Williams, Mason

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WQ El DREDGE & FILL NO* 67753
A B CC D
G KgRAL PERMIT Previous permit #
Clew m pn OComplete Reissue OPartial Reissue Date previous permit issued
fi �SIOVMZ
As authorized by the Department of Environment and Natural Resources
and the Coastal Resources Commission n an area of environmental _cQncern pursuant to 15A
I - I d'"1iINCAC
N
1
Rfu,
esIN 4a1c2he1d..
Applicant Name Project Location: County1j"N
Address AoC4) - Street Address/ State Road/ 4pt Ks) ,
CityState
ul— ZIP -.QN
Phone #
Agent
Authorized Agent
'4
A
Affected
0 Cw
AW
OPTA
OES 0 FITS
AEC(s):
OOEA
0 HIHIF
0 lH
0 USA 0 N/A
ORW:
0 Pws:
rT
PNA
J
(ni
yes/
yes
T�je-'o
roject/ Activity
q.77
I U,
A t,
Pier (dock) length W X1:4'fl)
LT Q! X-AL1f, I
Fixed Platform(sy .'1-4r
Floating Platform(s)
Z& Finger pier(s)...
Groin length
number,% —
Bulkhead/ Riprap length
avg distance offshore'd-ro•'
max distance offshore
Basin, channel --
cubic yards ----
Boat ramp
Boathous(BiCtfiift'_J�
Beach Bulldozing
Shoreline Length
SAV- not sure yes G01),
Moratorium: n/a yes Cn
Photos: rn,) yes
Waiver Attached: yes I C- — -.�; -
A building permit may be required by:
(Note Local Planning Jurisdiction) -',\
City V I ) 1. ; U111 T'w'
Phone#
Adj. aocly--s:L')
Closest Maj. Wtr. Body
calle:
Basin
MA,
L/
A
V
VtAl
/FTSee note on balk regardin-eRiver Basin rules.
Signature e r;mcl compliance statement on back of permit
Application Fee(s) Check#
Signature
Issuing Date Expiration Date

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❑ D�iEDGE &FILL N? 6'7753j04
RAL PERMIT Previous permit #
A B C� D
Flew DModlification ❑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 ' area o environmental ncern pursuant to 15A NCAC ooa
RulesN. ched.
Applicant Name aU 11.)? 1 - ' . n Project Location: County
Addr _ Street Address/ State Road/ (dot -#,(s) ) A
City
Phone #
ZIP
Authorized Agent J,J�'6'��—.-�
Affected ElCW )�EW
/VTA ❑ ES ❑ PTS
AEC(s): ❑ OEA ❑ HHF ❑ IH ❑ USA ❑ N/A
❑ Pws:
ORW: yes / LoJI PNA yes /
MIA
Pier (dock) length (U xhW5
Fixed Platform(s) ` +; b4)
Floating Platform(s)
Finger pier(s)
Groin length __._.___....._ .. _...,.._.._
number_
Bulkhead/ Riprap length �----
avg distance offshore' -
max distance offshore�
Basin, channel ---
cubic yards-
Boat ramp
Boathous B tlift - --
Beach Bulldozing
OthertC�'!�-
Shoreline Length
SAV: not sure yes V.
Moratorium: n/a yesn
Photos: yes Cnq)
Waiver Attached: yes �oj_......;� - _
��JJ l
A building permit may be required by:
( Note Local Planning Jurisdiction) �}
Notes/SpecW Conditi4ty `C..f,x,
Agent
Signature ` �e read compliance statement on back of permit
--�------ � yaps
Application Fee(s) Check #
City )Iaurw
Phone #
Adj. Wtr. Body
Closest Maj. Wtr. Body
iAVAV*Vl
Signature w v —
u - a he
Issuing Date Expiration Date

rn#
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NICAMA DREDGE & FILL NV 67753
GENERAL PERMIT Previous permit # A B e F D
$New ElModification ElComplete Reissue ElPartial Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environment and Natural Resources
t--
and the Coastal Resources Commission in an area of environmental concern pursuant to I SA NCAC J
(Rules attached.
Applicant Name
Y Project Location: County I, i.
Address, Street Address/ State Road Lot
Ci State ZIP
Phone# -Mail
E
Authorized Agent
El CW NEW nPTA [I ES
Affected I
El PTS
0 OEA El HHF 0 lH 0 USA
AEC(s):
El N/A
El PWS:
ORW: yes /",no PNA yes /!no
Type of Project/ Activity 1U, ek
r.
Pier (dock) length—, 1`sl 11Y
Fixed Platform(s)
Floating Platform(s)
Finger pier(s)
.
.. ...
1_4 .. ...
.... . .. ....
..... ....... ...
. ........
.. ......
......
Groin length,
number~,__.
Bulkhead/ Riprap length
.... ........
.
.
avg distance offshore -
max distance offshore
Basin, channel
..... .....
... ... .. . . ... ...
... ... ...
cubic yards°--`
Boat ramp
Boathouse/ Bo�atlift
'41
--------
-­ -
-
Beach Bulldozing
Other & IN
V
tact.;
Shoreline Length
SAV: not sure yes no
Moratorium: n/a yes no
_1,
Photos: yes no
a
Subdivision
City ZIP
I River Basin, k, Phone #
at /man /mnkn)
Adj. Win Body
Closest Maj. Wtr. Body
(kale:
Waiver Attached: yes `fio
A building permit may be required by: See note on back regarding River Basin rules.
(Note Local Planning jurisdiction)
Notes/ $peclal Conditions
Y
4, Wl" ej
Agent or ApplicAntPrinted Name PermitOfflice;.
.4V -
-------------
Signature tik ease read compliance statement on backof permit" Signature
Che�k# Iss
uing Date ExpirAio'n Date
Application Fe

