Portside Marina

L/
-. --CAMA / DREDGE & FILL A B C D
GENERAL PERMIT Previous permit#
JNew Modification ❑Complete Reissue ❑Partial ReissuEc 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 15A NCAC
❑ Rules attached.
Applicant Name
Address
City
Phone # ( )
Authorized Agent
Affected ❑ CW [ EW
AEC(s): ❑ OEA ❑ HHF
71 PWS:
ORW: yes / no PNA
_ State ! r' ZIPLie
-Mail
V PTA ❑ ES ❑ PTS
l IH ❑ UBA ❑ N/A
yes / no
Project Location: County
Street Address/ State Road/ Lot #(s)
Subdivision
City ZIP ^I
Phone # ( )( v - ' JRiver Basin
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Agent or Applicant Printed Name
Signature -•� Please read compliance statement on back of permit,**
Application Fee(s) Check #
PermitOfficer's Printed Name
Signature
g
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/ 1-888ARCOAST
252-946-6481
Fax: [phone]
Fax: [phone]
(Serves: Carteret, Craven, Onslow -
(Serves: Beaufort, Bertie, Hertford, Hyde,
North of New River Inlet- and Pamlico
Tyrrell and Washington Counties)
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)
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://vwvw.nccoastalmanagement.net/
Revised 08/27/ 14

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to r �"5 '1 r,L_y✓ I a i /yti 's
��� (Name of Property Ow er)
property located at 0 5 N r � ►/1 & -P (� � I'Y LL L 7C `
(Address, Lot, Block, Ro d, etc.
on A�r JeAA (`J1A-n'tg-� in r t��C',�� ; ► , N.C.
(Waterbody) (City/Town a/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)
e- /4
M4 J ji lc rI
WAIVER SECTION
1 understand that a pier, dock, mooring pilings, 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.)
1 do wish to waive the 15' setback requirement.
F� I do not wish to waive the 15' setback requirement.
(Property ^VVOwner Information)
Sigrurb,,
Print or Type Na e
MailingAdd s
City StatelZip
- 7zip 2to -
Telephone Number
1);- )G=--.201 g
(Adjacent
r Information)
6'i ature
l< <
0
R-Tint or Type Name
M
ling ddr ss j� r
City§tatelZip
o
Telephone Number
-00
Up
(Revised 611812012)

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
hereby certify that I own property adjacent to POAJi:� _ t` AIE4,MZZ i /V A 's
(Name of Property Owner
property located at �L2 I� iZJ=N r�L- �` /�/7`C- N
(Address, Lot, Block, Road, etc.)
on Atre 4r�,,�Q 0h t� ao-J in ,-�:��,:a Q �° r ilr , 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.
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)
Wig 1 /'! �e rl 4AC. e e�' ec'( tS
WAIVER SECTION
I understand that a pier, dock, mooring pilings, 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.)
_ V ty� I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(Property Owner Information)
Si Wure
PC~A/%LiZ , 4�15
Print or Type Name
"'-
Maillna Address
City StatgzZip
70 z' 7lkk 7% 7�
Telephone Number
Date
(Adjacent Property Owner Information)
tune
—-ems—i--4--475
Print or Type Name
Mailing Address
M
City/StatelZip
Telephone Number _Q
..-, 5 2 ,'- (3&n a
Date
(Revised 611812012)

