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ENERAL PERMIT Previous permit # A B C I D
New ElModification El Complete Reissue L1 Partial Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environment and Natural Resources
and the Coastal Resources Compnission in an area of environmental concern pursuant to I SA NCAC O
Rules attached.
Applicant Name Project Location.: County
Addre Street Address/ State Road/ Lot #(s)
Ci State zip,
Phone # E-Mail Subdivision
City Authorized Agent - , . I,-. I In'" ZIP
El Cw
14EW
41PT
Affected
AEC(s):
El OEA
El HHF
0 11H
Pws:
ORW:
Yes no
PNA
yes
Type of Project/ Activity
cubic yards-------""
Boat ram
Boathouse/ oatlic
Beach Bulldozin
Other
Shoreline Length
SAV- not sure yes no
Moratorium: n/a yes no,
Photos: es I no
Waiver Attached: t yes no
A building permit maybe required by:
Note Local Planning jurisdiction)
!?tef/ Special Condithon
'12
114Ageht opoplicant Printeo Name
El ES 0 PTS Phone#
El UBA El WA
Adj. Wtr. Body
no Closest Maj. Wtr. Body
7 7
(Scale:
See note on back regarding River Basin rules.
7-
PermitOffi 5e 5(Printed
eCe, ad compliance
Siggatt!re statement on 6ackof permit" Signatur J
Fees)Application Issuing D ate Expiration Date

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, certify that this project is consistent with the North Carolina Coastal Management Program.
River Basin Rules Applicable To Your Project:
EJ 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 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 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: [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

CaEN,"REDGE & FILL
3 111� 6 1 11
L A B C'! D
PERMIT Previous permit #
IN 0MOdification 0 Complete Reissue E]Partial Reissue Date previous permit issued
As authoLeedwby the State of North Carolina, Department of Environment and Natural Resources
and the Coastal Resources Commission in ;in area of environmental concern pursuant to I SA NCAC
PR616s attached.
, ".'Applicant Name I Project Location: County
Address Street Address/ State Road/ Lot #(s)
City I
Phone # U 12'-,
Authorized Agent,
Affected 0 Cw
AEC(s): 0 OEA
0,PWS:
ORW: yes no
State Ll ZI
E-Mail
2EW 'PTA DES 0 PTS
0 HHF LJ 1H D UBA D N/A
PNA yes /i, no �
Type of Project/ Activity
Pler (dock) length`"
Fixed Platform(s)
Floating Platforms) ------
Finger pier(s)
Groin length
number
Bulkhead/ Riprap length.-.-.,---'
avg distance offshore
max distance sho6e
Basin, channel
cubic
Boat ramp
Boathouse/ 4oat,if:t U
Beach I
Other
Shoreline Length
SAV. not sure
yes X no
Moratorium: n/a
yes ono
Photos:
yeses
Waiver Attached:
ryes no
Subdivision
City
Phone # Y"X
Adj. Wtr. Body f
Closest Maj. Wtr. Body
ZIP
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A building permit may be required by:
J "V,
J El See note on back regarding River Basin rules.
(Note Local Planning Jurisdiction)
K
J
ial cial Conditions
�%�otes/ Spec
V
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IPt MtTrintecl Name
Permit Officer'jsv-Pri6ted t4ame
7,
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Signature plqpie)read compliance statement on back of permlt't,
Signature
(cation e
l _"FV,� (s)
`Check#_L
Issuing Date
Expiration Date

11/24/2015 11.27 KU 336 274 4650 HIGGINS BENJ_411N
0 002/002
Nov.M.201E+ 04,33 PM INTERSTATE BATTERY OF MOR 252726360$ PAGE. 2/ 2
• MJAClMT R�JIRIAN�OPERTY dWNER STATE
t heraby cer ffy tug 1 own property a4ec ent top
, (None Of Properly Owner)
u z x , i Tri U I MW 19- W- A
milli i,,, 7,777M
N.C.
The arppr-s hope dw--Abed to me, as shmm betas►, the development proposed at the above
1 how no objection to this proposal.
I have objections to proposal.
DfERCR1P nON ANDVOR DRAWING OF PROPOSED LOPLWN
MV4NWcW nr000*bkO- are1- -kM ftWf must RN In de=#fP foa bsf w Or stbrc* a Oft dl vu
MV
I urKieround ta pier, dock, moor
ing piilrVc breal er, boaehow% Rk or groin must be set
back a minimum disfen a of 15 from my arae of ripeftn wom unless walmd by me. (if you
wish -to waive the setback, you nu at kdW the appropriate blank below.)
i do wish to waive the 1 s setback requirm rent.
I do not wish to-wa" the IS' setbadc requimment.
U►dMm n ProperlY Owner lrnbmmation)
%i„rr r On .
. H i 6-6- J Af 1.�%
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(Revised 61 a02012)
33�-87o-ig�fl

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to ITV ICl e F—Irl n \Je-re_fA,-\ is
(Name of Property Owner)
property located at I l L4 INaXt( Lr�_A e, i_ _0+ 1-1
m
The applicant has described to me, as shown below, the development proposed at the above
location.
_ 1 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)
AVER 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.
(Pro erty Owner Information) (Adjacent Property Owner information)
,ature Signature
oyrC� T �}-ye�y.� -Rune V 6 ADDE55
Print oILAr Tye Nam Print or Type Name
taAddrew Q _105 IZlLILYMailingMailing Address NFw prortir
o. a 5-70 NA Co 2657o
C/Stet ip City/State/Zip
pia-g►a-a3 � P_A2 7z4 i7 t
Telephone Number Telephone Number
0 $ /1, / 20l_S 1, I7, /!o
Date Date
(Revised 6/98)2012)