Trevino, Ray

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NLAMA/ ❑DREDGE & FILL
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ENERAL PERMIT Previous permit # A B D
New El Modification OComplete Reissue El Partial Reissue Date previous t issued
As auth rirized by the State of North Carolina, Department of Environment and Natural Resources
and the Coal Resources Commission in an area of environmental concern pursuant to I SA NCAC
Li Rule� attached.
11; %
ll� Applicant'Na e Project Location: County
Address Street Addre§s/ State Road/ Lot #(s) City i State i VILZIP
Phone
hone # # -Mail Subdivision
Authorized Agent t, iCity ZIP A, V
Affected 4p.CW
rrA OES El PTS Phone # i iver Basin
El OEA 'tHF )EI(IN El UBA 0 N/A AEC(s): Adj. Wtr. Body_ Anat /man /unkn
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Closest Maj. Wtr. Body L
ORW: yes Pno PNA yes/ nlp
Type of Project/ Activity
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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, certify that this project is consistent with 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/ 1-888-411COAST
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

a.
AGENT AUTHORIZATION FORM FOR PERMIT APPLICATIONS
Name of Property Owner Applyingfor Permit:or
Mailing address:
Telephone Number:
I certify that I have authorized
to act on my behalf, for the purpose of appi)ing and obtaining all CAMA permits
necessary for the proposed development of
1
sae cA I W li
at my property located at
a(4
M
This certification is valid through (date).
(Property Owner Information)
r
Q Signature U
� �0
71- e I/ e- Z)
Pnl7t or Type Name
®asUIeL
Title, co. owner or trustee for property
Date
Telephone Number
Email Address
RECEIVED
JUN 24 2016
DCMW MHD CITY
RECEIVED
JUN 2 p 2016
DCM- MHD CITY

{hereby certify that 1 own ro
p pertY adjacent to
property located at t (Nara pf Property owner)
on P7 (Address, fat to
0 - aterbody)
in ,Road, etc..
The applicant has described to { ityl down andlOr ountrl .C.
me,; as shown below, the development proposed
-- 1 have no objection to this proposal. at$ above
---- t have objections to this proposal.
�te3CRjp' ON AAiLiIo
(Iradivio`tral o osir� develo trte RAWl1Vi's PROPpg
ust f /I i 1=1t�i.QP NT
criPtior� w a
/ ': ,� a ite drawing)
iA
4
! Al S
understand that a pier, do c , on T
must be set back a minimum d pilings, b at ramp, breakwater, boathouse lift or
Me. (if you wish to waive the s tanc of 15' from my area of riparian groin
parfan access unless waived by
back, ou must i ial the appropriate blank below.)
*?.�;4
1 do wish to.Waive e� setbact< irement, R'ECEIV do not wish to
(Prop ive th 15' setts requirement J U N 2 4 2 01
a wr�er�lnfgrrnation)
ja n er forma M H D C Y.
l P TYAe /�� Prirri rT e Aye
Mai/in A�a�, M 6
tr 6 � � � Mailin i
slap one tVumemaff� m.j�
-Valid for one calendar Yeal after
_ RECEIVE
(Revised Aug. 2014)JUN 2 0 2016
DCM- MHD CITY

1
I hereby certify that 1 own property ac
Property located at
on -j;j f9--7/'lam /!7 _ ` {
3s
N.C.
The applicant has described to me,; as shown below, the developmen#p.oun
locati n. Proposed at the above
4&Z I have no objection to this ro
P posat.
--- 1 have objections to this proposal.
(individual proposing developoaerrf m sf fr� 3 des ROfaor� EDbelow c DEVELOPMENT
LOP b a -
�Ci'MENT
sr�e dramrirag)
0
�1W�����
® Q t�
o
I understand #hat a pier, dock, mooring tings bo t ramp. brer, 60
must be set back a minimum distance o 15` from cc
athouse,lift, or gro� EC E IVme. (!f you wish to waive the setback, yo must in the app opn�a#e blankess unless
waived by
.,.__._ _ _, I do wish to waive the 15' .s #back requ rement J U N 2 4 2016
-c=�--=-_ 1 do not wish to waive # D CITY
he. 5 setback equirement. ®C M o M i-�
Prope . Qwntr information)
"Jacent PropeftY Owner information) EC E IVED
/� (� ignt sr -- JUN 2 0 2016.
I Print or Typeme
""'? n5Type lUame
A CM- MHD CITY
Niailin ss• ! rrshinddm
' u L✓dr �,
74
e/epho a umberf ema a dress augd
elephone Number/em 7 add
Date - A
*Valid for one calendar year after sig re* (Revised Aug 2oj4)