PORTSIDE lIkUNA - MIRM"AR 80.4TI
+n ARENDELL S71 PO BOX 3569
�KREHEAD Ct i Y NC 28557
252-726-70—n {F} 252-126-5523
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PORTSIDE MARINA - MIRAMAR BOATS
209 ARENDELL ST PO BOX 3569
MOREHEAD CITY NC 28Fa'7
252-725-7678f,Fj252726 6923
E pars;[e-mail]
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Locality Permit Number
Ocean HazaYd Estuarine Shoreline ORW Shoreline Public Trust Shoreline Other
(For official use only)
GENERAL INFORMATION
LAND OWNER - MAILING ADDRESS
Name E h% Tt fZ I .S P® ��i % b e I4y e-r '1 C_�t'
Address at) c A )-1- Z-5
City 11v"e k et4h C ► State t/__ ZipZf1Cy7 Phone z� � - 7Z& 76 7
Email
AUTHORIZED AGENT
Name -�a W P
Address
City
Email
State
Zip Phone
LOCATION OF PROJECT: (Address, street name and/or directions to site; name of the adjacent waterbody.)
DESCRIPTION OF PROJECT: (List all proposed construction and land disturbance.)
a 5 i ki 4 °i— F d
SIZE OF LOT/PARCEL: square feet r0Q d w v acres
PROPOSED USE: Residential (Single-family ❑ Multi -family Commercial/Industrial �K Other
COMPLETE EITHER (1) OR (2) BELOW (Contact your Local Permit Officer if you are not sure which AEC applies
to your property):
(1) OCEAN HAZARD AECs: TOTAL FLOOR AREA OF PROPOSED STRUCTURE: square feet (includes
air conditioned living space, parking elevated above ground level, non -conditioned space elevated above ground level but
excluding non -load -bearing attic space)
(2) COASTAL SHORELINE AECs: SIZE OF BUILDING FOOTPRINT AND OTHER IMPERVIOUS OR BUILT
UPON SURFACES: square feet (includes the area of the foundation of all buildings, driveways, covered decks,
concrete or masonry patios, etc. that are within the applicable AEC. Attach your calculations with the project drawing.)
STATE STORMWATER MANAGEMENT PERMIT: Is the project located in an area subject to a State
Stormwater Management Permit issued by the NC Division of Energy, Mineral and Land Resources (DEMLR)?
YES NO
If yes, list the total built upon area/impervious surface allowed for your lot or parcel: square feet.

Coastal Management
ENVIRONMENTAL QUALITY
APPLICATION FOR
CAMAMINOR
DEVELOPMENT
PERMIT
In 1974, the North Carolina General Assembly passed the Coastal Area Management Act
(CAMA) and set the stage for guiding development in fragile and productive areas that
border the state's sounds and oceanfront. Along with requiring special care by those who
build and develop, the General Assembly directed the Coastal Resources Commission
(CRC) to implement clear regulations that minimize the burden on the applicant.
This application for a minor development permit under CAMA is part of the
Commission's effort to meet the spirit and intent of the General Assembly. It has been
designed to be straightforward and require no more time or effort than necessary from
the applicant. Please go over this folder with the Local Permit Officer (LPO) for the
locality in which you plan to build to be certain that you understand what information he
or she needs before you apply.
Under CAMA regulations, the minor permit is to be issued within 25 days once a
complete application is in hand. Often less time is needed if the project is simple. The
process generally takes about 18 days. You can speed the approval process by making
certain that your application is complete and signed, that your drawing meets the
specifications given inside and that your application fee is attached.
Other permits are sometimes required for development in the coastal area. While these
are not CAMA-related, we urge you to check with the Local Permit Officer to determine
which of these you may need. A list is included on page two of this folder.
We appreciate your cooperation with the North Carolina Coastal Management Program
and your willingness to build in a way that protects the resources of our beautiful and
productive coast.
Coastal Resources Commission
Division of Coastal Management
a
y_
�C n
RECEIVEDEl
MAR 16 2018 o y
DCM- MHD CITE" �z
DCM Form EB 1952-2015/Revised
A

