Balon, David

CAMA / 7 DREDGE & FILL A B C D
-
GENERAL PERMIT Previous permit #
New -Modification El Complete Reissue '-JPartial Reissue Date previous per
mit 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 E] Rules attached.
Applicant Name Project Location: County
Address 4 Street Address/ State Road/ Lot #(s)
City— State ZIP-,
Phone # E-Mail
Authorized Agent
Affected El CW El EW ❑ PTA DES [71 PTS
AEC(s): El OEA E HHF E lH El UBA El N/A
El PWS:
ORW: yes / no PNA yes / no
Type of Project/ Activity
Pier (dock) length
Fixed Platform(s)
Floating Platform(s)
Finger pier(s) ✓
Groin length
number
Bulkhead/ Riprap length
avg distance offshore
max distance offshore,,,.L___
Basin, channel
cubic yards
Boat ramp
Boathouse/ Boatlift!
Beach Bulldozing
Other
`H
Shoreline Length
SAV: not sure yes.
Moratorium: n/a yes
\
Photos: yes no
Waiver Attached: yes no
A building permit may be required by:
( Note Local Planning jurisdiction)
Notes/ Special Conditions
Agent Applicant Printed Name" I
Signature Please read compliance stair inent on back of permit
Ilk
Application Fee(s) Check #
Subdivision
City— ZIP
Phone # O River Basin
46A /man /unkn)
Adj. Wtr. Body
Closest Maj. Wtr. Body —
(Scale:
See note on back regarding River Basin rules.
t ) !--7.1 . ,I I . I-
1 ".4
P.'1 �,
r
Permit Officer's Printed Name
Signature
Issuing Date 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 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 comply with these buffer rules.
Division of Coastal Management Offices
Morehead City Headquarters
400 Commerce Ave
Morehead City, NC 28557
252-808-2808/ I-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)
http://www.nccoastalmanagement.net/
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)
Revised 08/27/ 14

I hereby certify that I own property adjacent to (Name of Property owner)
property located at _
(Address, Lot, Block, Road, et N.C.
on ` ` ' in
(CitytTown and/or County)
— (Waterbody)
The applicant has described to me, as shown below, the development proposed at the above
ttv�-
I have no objection to this proposal.
I have objections to this proposal.
NT
DESCRIPTION AND►OR DRAW/ a in o��Pon below oOSED r aOa �Ea site drawing)
(individual proposing development must
WAIVER SECTION
athouse, lift, or groin
lerstand that a pier, dock, mooring pilings, boat ramp, breakwater, bo
be set back a minimum distance of 15' from my
the appropriate blank below.) area of riparian acss unless
waived by
(If you wish to waive the setback, you must
I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
Information)
Sivrtature
Print or Type Name
Mailing Add ssmr
f .
l ?
=1ephone
umber)"email address
Date
*Valid for one calendar year after signature*
(Adjacent Property tjw►n": ���••••...M..-..,
Signature*
Print N,c,u<<G�p�Na'i��
�/`4� _:i,I,(J
i
G,MailingAddre
L7�
Cyt/Stota/Z
Telephone Number/ email address
Date*
(Revised Aug. 2014)

I hereby certify that I own property adjacent to Owner)
(Name of Property
property located at (Address, Lot, Block, Road, etc.) , N.C.
on od ' in (City/Town and/or COMM
(Waterb y)
The applicant has desc
ribed to me, as shown below, the development proposed at the above
loc. I have no objection to this proposal.
I have objections to this proposal.
WING OF PROPOSED DEVELOPMENT
DESCRIPTION ANDIOR D'RA
sin development muss fill in description below or atEaah a site drawing
(individual proposing
I
1
a
WAIVER SECTION
dock, mooring pilings, boat ramp,
breakwater, boathouse, Lift, or groin
i understand that a pier, area of riparian access unless waived by
fro
must be set back a minimum distance of m'ust initial the appropriate blank below.)
me. (if you wish to waive the setback, y
` e 16 setback requirement.
! do wish to waive th
I do not wish to waive the 15' setback requirement. Information)
Own-ormation)
A ature r
Date
Number/ email address
*Valid for one calendar year after signature*
(Adjacent Property Owner
Sign hire©
j
Print or Ty Name R
Mailing Addresl
e* - 1 V_ _e S
City_/ temp � 4 ^� �+ 3
-ico S 3
Telephon Number/email address
� ,o
Date*
(Revised Aug- 2014)

