Whitehurst, Jeanette

r
Type of Project/ -Activity
Pier (dock) length
Fixed Platform(s)
Floating Platform(s)
Finger pier(s)_____L_L
Groin length
number
11,1 �ea iprap length 0
avg distance offshore
max distance offshore
Basin, channel
cubic yards —
Boat ramp
Boathouse/ Boatfift
Beach Bulldozing
Other
Shoreline Length
SAV: not sure yes C9
I- ----- I
Moratorium: n/a ye s
f. Photos: yes
Waiver Attached:, yes
no
A buildjn ,g permit may be required by: dr
Note Local Planning jurisdiction)
Notes/ Special: Conditions
4.
IA
Age,�t or Applicant Printed Name
Signature' l4Lease read compliance statement on
Applic Fee(s)
T"
'-VtA ermis.'I
(Scale: IV
7--f
El See note on back regarding River Basin rules.

W
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:
❑ 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 howto complywith these buffer rules.
Division of Coastal Management Offices
Morehead City Headquarters
400 Commerce Ave
Morehead City, NC 28557
252-808-2808/ 1888-4RCOAST
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.nccoastalmanagement.net/
Revised 08/27/ 14

CAMA /DREDGE & FILL
it-N
Previous permit
..PERMIT.�" A B
, #
New ❑Modification ❑Complete Reissue OPartial Reissue Date previous permit issued
o'ri�ed Esy the State of North Carolina Department of Environment and Natural Resources
Ggastal Resources Commission in an are of en Ironmental'concern pursuant to.15A NCAC 5aftAJ � .
�D (✓
f es attached.
ftlVliName
P"roject Location: County �Y
s Street Address/ State Road/ Lot #(s) ,
State ZIP
E-Mail Subdivision
zed Agent f.� Y fir+ l `. ZIP
City�r
d ❑ cw1 A des ❑ Prs Phone # (_) er Basin W e "a,
❑ OEA ❑;HHF ❑ IH ❑ UBA ❑ N/A
❑ PWS: Adj. Wtr. Body`'' a man lunkn
es no PfVA yes / o Closest Maj. Wtr. Body
of Project/ Activity A /i P Pr,MP,�
ock) length
�r
'latfgrm(s)
g Platform(s)
pler(s)
ghgth
umber
FIT
a�praplength_
ig distance offshore
lax
"distance offshore �—
:hannel 14 1 1' 1
C� yards
■■■■■■■■■■■■aNNow
i. :..tllft
■■■WEs�■■■■■■■■■■■■■■■■■
-------------
iiiiEiiiiiiie�iii�■®-■■■■ii■�
SEEM
=;
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■■■■■■■■■■■■ENO■■■■■■■■■Nlivi��l,►'1■■■
■■■■■■■■■■E■■■■N■■■■■N■
MEN
■■■■■■■■■■®■■■
le Length o
■■■■■■■■■■■■■■■■■■■■■NNE■■■■■'►�ti�►��■�■■■■■
�,notsure yes
.
■■■■■
EEEN■E■■■■NENNE■E■■■■■■NNE■E®■N■E■■■■■■E
NONE
■■■■■■■■E■■■■■■■■■■■■EillN
iiLO■■■■
ling permit may be required by:f
Local Planning jurisdiction)
Spal Conditions , eci
tr
AjSplicant Pryrited'flame
in
* I ease read compliace statement
°r
e(s) Check�4

AGENT AUTHORIZATION FORM FOR PERMIT APPLICATIONS
Name of Property Owner Applying for Permit:
Mailing address:
Telephone Number:
D.t;-a - -2s6 - 3s�
I certify that I have authorized J.:0a',gent/contractor),
to act'on my behalf, for the purpose of appi rng and obtaining all CAMA permits
necessary for the proposed development of
at my property located at
This certification is valid through _ za-::� C� (date).
(Property Owner Information)
Signature
Print or Type Name
Title,Li&o. owner or trustee for properly
)/ - ,.)) 6
's2 Date
Telephone Number
�0
Email Address
RECEIVED
NOV 2 2 2016
DCM- MHD CITY
RECEIVED
NOV 15 2016
DCM- MHD CITY