OTHER PERMITS MAY BE REQUIRED: The activity you are planning may require permits other than the CAMA
minor development permit, including, but not limited to: Drinking Water Well, Septic Tank (or other sanitary waste
treatment system), Building, Electrical, Plumbing, Heating and Air Conditioning, Insulation and Energy Conservation, FIA
Certification, Sand Dune, Sediment Control, Subdivision Approval, Mobile Home Park Approval, Highway Connection, and
others. Check with your Local Permit Officer for more information.
STATEMENT OF OWNERSHIP:
I, the undersigned, an applicant for a CAMA minor development permit, being either the owner of property in an AEC or a
person authorized to act as an agent for purposes of applying for a CAMA minor development permit, certify that the person
listed as landowner on this application has a significant interest in the real property described therein. This interest can be
described as: (check one)
an owner or record title, Title is vested in name of I'V4 - r--.3 J4 T_ /W4 ep tva'
see Deed Book _y�� page _ in the County egistry of Deeds.
an owner by virtue of inheritance. Applicant is an heir to the estate of
; probate was in County.
if other interest, such as written contract or lease, explain below or use a separate sheet & attach to this application.
NOTIFICATION OF ADJACENT RIPARIAN PROPERTY OWNERS:
I furthermore certify that the following persons are owners of properties adjoining this property. I affirm that I have given
ACTUAL NOTICE to each of them concerning my intent to develop this property and to apply for a CAMA permit.
(Name) (Address)
(1) . 1�:-Al bcJ_ L 5 --
(2)� ✓•-► Ins ©I /9ezrA! ,---- C J.- e- Z;T;
(3)
(4)
ACKNOWLEDGEMENTS:
I, the undersigned, acknowledge that the land owner is aware that the proposed development is planned for an area which
may be susceptible to erosion and/or flooding. I acknowledge that the Local Permit Officer has explained to me the particu-
lar hazard problems associated with this lot. This explanation was accompanied by recommendations concerning stabiliza-
tion and floodproofing techniques.
I 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.
This the — /6 day o, 20
Landowner o4erson authorized to act as his/her agen( for purpose of filing a CAMA permit application
This application includes: general information (this form), a site drawing as described on the back of this application, the
ownership statement, the Ocean Hazard AEC Notice where necessary, a check for $100.00 made payable to`t`h� ity, and
any information as may be provided orally by the applicant. The details of the application as d '1�dEces are
incorporated without reference in any permit which may be issued. Deviation from these details will constitute a violation of
any permit. Any person developing in an AEC without permit is subject to civil, criminal and admit z" cM.
DCM- MHD CITY

SITE DRAWING/APPLICATION CHECKLIST
Please make sure your site drawing includes the following information required for a CAMA minor development permit.
The Local Permit Officer will help you, if requested. '
PHYSICAL DIMENSIONS
Label roads
Label highways right-of-ways
Label local setback lines
Label any and all structures and driveways currently existing on property
Label adjacent waterbody
PHYSICAL CHARACTERISTICS
Draw and label normal high water line (contact LPO for assistance)
Draw location of on -site wastewater system
If you will be working in the ocean hazard area:
Draw and label dune ridges (include spot elevations)
Draw and label toe of dunes
Identify and locate first line of stable vegetation (contact LPO for assistance)
Draw and label erosion setback line (contact LPO for assistance)
Draw and label topographical features (optional)
If you will be working in a coastal shoreline area:
Show the roof overhang as a dotted line around the structure
Draw and label landward limit of AEC
Draw and label all wetland lines (contact LPO for assistance)
Draw and label the 30-foot buffer line
DEVELOPMENT PLANS
Draw and label all proposed structures
Draw and label areas that will be disturbed and/or landscaped
Note size of piling and depth to be placed in ground
Draw and label all areas to be paved or graveled
Show all areas to be disturbed
Show landscaping
NOTE TO APPLICANT
Have you:
• completed all blanks and/or indicated if not applicable?
• notified and listed adjacent property owners?
• included your site drawing?
• signed and dated the application?
• enclosed the $100.00 fee?
• completed an AEC Hazard Notice, if necessary? (Must be signed by the property owner)
FOR STAFF USE _
Site Notice Posted Final Inspection Fee Received
Site Inspections
Date of Action: Issued Exempted Denied Appeal Deadline (20 days from permit action)