City of New Bern - 70962

-� MCAMA / DREDGE & FILL AP N2 10962 A B C D
GENERAL PERMIT Previous permit #
L�New ❑Modification ❑Complete Reissue [-]Partial Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environmental Quality
and the Coastal Resources Commission in an area of environmental concern pursuant to I SA NCAC
rt O Rules attached.
Applicant Namek, t �+ Project Location: County
Address ;irk i } .� Street Address/ State Road/ Lot #(s)
City f 1 (`1 State
f �� `` Phone # E-Mail
j� Subdivision
(' • )_��
Authorized Agent i 0 (i City -'a / ZIP
❑ CW ElEW El PTA [I ES ❑ PTS Phone # ( ) River Basin
Affected ❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A Ad' Wtr. Bod 1,
r i C "F'.-_.- (nat /man /unknEl PWS:
ORW: yes / no PNA yes / no' Closest Maj. Wtr. Body 1
Type of Project/ Activity
Pier (dock) length
Fixed Platform(s)
Floating Platform(s) I `Z I-o"W
Finger pier(s)
Groin length
number
Bulkhead/ Riprap length
avg distance offshore
max distance offshore
Basin, channel
cubic yards
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing'�
Other
r
Shoreline Length
SAV: not sure yes no.
Moratorium: n/a yes no
Photos: yes no
Waiver Attached: yes no,
A building permit may be required by: _
( Note Local Planning Jurisdiction)
Notes/ Special Conditions
�r
r' Ag the or Applicant Printed Nam
(Scale: )
.1t , jfr} as lam_ See note on back regarding River Basin rules.
Signature Please read compliance statement on back of permit**
Application Fee(s) Check #
Permit Officer's Printed N i
Signatrre
Issuing Date Expi tion ate

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 complywith these buffer rules.
Division of Coastal Management Offices
Morehead City Headquarters
400 Commerce Ave
Morehead City, NC 28557
252-808-2808/ 1-888ARCOAST
Fax: [phone]
(Serves: Carteret, Craven, Onslow -
North of New River Inlet- and Pamlico
Counties)
Elizabeth City District
401 S. Griffin St.
Ste. 300
Elizabeth City, NC 27909
252-264-3901
Fax: [phone]
(Serves: Camden, Chowan, Currituck,
Dare, Gates, Pasquotank and Perquimans
Counties)
http://portal.ncdenr.org/web/cm/dcm-home
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 7/06/17

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: l_ � cS
Mailing Address:
Phone Number: � S a -- 6,3 CA
Email Address: If Cu ;ve, ;b ^ - 0 c-
I certify that I have authorized np\\-l10 k'�'3
Agent / Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development:
�'f �ec-V N'Ne 11
at my property located at l3o'Z Cc,.,. --
in Ct'av to
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:
I
Signature
NA V\e S
Print or T pe Name
Title
l 3.-A l\ 16
Date
This certification is valid through / /

CERTIFIED MAIL - RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONMAMR FORM
Nanfe of Property Owner C 1ve� Sec
Address of Property:
(Lot 07 Street #, Strst cr Road, City & County)
Agents Name #:
Agents phone #:
Mailing Address:
I hereby certify that I own property, adjacent to the above referenced property. The individual
applying for this permit has described to me as shown on the attached drawing the development
they are proposing. A descriptiorrot dnaMrinsr with dimensions must be otov4ded with this letter.
ft{ I have no objections to this proposal. _ I have objections to this proposal.
!f you have objections to what is being proposed you must notify the Division of Coasta/Afenagement
(DCM) in writing v &h1n 10 days of receipt of this notice. Contact information for DCU oft" is
available at hMpY1vrww-ft4_C_ talmanatremenLnethvetaNnlstW4isfina orby calft 1.W8-4RC0AST..
No response is considered the same as no oblecupp, !t you have been notified by Cert fed AIR
WAIVER SECTION
I understand that a pier, dock, mooring pilings, boat ramp, breakwater, boathouse, or lift 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, yount Inifial the appropriate blank below_)
I do wish to waive the 15' setback requirement.
M ,(J� IaF I do not wish to waive the 15' setback requirement.
(Property Owner Information)
Signatuire '}..`�
Print or Type Name
st
1301 �. nTr C.\"'6 r--r) .
Mailing Address
IJ e.,-; e: 1-c.. aaS b -.�.
cdymateop
(Riparian Property Owner Information)
Mort/ 8e4ii H-nu-ikr1 - NCIDOT
Fwnt or Type Name
20G S_ Gtenbtainie Room
Mailing Address .
New 4er-n , NC 2B6Loo
Cftyllstat&zip
a 5 a 63tt - 2 �tts }l.r3lze� N4y`,^- 252 - 51r-4� - 4 rTIU
Telephone Number/Email Address Telephone Number/Emar7Address
a- --4 - NAo� r c h 2, Zo I
DawLate
(Revised Aug. 2094)

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Dock Live Load of 62.5 Ibs/sgft
Low Profile Dock Live Load 30 Ibs/sgft
2 6'
NOTICE! Read P2 Dock limited Warranty carefully. Among other things, EZ Dock does not warrant damages,
failures or defects caused by unauthorized modification of EZ Dock Product, and/or unauthorized attachment to/of
EZ Dock Product.

3/1/2018
1307 Country Club Rd - Google Maps
Go gle Maps 1307 Country Club Rd
imagery wzuia Google, Map data 02018 Google 100 ft
https://ww-.google.com/maps/place/1307+Country+Club+Rd,+New+Bern,+NC+28562/@35.1033829,-77.0556791,348m/data=!3m 1 ! 1 e3!4m513m4! 1 sOx89a8d 1 a75aa45091:Ox4Oee 116b4cfaOb6O!8m2!3... 1/2