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❑CAMA / ❑ DREDGE & FILL
A B C D
GENERAL PERMIT Previous permit #
[]New , ❑Modification ❑Complete Reissue FL —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 I SA NCAC
❑{Rules attached.
Applicant Name
Address
Cityi:. State _ ZIP '
Phone # E-Mail
Authorized Agent T
Affected ❑ CW ❑ EW ❑ PTA ❑ ES ❑ PTS
AEC(s): ElOEA D HHF ElIH ElUBA ❑ N/A
❑ PWS:
ORW: yes / no PNA yes / no
project Location: County �-----
Street Address/ State Road/ Lot #(s)
Subdivision
City _ ZIP_
Phone #(M > River Basin
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Agent or Applicant Printed Name
Permit Officer's Printed Name
Signature Please read compliance statement on back of permit Signature
Application Fee(s) Check # 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 Washington District
400 Commerce Ave 943 Washington Square Mall
Morehead City, NC 28557 Washington, NC 27889
252-808-2808/ 1-888-411COAST 252-946-6481
Fax: 252-247-3330 Fax: 252-948-0478
(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: 252-264-3723
(Serves: Camden, Chowan, Currituck,
Dare, Gates, Pasquotank and Perquimans
Counties)
http://www.nccoastalmanagement.net/
(Serves: Beaufort, Bertie, Hertford, Hyde,
Tyrrell and Washington Counties)
Wilmington District
127 Cardinal Drive Ext.
Wilmington, NC 28405-3845
910-796-7215
Fax: 910-395-3964
(Serves: Brunswick, New Hanover,
Onslow - South of New River Inlet -
and Pender Counties)
Revised 08/27/ 14
AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: Jamie Mitchell I��n��
Mailing Address:
Phone Number:
Email Address:
1 certify that 1 have authorized
1225 Old Sanders Road
Smithfield NC 27577
919-8683385
imitche11490@aol.com
Harber Contracting
Agent 1 Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development:
Repacing the dock and a boat lift
at my property located at 400 Dolphin ST ,
IN
Carteret
County.
t 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:
�Signa�tur
Print or Type Name
Title
Date
This certification is valid through 12 !�_! 18
RECEIVED
APR 2 3 2018
DCM-MHD CITY
ri , 14
ADJACENTAQJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to Jamie Kitchell Is
(Name of Property Owner)
property located at 400 Dolphin Street
(Address, Lot, Block, Road, etc.)
on Bogue sound in Cape Carteret I N.C.
(Waterbody) (City/Town and/or County
The applicant has described to me, as shown below. the development proposed at the above
I cation. I
,;� .9,-, �V 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)
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)
'%ffifg"Mitchell
Print or Type Nairne
Mailing Address
CitylStatelZip
Telephone Number / email address
0,11e
*Valid for one calendar year after signature*
(Adjacent Property Owner Inforpation)
-----"'-
Print 0,J951Y%owpp
"'IN'Wffne Drive
CIV%W�oro NC 28254
Telephone ie Numbed email address
)-,LV1 24
Date
0Re M 9) VA R
APR
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to Jamie Mitchell is
400 Dolphin (Name of Property Owner)
property located at
(Address, Lot, Block, Road, etc.)
on Bogue Sound in Cape Carteret N.C.
(Waterbody) (City/Town and/or County)
The applicant has described to me, as shown below, the development proposed at the above
location
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)
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.
1 do not wish to waive the 15' setback requirement.
(Property Owner Information) (Adjacent
/jProperty Owner Information)
S'AM'Mitchell S' na L r
,VE/G G%
Print or Type Name Print or Type Name
2006 O Berry Center Road
Mailing Address Vffiftdroeft 28584
City/State/Zip City/State/Zip
Telephone Number / email address Telephone Number / email address
Date Date* 51116 Z 0 /
(Revised Aug. 2014)
*Valid for one calendar year after signature"
Jamie Mitchell
Dock
�12 6
13k o
Boatlift N
4x10 girder
ce
13'
148.5'
Harter Contracting Inc
Drawing:
Note: '/. thru bolts
P.O. Box 4562
400 Dolphin St.
used at 4x10 girders.
Emerald Isle NC
For :Jamie Mitchell
28594
5/8 thru bolts used at
252-342-9987
hogslats and 6x6s