Kildow Jr, Richard D.

CAMA / DREDGE & FILL A B C D
GENERAL PERMIT Previous permit#
_
New f p+difi1t�q �� � O"t
sue _Partial Reissue Date previous permit issued
As authorized by the State of rt'n1 r I a D of Environment and Natural Resources
and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC
Rules tache .
Applicant Name
Address
Ci
State
Phone # (- ) E-Mail
Authorized Agent
-_ ZIP
Affected ❑ CW EW _ PTA ES PTS
AEC(s): ❑ OEA HHF IH UBA N/A
❑ 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
Basin, channel
cubic yards
Boat ramp
Boathouse/ Boatliff
Beach Bulldozing
Other ._-
Shoreline Length
SAV: not sure yes o
Moratorium: n/a yes /
__.,.... .... ..
Photos: yes
Waiver Attached: yes no
A building permit may be required by:
( Note Local Planning jurisdiction)
Notes/ Special Conditions
Agent or Applicant Printed Name
Signature ** Please r d compliance statement on back of permit
Application Fee(s) (i ^ Check #
Project Location: County
Street Address/ State Road/ Lot #(s)
r
Subdivision
City r' .
Phone # River Basin
Adj. Wtr. Body K''-- ty (nat /man /unkn
Closest Maj. Wtr. Body
(Scale:
❑ See note on back regarding River Basin rules.
Q
PermitOfficer's Printed Natiie
Signature
Issuing Date �_ j tElpi �iA/i DatV Y
11 ti

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
Iandowner(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 consistentwith 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

LAMA / T DREDGE & FILL A B j C D
ENERAL 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 Commissiog in an area of environmental concern pursuant to 15A NCAC
Rules a ; ch
Applicant Name 1 1 j1 !lrto',')Project Location: Countx
h
Address i ;j ! ` Street Address/ State Road/ Lot #(s)
State ZIP /� ^ ( r --
Phone # (`���►i'/ F_Mail Subdivision , . 1
Authorized Agent ``--" " `- City `r.` zip -
El
Affected CVV , ,,I�,ES ❑ PTS Phone # is 'ver Basin
AEC(s): ❑ oeA ❑ HHF ❑ IH\/ ❑ ❑ N/A Adj. Wtr. Body. {
�'," .
❑ Pws: ,...,
ORW: yes / no PNA yes / io -
Closest Maj. Wtr. Body
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4
Agent or Applicant Printed Name Permit Officer's Primed N
---- a
Signature !* Please read compliance statement on back of permit" Signature
Application Fee(s) Check# Issuing Date Expiration Date

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: I-Y4 rcl C /0 /6/,o U.J
Mailing Address:
C;a a Cab po-� n
CC�-C e-� { c Z g 5,6 `y
Phone Number: Lq l c) 3 S - c/ q Z-
Email Address: n o _ CkC CC,) yc' vv'�0• Cv0'l
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:
at my property located at
,�2 9 ;)- C�&,91 /�&- i�Or �- �;x e�;� x�-
in 0&/L, LMIP,i County.
I furthermore certify that 1 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:
2ELb P
Signatu e
Print or Type Name
Title
Date
This certification is valid through
11,
! AUG 17 2017
®CM- MCI® CITY

ADJACENT RIPARIAN PROPERTY-QINIVR STATEMENT =
I hereby certify that I -own. property ad]acertt to `� 1x�ir
property located at f 7:f1.(�1a 0PrcpY
Bto
on 4%r-�Q;` Address, t� c R ..•
r� '
W. Gc
«'r
(Watndfor,-Coy
3_
The applicant has dWdbdd to ino,-as-shown below, -the. development proposod at the 'above.
locati6n..
hhave no-okijection ta.this..proposal:
have. objenso #is proposal. .
.DE-86—WTIOhiA CVEYl t3F d'fAflill000 O OPi $ED.DI VELOPMENT: - -
(Inafiwidual proposing dweiopmt >!i fifA^in descriip'on below ar attach a site drawing)
-- -
yar
WAIVER SEMON
understand fftaf-a pier, -deck, Mgonng'OMh�s,:bFdAWafer, boathouse, lift; or groin most be set
back.a minimum dist; nc�e of t&;ff.cp-rtf�i.at a ef_J�panan access unless waived by me. (If you
wish io waive the setbaLA%Yvy must rani U UNk apprQpnate blank below.)
' I do wish. fia vvaivo.tFe I requirement`
do riot wish to ww: Jve tf�e .16 sef -'requirement
{P�rgpei'ty fiiwner-Irnoririoe) ` .(Adjacent Property OwperjInformation)
� «��� ,•�'l •-.. - s ';fir
r�
Die
f-
-y
a A.
i
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(Revised R/1820i2)
2017

ADJACENT RIPARIAN PROPERTY OWNI=R STATEMENT
hereby certify that I own property adjacent to «/3/ /f % /C 's
• (Name 0 Property Owner)
property located at
(Address; io Bloc,:R , eikc'.j
on —'= it u L' 1 N.C.
(CltYf Own -andlor.Count `
The applicant has d scrib6d to ine,.asshown below,`the.devalopment proposed atthe'above.
location..
have no objection to .this .proposal:
have. obi edbri to this proposal. .
DESCRIPTI01� AND G.R QRAVIClNQ OF i ROPOSED DEVELOPMENT
(Inaliii�dual proposing developm tt must f�J ' descripilon bel®w or ai`tach a site drawing)
Yair d`
WAIVER SEQTION
I understand tf at: a ierx dock, hroormg il�ngs,' breakwater, boathouse; Nft; or groin must be set .
back, a minimum distance bf 15'.f to rrt�i area of Xipariawaccess unless waived by me. (if you .
wish -to waive .the setback; :you must initial the_ appropriate, blank below)
' I do wish. to waive. the 1 V' setback requirement. -
1 do riot wish to waive the 16' setback requirement.
(Property Owner; Information} ' (Adjacent Property Owner Information}
ture C . Suture .
Pf tC�iQr� IA�Oc✓ -e ni•[ L
Printor'T . ' 1V a Print or Typ Name
a. ...0(A7. 'Dr z4' Glvh.D�c;�,� �2
inng A'. ess c �, r, , Mailing Address
T
IctV tate i
on N tuber l�eMphcne iVum er
i 3117 .S 13 / AUG 17 2�17
Dater Date