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Dan Foley
1810 Old Airport Rd
New Bern, NC 28560
252-636-2515
foleycontractors c,,g�mail.com
This quote prepared tor: IJavia tsaion time: 11/Jv/ 1 i
Customer Name I Property Address
David Balon
907 Leeward Dr
New Bern, NC 28560
Dan Foley hereinafter referred to as "Contractor," hereby proposes to furnish all material, labor & equipment necessary
for the installation & satisfactory completion of the following at the property of hereinafter referred to as Owner(s).
— t _7-__ - A. ,`.i— fnr 11 ,- fnllnvvina-
w e nereo
Item#
Detailed Description
Amount
1
Build walk way 4' wide approximately 170' long over wet land labor, equipment and
18,020.00
material
2
Build walk way over water 4' wide approximately 50' long labor, equipment and material
5,300.00
3
Build section at end off walk way 12' x 16' long labor, equipment and material
5,088.00
4
Install (4) piling for boat each 25' long labor, equipment and material
2,100.00
Estimated building permit cost associated with this project:
A) Coastal Area Management Authority (CAMA)
(Contractors permission from attached)
1. Bulkhead & Rip Rap Rock
2. Dock, Boatlift & Boathouse
.00
B) County Building Permit
85.00
185
C) Local, City & Other Building Permits
Note: Please sign NCDENR form attached & return to contractor
Note: If contact is by the hour on any of our equipment, the owner in encouraged to be on -
site to read the equipment meter reading on equipment or have someone else if they feel it
necessary.
Note: All piling are Bid with 8'ft Penetration (required by NC Building Code) 16'ft being
the longest piling any longer required is a Change Order will be issued to the customer for
signature.
Total
We hereby propose to furnish material, labor & equipment of complete the above in
31,093.00
accordance with the specifications excluding items that maybe shown above as being
completed on a "Cost Basis" for the sum of.

P t to be made as follows•
aymen
# Terms
Amount
�- p. U�
1 A beginning deposit in the amount of shall be paid the Contractor upon the execution this
agreement.
4,200.00
2
A draw in the amount of shall be paid to the Contractor at the time equipment and material is on
Set payment
job site.
arrangement
3
A draw in the amount of shall be paid to the Contractor at the time material is on site.
A progress draw in the amount shown at the right, shall be paid to the Contractor upon the
Set payment
4
satisfactory installation of approximately one-half ('/2) of the construction in this agreement;
arrangement
This draw is due at the request of the contractor.
The balance shall be the Contractor in full upon the satisfactory completion of the agreement. The
Set payment
F
Owner's or agent should make arrangement to be on -site at the completion of the job.
arrangement
Material
All material are guaranteed to be specified, and the above work to be performed in accordance with standard practice and
drawing & specifications submitted for above work and completed in a substantial workman like manner.
cif"ications
Item# I Description I Dimensions I Retention Level
All specifications & code shall meet or exceed all State/Local requirements under the codes.
Any alteration or deviations from specifications involving extra cost will be executed only upon a "written Change Order"
and will become an extra charge over and above this quote. All agreements are contingent upon strikes, accidents or delays
beyond our control.
Before the work of any installation has commenced, Owner shall furnish the Contractor with the location and character of
any underground wires, pipes, sewer, conduit, obstructions, other conditions or restrictions of any nature which might
interfere with or be damaged by the contractor's work or be cause or occasion of injuries or other damage. If owner shall
to do so, owner agrees to release, indemnity, save harmless & defend the Contractors from and against all liability, loss,
damage and expense caused or occasioned thereby.

Respectfully Submitted:
Dan Foley Contractor
1810 Old Airport Rd
New Bern, NC 28560
Date:
As owner (s) of the property to be improved, Uwe promise to pay the quoted price associated with the improvements to be
made. Payment shall be made according to payment schedule outlined above. Final payment is to be paid to the Contractor
in full upon completion of the construction. A late penalty of Ten (10%) percent will be paid by the Owner (s) on any
outstanding balance not received within Ten (10) days of the invoice date. Any outstanding balance over Thirty (30) days
will be subject to a Finance Charge of Eighteen (18%) percent per annum or
One point Five (1.5% ) percent per month.. All accounts over Sixty (60) days will be referred to the Credit Bureau.
The above prices, specifications and conditions are satisfactory and hereby accepted. Uwe certify that we are the legal
Owners of this property and therefore you are authorized to complete the work as specified.
Payment will be made as outlined above
Accepted
Date:
Accepted: Date:

AGENT AUTHORIZATION FORM FOR PERMIT APPLICATIONS
NAME OF PROPERTY OWNER APPLYING FOR PERMIT David_ Balon
MAILING ADDRESS _907 Leeward Dr
New Bern, NC 28560
TELEPHONE NUMBER
I certify that I have authorized Dan Folev (agent/contractor) ,
to act on my behalf, for the purpose of applying and obtaining all CAMA permits
necessary for the proposed development of
at my property located at
This certification is valid through (1) Year (date).
(Property Owner Information)
Signature
Print or Type Name
Title, co. owner or trustee for property
Date
Telephone Number