ADJACENT RIPARIAN PPC)pER i � WNER sT MEN T
I hereby certify that i own property adjacent to
Property located at ) 2 N l e of Property Owner)
onftaterbody)
o n ;Address, Lot, l�ioclt, road, etc.)
in
(CI`ty/Town and/or County) N. C.
The applicant has described to me, as shown below, the development proposed at the
location.
above
I have no abjection to this proposal. �-�"� a'"� b!to—
1 have objections to this proposal._
-�W%o ir-! 1" 111101OR DRAWING of d�PRopoS D DEVELOPMENT
(I�P?fitli!/Lr�,fa% 0�'©�705di?!�Y FPBJ!O�CIf�'de1?f Must�i'fl in deSCP7PtiQf'1 bE/i?i/U or r7`li3Cf; ci 51iG' drawing)
��i
e
(
ra ter' P @ Owner Inrorrnatton) r
Adjacent Property O'A'ner Information)
Signatw a <<
Print or Type Name
l
h� %4� Pent or Type Name
1!/lai/ittg Address O /,-,
r p 42 n J i i P N C 9 Address
CityrarareMp
Ci /S te/Lp
Telephone Number/email address
at - ? s6 — 3 53 6 -3 sa - 9,,� _ a �v s"r BiephORe
Db r 1Vumbert email address
Date
Date`
ii
fo'% RECEIVED
1�
( NO V ,
2 2 2016
l understand that a pier, dock, moorinWAIVER SEaTiON DCM- MHD CITY
at ramp
must be s t back a minimum distance of t115, fromomy a ea Of riparian access unless 'waiv groin
me. (If yo wish to Waive the setback, YOU must Initial the appropriate blank below.) lved by
_ I do wish to waive the 154 setback requirement. 4 i
1 do riot wish to waive the 15' setback requirement.
V
aGd for one calendar year after signature'
(Revised Aug. 2014RECEIVED
NOV 15 2016
DCM® IVIH® CITY

Nov 01 16.05:01 p Larry G. ArnoldLa
2527263018 p.1
AWACENT RlpARIAN Pj-,.O -.z-u
l hereb s
Y certify that I own property adjacent to
Property located at
(!�arne of s
ProneirLIF Owner)
on {dciYess, toot, Biocic,
Road, etcin
,�
(City/Town N.C.
to
The applicant has described
tocatio . me, as and/or
shot�vn below` � p the devemeet roio posed at the above
,j ✓/i have no objection to this proposal.
------- I have objections to this proposal.
(irrd7viduaf prop GS1120 devefop n,j©
nmw
hQPsQS1=L�3�}7S�QPf1;Mf'
ii` 7 ofescC7 ors be oiry
orar a5' jra
RECEIV D
I understand that a pier, dock, mooring r iilEit -EC 3 €ON
must be set back a minimum distance op 7. €$ Rinfr m°acmm NOV 2 2 201
me. (1r you wish to waive the setback, you mast i7imy the a breakwater, boathouse, 1rif, or grain
l area of riparian access unless y,,ai
r appropriate blank below.) vOOM- MHD PITY
--7,C, i do wish to waive the 15` setback requirement
t
do not Wish to waive the i5' setback requirement.
{s=r�PI---Y U14mer Warm
aYion)
�r:7ype
s '
Pric���
fy�Nam
Alai f g Ad�C,
C#ylstatemn
Telephone Numbed emafl address
Dart
"Valid for one calendar Year after signaiure
knot-
PPo e , .
p rfij din flan Fail7J$LTa!rY}
PorTvoe Nam. Y'r<�
Telephone Numberlmail address
Dwe � .".2—f RECEIVED
NOV 15 2016
(ReYised /dug. 20-14)
DCM- M-HD CITY