Town of Morehead City

JCAMA / J DREDGE & FILL A B C D
GENERAL PERMIT Previous permit #
[ 1New JModification ❑Complete Reissue ❑PdrtlaPReissue 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
/ Eil Rules attached.
Applicant Name E, =, l ` Project Location: County
Address
City State ZIP L�
Street Address/ State Road/ Lot #(s)
Phone # ( ) E-Mail Subdivision6'
Authorized Agent 1 t i + Ci
}3 }; rC ty i ZIP
❑CW ❑,EW PTA uES ❑PTS Phone # (!") �bV River Basin_---,
Affected ❑ OEA 71 HHF IH ❑ UBA ❑ N/A {
AEC(s): Adj. Wtr. Body /�uV ►' ( _ nat /man /u_ nkn
❑ PWS: �� ?°`ar_
ORW: yes / no PNA yes / no Closest Maj. Wtr. Body ' ' ---
Type of Project/ Activity _ ,, I
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 4 5t /
11
cubic yards
Boat ramp �^------
Boathouse/ Boatlift
Beach Bulldozing
Other
Shoreline Length
SAV: not sure yes
jlio
Moratorium: n/a yes
{.f:.'
Photos: yes
Waiver Attached: yes
A building permit may be required by:
( Note Local Planning Jurisdiction)
Notes/ Special Conditions
Agent orr Appliednt Printed Name
Signature _." Please read compliance statement on back of permit"
s
(Scale: _ )
❑ See note on back regarding River Basin rules.
a '
'A -
PermitOfficer's Printed Name
Signature r"
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 complywith 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

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify tnat I own property adjacent to 1.' H ` C • + ,, Dr( ks s
(Name Owner)
property located at ` C 7 {1 NUt, rS ; 'i"
1—'(`A'ddress, Lot, Block, Road, etc.)
on _ JJk6 SP4lll in Mc&Jl&,r1 C , 4-V /Cv1 4-t-ir-t. h C
(Waterbody) (CitylTown an/or County)
The applicant has described to me, as shown below. the development proposed at the above
to�jat�
kr I have no objection to this proposal
1 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. 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) (Adjacent Property Owner Information)
tuk
Print or Type Narne
I COO r-'shor'3
Mailing Addresjf
M�t41pu C "A- 14C.
CltylStatelZip
3 15-1 - -7 1C ~ 503 Era- H
Telephone Number
Date
Pint or Type Name t
Mailing address
c y/srar ip
rel6phon6'Ntjm,her
,C
pure '
)Revised 611812012)

e
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
i hereby certify that I own property adjacent to M 1+6 L , -+ DO(- 1< 5 is
/ (Name of Property Owner)
property located at is % 5)1FIx: vCi' S -►
(Address, Lot, Block, Road, etc.)
on a�, �� Sc y h �� in C ' 4-,, / (e, ��� c'YC'�' . N.C.
(Waterbody) (CitylTowKand/or County)
4T 4ati.
cant has described to me as shown below, the development proposed at the above
I have no objection to this proposal
I have objections to this proposal.
DESCRIPTION AND)OR DRAWING OF PROPOSED DEVELOPMENT
(Individual proposing development must till in description below or attach a site drawing)
WAIVER SECTION
I u-iderstand 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 waivec 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 wave the 15' setback requirement.
(Property Owner Information)
' )
Si afore
Print or Typ Nam
11. cc
'✓laiiing Address
/Yir� � ice, h r- tj 4/ N
CifyiState/Z
:�ti -A - f ) E 3 Ek+
Telephone Number
Date
(Ad' ent Property ner In
f'
1<.3 to, 4,-d- 'tit/ ' Y
Pant or Type dame L
3yo3 O I d._ e
Matting Add `e¢s,_ n X
Telephone It, e/,
Date ,`11
y�! V W,.Viised 611812012)

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