Waldrop, Thomas

Q
AFAA El DREDGE & FILL J''^"�'1 „ N2 67724 A B D
GENERAL PERMIT Previous permit #
New ElModification ElComplete Reissue E]Partial 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
ulesattaqhed.
Applicant Name fA Project Location: County
Street Address/ State Road/ Lot #(s) Address
City State zlpCA k— Li F— zof!l v
�
Phone # E-Mail Subdivision
Authorized Agent t "4" '1. City— ZIP
;
Affected
El CW _4EW PTA El ES 0 PTS Phone # JRJver Basin
'q
El OEA 0 HHF 011H 0 UBA El N/A ;
-(nat Iman /unkn AEC(s): Adj. Wtr. Body
. 7
0 PWS: tt r. Body
ORW: yes _no-' PNA yes Closest Maj. Wt
no., LV
f.
Type of Project/ Activity
Pier (dock) length
Fixed Platform(s)
Floating Platform(s)
Finger pier(s)
Groin length
number
Bulkhead/ Riprap length
ayg distance offshore
max distance offshore 4,
Basin, channel
cubic yards
Boat ramp
Boathous4tBoatlift-, X
Beach Bubo79,
Other(,
Shoreline Length
SAV. not sure yes pol
Moratorium: n/a yes no
Photos: yes no
Waiver Attached: yes no
A building permit may be required by:
Note Local Planning jurisdiction)
Notes/ Special Conditions
Si'r— Please read clo gn;)tu
err
Ap
plication Fee(s).�.
(Scale:
El See note on back regarding River Basin rules.
Permit Officer's Printed Name
npliance statement on back of permit" Signatu9b J
ssul g a ..
Check# I Date '
ExpAtion Date
0,

e
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 andvoid.
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, certifythat this project is consistent with the North Carolina Coastal Management Program.
River Basin Rules Applicable To Your Project:
Tar- Pamlico River Basin Buffer Rules 0 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 complywith these buffer rules.
Division of Coastal Management Offices
Morehead City Headquarters
400 Commerce Ave
Morehead City, NC 28557
252-808-2808/ 1-888-4RCOAST
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. nccoastai management. net/
Revised 08/27/14
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 andvoid.
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, certifythat this project is consistent with the North Carolina Coastal Management Program.
River Basin Rules Applicable To Your Project:
Tar- Pamlico River Basin Buffer Rules 0 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 complywith these buffer rules.
Division of Coastal Management Offices
Morehead City Headquarters
400 Commerce Ave
Morehead City, NC 28557
252-808-2808/ 1-888-4RCOAST
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. nccoastai management. net/
Revised 08/27/14

C;AK/I�c / ❑DREDGE & FILL
o A B
Ci D
GENERAL PERMIT
Previous permit #
New ❑Modification . ❑Complete Reissue ❑Partial 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 a vironmental concern pursuant to 15A NCAC (�� I ;
Applicant Name `j C�
ules atta hed.
Project Location: County _ - "
s� I
Address A,S
Street Address/ State Road/ Lot #(s)�`�
,City
- " a State ZI
Phone # a.
E-Mail
Subdivision
Authorized Agent /Y1I
R
" f:. a� i
City ZIP
Affected ElCW tEW PTA 0 ES ❑ PTS
Phone # ( ) River Basin I
❑ OEA ❑ HHF ❑ IH ❑ USA ❑ N/A
AEC(s)c
`
Adj. Wtr. Body i,o,l an unkn
❑ PWs
ORW: yes PNA yes' / no
h
Closest Maj. Wtr. Body r `.
Type of Project/ Activity , • Z oe
K,L
Pier (dock) lengthdi ot
Fixed Platform(s) :✓ x
Floating Platforms)
Finger pier(s)
Groin length .�-
number
Bulkhead/ Riprap length '
avg distance offshore ,-
max distance offshore r-
Basin, channel
cubic yards -
Boat ramp
Boathous Boatli
Beach B I110 ing
Other ry
Shoreline Le
SAV: 'not s r yes
Moratorium: n/a yes fin _ Photos: yes
Waiver Attached: yes no
A building permit may be required by:
Note local Planning jurisdiction)
Notes/ Special Conditions
-:14plicant PrWt& Name
(Scale: / 1 )
Sv I t l I 1 Y I I I 1 I I I I I I 1 -..I If Ill
JI/ V lvi
❑ See -note on back re;
Permit Officer's Printed Nam .
Iin rules.
Si,
to-e '*.Please read compliance statement on back of permit
cation Fee(s): Checkfh
Signatu
(h
Issuuig Dat Expi tlon Pate ,

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit:
Mailing Address:
u
Phone Number: 919 -�q <3
Email Address:
I certify that I have authorized
Agent / Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development:
21—:L= L)6,,k-
at my property located at
in c--, .t County.
1 furthermore certify that I am authorized to grant, and do in fact grant permission to
Division of Coastal Management staff, the Local Permit Officer and their agents to enter
on the aforementioned lands in connection with evaluating information related to this
permit application.
Property Owner Information:
C.J
Signaturd
of
Print or Type Name
Title
Date
This certification is valid through I /
RECEIVED
JUL 14 Z016
DCM- NIHD CITY

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
_ ,
I hereby certify that I own property adjacent to--T—h 0 V" w.S oo L Of-o P 's
property located at Q j L�, � (Name of Property Owner)
.Z�g
(Address, Lot, Block, Road, etc.)
on `i �g'�) L'e 4� cIt-19 , in T lL-75 , 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.
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)
artZi--45
V�
o a
�Q sRECEIVED
N r JUL 14 2016
r
WAIVER SECTION D C M- M H D CITY
I understand that a pier, dock, mooring pilings, boat ramp, breakwater, boathouse, lift, or groin
must be set back a minimum distance of IS 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 wish to waive the 16 setback requirement.
I do not wish to waive the 15' setback
(P-rop+erty Owner Information)
�{- _ W C�
S. W tu►re�
1 Leo m 4c
or Type Name
vIE'
Teleph a Number / email address
- r)- l�
Date
*Valid for one calendar year after signature*
Information)
,fiignatu�e
PS Z
Print or Type Name
Iry Rox Jgoz
CHYAOtf P
� 2-z3 Iz iz
Telephone Number/email address
fla�'
(Revised Aug. 2014)

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that 1 own property adjacent to`' o wi pS Woo LOC o IP s
property located at 'Z3`� (Name of Property owner}
(Adds Lat Block, Road, etc.)
(Waterbody) — - - (City/Town andfor County)
The applicant has described to me, as shown below, the development proposed at the above
location.
I have no objection to this proposal.
I have objections to this proposal.
DESCRIPTION ANDIOR DRAWING OF PROPOSED DEVELOPMENT
{Individual proposing development must fill In description below or attach a site drawing)
e
RECEIVE®
JUL 14 2016
WAIVER SECTION D C Its _ M H ® CITY
I understand that a pier, dock, mooring pilings, boat ramp, breakwater, boathouse, Ift or groin
must be set back a minimum distance of I& 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
(Property Owner information)
S-&mature
7T%"om4< �Jsc Q)ea�I
Pam# ar Type Name
l�S 12 GeE&7i��
Aar
CNy/Siaie2ip
Tele Number/email address
Lo l--) -16
fiTMI
rner information)
V—
. (Revised Aug. 2014)
*Vaud for one calendar year after signature`