do wish to waive that setback requirement.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
k _0
C
MAR 2 9 2016
DCM- MHD CITY
RECEIVED
MAR 2 4 2016
DCM- MHD CITY
Signature
h111? r� �
Print or Type Name
�Q
Teleph a Number
Date:
v ,�
ADJACENT RIPARIAN PROPERTY OWNER STATER ENT
(FOR A PIERIMOORING PILINGSIBOATLIFT/BOATHOUSE)
I hereby certify that I own property adjacent to 11--' >>jp Sc,Oee' 's
(Name of Property Owner)
property located at 1 12- SA-,Oml r\c � (-; 0 <- ,
(Lot, Block, Road, etc.)
on� in CcricccA N.C.
.
(Waterbody) (Town and/or County)
He has described to me, as shown below, the development he is proposing at that location,
and, I have no objections to his proposal. I understand that a pier/mooring
pilings/boatlift/boathouse must be set back a minimum distance of fifteen feet (15') from my area
of riparian access unless waived by me.
I do not wish to waive the setback requirement.
i/ I & wish to waive that setback requirement.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
R
MAR 2 9 2016
DC�M-�M H ® CITY
RECEIVED
MAR 2 4 2016
®CM- MHD CITY
y� cn ' e 4 _ ` ( '(' C t adQso n
Print or Type Name
O�501-- 7�? C7-
Telephone Number
Date: M CJ-S ( .23 0) 0 I s