Taylor, Scott

j"
CAKAA I] DREDGE & FILL OqT'
N 40 66783 A B D
GENERAL PERMIT Previous permit #
ONew ElModification ElComplete Reissue ElPartial 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
El Rules attached.
".
Applicant Name Project Location: County ".; i )�J f' - -A
Address
N
City- State ZIP
Phone # E-Mail
Authorized Agent
Affected 0 CW EW .,R PTA EIES 0 PTS
AEC(s): El OEA 0 HHF 0 1H El UBA 0 N/A
0 PWS:
ORW. yes/ no PNA yes / no
Street Address/ State Road/ Lot #(s)
Subdivision
City ZIP
Phone # River Basin
Adj. Wtr. Body {nat hna6 %unkn)
Closest Maj. Win Body
Type of Project/ Activity
(Scale:
Groin length
number
avg distance offshore_
max distance offshore
Boathouse/tiBoatlift
Shoreline Length
SAV: not sure yes no
A building permit may be required by: El See note on back regarding River Basin rules.
Note Local Planning jurisdiction)
Notes/ Special Conditions
A

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 I) 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:
Tar - Pamlico River Basin Buffer Rules ❑ Other:
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 how to complywith these buffer rules.
Division of Coastal Management Offices
Morehead City Headquarters
400 Commerce Ave
Morehead City, NC 28557
252-808-2808/ 1-888ARCOAST
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)
� M f A) � L-5- L
http://www.nccoastaimanagement.net/
Revised 08/27/14

'eAKIIA
/ ❑ DREDGE & FILL
GENERAL PERMIT
A B C D
Previous permit#
ONew ❑Modification El Complete Reissue El Partial. Reissue Date previous permit issued
horized by the State of North Carolina, Department of Environment and Natural Resources
e Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC
❑ Rules attached.
ant Name
Project Location: County f =
ss:'?
Street Address/ State Road/ Lot #(s) 4'
State ZIP
E-Mail
Subdivision
rized Agent
City ZIP
❑ CW p EW •,❑p PTA ❑ ES ❑ PTS
Phone # (_) River Basin
❑ OEA ❑ HHF ❑ IH ❑ USA ❑ N/A
1
Adj. Wtr. Body (nat /man %unkn)
❑ PWS•
f -
yes / no PIMA yes / ono
Closest Maj. Wtr. Body .. = `•
of Project/ Activity
1
(Scale: f )
;dock) length
I Platform(s)
—
—

a i4CAMA / ❑ DREDGE & FILL
PERMIT
66783 A B c D
GENERAL Previous permit #
New ❑Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued
1-prized by the State of North Carolina, Department of Environment and Natural Resources /
Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAG .? !
grit Name` �t
Li Rules attached.
P
Project Location: County
Ve
Street Address/ State Road/ Lot #(s)
O E-Mail
Subdivision =? L
ied Agent
_x`
City ZIP
,d ❑ CW 7 EN/ PTA ❑ ES.. ❑ PTS
Phone # (_) River Basin "Ll .;
❑OEA ❑HHF ❑IH ❑UBA ❑N/A
fi i Y tl� 1
Adj. Wtr. Body _ f— Ck nat an
yes /;�io ` PNA yes /i
unkn
Closest Ma Wtr_ Body
; "� _%
of Project/ Activity . (= )
-
t
i (Scale: �~ )
Jock) length
d/ Riprap length
;,distance offshore r
oc distance offshore
bic yards
:r j
eline Length _
not sure yes
I
i
corium: n/a yes
os: es rn9 1
t
—
Y
�er Attached: Gnq
-
ulding permit may be required by: ( T. .;, t r o F! See note on back regarding River Basin rules.
>te,Local Planning Jurisdiction)
es/ Special Conditions
P
t
_ i i
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t
,.n ti �g l i. � M ..♦ ��Y l i� l r4 �
1�� l �F 4 Y. ;� �r 1
o �piicant Printed N
Permit Officer's PWed NameIr
Qstmatent
PI a read compliance on back of permit Sig at re
anon Fee(s) `
x v
Check#
Iss m Date
g
,expiration Date

N.C. DIVISION OF COASTAL MANAGEMENT
AGENT AUTHORIZATION FORM
RECEIVED
Date <10J6 iy�54,/Zof(o
JUN 16 2016
DCM- MHD CITY
Name of Property Owner Applying for Permit:
Mailing Address:
I certify that I have authorized (agent) 17CNI11 f Sc�N� II�CIk I1JE ggA!gj#o act on my
WI LLI14It1 ��NAi LS
behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to
install or construct (activity) -DCCK 4 G0A`f-L41='T ,
at (my property located at) "7-76 SEA 6p"M D26 VE N6w'poP--r- NC
RECEIVED
JUN 22 2016
This certification is valid thru (date) ).).%3l j -2Dt (a
DCM- MHD CITY
/3-i(a
Pr9 a Signature Date