�y
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 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 how to complywith these buffer rules.
Division of Coastal Management Offices
Morehead City Headquarters
400 Commerce Ave
Morehead City, NC 28557
252-808-2808/ 1-888-4RCOAST
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.nccoastaimanagement.net/
Revised 08/27/ 14

PAMA / ❑ DREDGE & FILL 67753 A g C D
MINERAL PERMIT Previous permit#
!slew ❑Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued
!zed by the State of North Carolina, Department of Environment and Natural Resources *�
oastal Resources Commission in an area of environmentalconcern pursuant to 15A NCAC
f '
Rules a ched.
Name r v ) i � t
Project Location: County
Street Address/ State Roa
31 State ZIP ! r'
E-Mail r Subdivi 'one_
'd Agent { r - .- .. City 1�
❑ CAN ,hT ❑ ES ❑ PTS Phone # ( r'
❑ OEA ❑ HHF ❑ IH ❑ UBA p N/A tY
❑ PWS:
Adj. Wtr. Body
.�,.
es / no PNA yes / /j Closest Mal. Wtr. Body-
Project/ Activity Ulu r
y f�
latform(s)
r(s) '
gthr
iber�r„_
';Riprap length
distance offshorw—
distance offshore`___"
nnel `'"'"""",
B atlift; ,
Length '
not sure yes kno/
1m: n/a yes `(no
yes 09
ttached: yes o
g permit may be required by:
Deal Planning Jurisdiction)—
lqhqw
note on ba
�y
UC�cale: ! 00 ) .
��- �niiii�rii■■
®MEN
iver Basin rules..
;.
t ,rnnted Name Y
a� Permkoffic 's(P ' ted afhe
ee
read compliance statement onbackofpermit Signature'
?'
L
Check# IssuingDate
Expiration Date

N.C. DIVISION OF COASTAL MANAGEMENT
AGENT AUTHORIZATION FORM
Date 5 '?, 4 1
Name of Property Owner Applying for Permit:
Mailing Address:
0O t+-&vj cPrk' �u<�,Z)7
RECEIVED
JUN 16 Z016
DCtA- MHD CITY
I certify that I have authorized (agent) �'e ! .>irtl2� to act on my
behalf, for the purpose of applying for and obtaining an CAMA J
Permits necessary to
install or construct (activity) d-061Z., �t n� `y I& 1 Aes-
) ,
at (my property located at)
104S,
MVf e6 ea
I34 S-Fz,'i"
This certification is valid thru (date) 1 d — 3 1 ` 1 4c
Property Owner Signature
RECEIVED
AUG 03 2016
Date

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a .._ 2£+�., ,J.i'skbnma ..aek;, .l ki.O.r�t izs..,<,.e.,s.� i .its
,n .. ., y,....•�, vo..-._„ .. .. ............ .. ...._. 1..,_� �. .........,,.......
.........
RECENED
AUG 0 3 2016
DCM- MHD CITY
�
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ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I herebycertify that I own property adjacent to a so^ / lit i e t m 5 is,
fy P l� y I
(Na a of Property Owner)
property located at 4� ' 13
�`�''`
(Address, Lot, J3,11ock, qoad, ebte.)
on © 4-f- 04-t^ , in- r� �°u Ge , N.C.
IJ (Waterbody) (Cityffown and/or ounty)
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 QE PROPOSED DEVELOPMENT
(IndAddual proposing development must rill In description below or attach a site drawing)
r,
see
RECEIVED.
AUG 032016
DE FJ\JED
DCM- MHD CITY 2016
30N 16
®CW Wt) 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 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) Adjacent Pr Owner Information)
Signature
M ,ASaA,, l W) L—LI 4 JA-1
Print or Type Name
Mai ld Address ') -7 C, i
CitylSrate,zip�z .1
Telephone Number / email address
Date
Mod
Teleph9va,Numberlemail address
.-_ ri6
Bate*
(Revised Aug. 2014)
*Valid for one calendar year after signature*

o ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby cedi that I own property adjacent to a so^ 1 It etm s 's
{Y
S (�e of Property Owner)
property located at
(Address, Lot, Iock, qoad, c.)on 90qtt-f- SD4-4/ld 04
,+a
(Waterbody) (City/Town and/orCounty)
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 OR DRAWING OF PROPOSED DEVELOPMENT
(Individual proposing development must iyi/ in descripdon below or attach a site drawing)
JUN 16 2016
RECEIVED®CM- MH® CITY
AUG 0 3 2016
WAIVER SECTQ19 M- NI FI D C F F Y
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.)
I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(Property Owner Information)
Signature
Print o4Type Name
Mai g I C> Address
CitylStatemp 1
�'71 q, 4
Telephone Number/ email address
. ;2z".1A
Date
*Valid for one calendar year after signature*
Date*
Information)
lam * (Kl'�u
(Revised Aug. 2014)