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to '--x T/ / -/nI 10/(-- 's
(Name Ptopedy, Owner)
property located at r7 '7u Sc��-� ►c- � A/e
(Address, Lot, Block, Road, etc.) '
on TnJyaCc30--'4w1 , in , N.C.
(Waterbody) (City/Town and/or County)
The applicant has described to me, as shown below, the development proposed at the above
locatioy�:
I have no objection to this proposal. -1"k 14 t 7
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)
DECEIVED
16 2016
DCM- I'1!IHD CITY
WAIVER SECTION
I understand that a pier, dock, mooring pilings, boat ramp, breakwater, boathouse, lift, or groin
must be set back a minimum distance of 15' from my area of riparian access unle tVED
me. (If you wish to waive the setback, you must initial the appropriate blank below.)��"
�%% I do wish to waive the 15' setback requirement. JUN 2.2 2016
I do not wish to waive the 15' setback requirement. DCM" MHD CITY
(Prope Owner I ormation) (Adjacent Property Owner Information)
gnat Signat
�� i i' � c► for' �i � �T i�r�� ����
Print or Type Name_ , �� Print N T me Se
`7 7Ce Sc GEC j"�
Mailing Adcfres Mailin Address
Iye A,4%C4— IX.) , G ;2-� 3;nw ;477 l l fV C, -2
City/ ate&ip City/State&'
252. — �0�--7 (MCP �5- - -7) 7 —
Telephone Number/email address Telephone Number/email address
Date
Date*
(Revised Aug. 2014)
*Valid for one calendar year after signature"

ADJAcENTRAfi Z lPROPE1 .oNvNEsTAmmufpECEIVED
A PHRWOOIMG ]P SIBOAT9I i ATBO JUN 16 2016
ffm=b\yt fyth tt1mw - IIHD CITY
�7 Blokr Roadl .;)
an . in wNC
He has dmsfnbed ttD mmr, as sbown b6owA tw dim pmmcntt he is Ipmpwing at *M ff="mama, and, d
have no objedi lo'Wks propmal ff un&rstand tiMmtt a pme/i mfinng jpb)ngs%oof1nff n ho-mc
must be sd bmdk m mmfimm dntmm of fiftem fee4lfl fiumm my ama of npmwn ace= uni
,wamed by um f you \v&;h to wal `ffie setbmel�, you :mmA laMW the <Appmpemde blEmk
1 lb not ~gib ttD vimea
7do whbttD vrAWc sedockmx
RECEIVED
JUN 212016
DCM- MHD CITY
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252 - 3(-p1- 5 Z2,Q
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ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
5
I hereby certify that I own property adjacent to
(Name of Property Owner)
's
property located at
(Address, Lot, Block, Road, etc.)
on , in , N.C.
(Waterbody) (City/Town and/or County)
The applicant has described to me, as shown below, the development proposed at the above
location.
I have no objection to this proposal.
l 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)
WAIVER SECTION
I understand that a pier, dock, mooring pilings, boat ramp, 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.)
1 do%/w�waive
ishhe 15 set�uirement.
1 do not wish to waive the 15' setback requirement.
Owner In rmation)
. .'��
Print or Type Name
7 -)5la �.A?s>V M
Mail " g Address
z
City/State/Zi _,, J
Tel ho a Number/email address
Date 511✓ / -sl-- 1 y
(Adjacent Property Owner Information)
6r
City/State/Zip '
Telephone Number / email address
zo/
Date
(Revised Aug. 2014)
*Valid for one calendar year after signature*

Address of Property:
Applicant phone #:
(Lot or Street #, Street or Road, City & County)
Mailing Address:
hereby certify that 1 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, 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.nccoastaimangemenf.net(contact dcm.htm or by calling 1-888-4RCOAST. No
response is considered the same as no ob ectlon 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.)
—a. I do wish to waive the 16 setback requirement.
I do not wish to waive the 15' setback requirement.
(Pr a Owne Inf mation) (Rip r n Property Owner I ormation)
Slinature Signatures
1D694,113 / : u,4p
Print or Type Naha Print or Ty e Name
'j 2 s 5- 6 &r-&
Mailing Ad ress Mailing Add r ss
City/Stat ip *ilsftaterZip
,;� S'a — k)<k _ -7 / C--- z �'sZJ Y
Telephone Number -r -- Telephone Number
k-15
Date Date

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