Town of Morehead City (2)

X-
1 CAMA / —J DREDGE & FILL A B C D
GENERAL PERMIT Previous permit#
New ❑Modific?iion El Complete Reissue 'Partial Reissue Date previous permit issued
As authorized by the' Late 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
Project Location: County_
Street Address/ State Road/ Lot #(s)
City State ZIP
Phone # ( ) E-Mail Subdivision
Authorized Agent
❑ CW ❑ EW CEMTA L E'S ❑ PTS Phone # ( ) _ River Basin
Affected OEA ❑. HHF IH ❑ UBA El AEC(s): ❑ Cl Adj. Wtr. Body (nat /man /unkn)
❑ PWS:
ORW: yes / no PNA yes / no Closest Maj. Wtr. Body - -
ZIP
Type of Project/ Activity
(Scale: )
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 t __
Boat ramp
Boathouse/ Boatlift -
Beach Bulldozing ---
Other
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
Agent or Applicant Printed Name
Signature ** Please read compliance statement on back of permit
See note on back regarding River Basin rules.
Permit Officer's Printed Name
Signature
Application Fee(s) Check # Issuing Date
Expiration Date

r
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
Neuse River Basin Buffer Rules
Other:
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.nccoastaimanagement.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 that I own property adjacent to CJ'ff , 5 LIMA he / G 41 - 5W'4f+10 rl 's
(Name df Prope Owner)
property located at 7C 7 5 h f r l 5�
(Address, Lot, Block, Road, etc.)
on _t ; k� Sc N nc� in Moi ek NarA (, + / <<ar+r'r cif N.C.
(Waterbody) (CitylTown nd/or County)
The applicant has describes to me. as shown below, the development proposed at the above
location
-' 1 have no objection to this proposal.
I have objections to this proposal.
/
/►^jfj
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(individual proposing development must fill in description below or attach a site drawing)
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 thle setback. you must initial the appropriate blank below
11 1 do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement
(Property Owner Information)
Si�,iure
If rr i P 2
Print or The Namb "
IcOC F11111-r St
Mailing Address
city'Istate/z,
Telephone Number
H / 10 Me?
Date
(Adjacent Pro early Owner Information)
5'iQn c°
Pri _ or Type Nwe
Mailing Addr ss
C e,2+p� f — T7
TeleDhone Number
Date
(Revised 611 a/2012)

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to ©f '15 Lu rCI, ►,y �_ t ( fh }, - ,� 's
(Name ofProperty wner)
property located at _ -C ? 5
��(A dress, Lot, Block, Rod, etc.) <
on � �a a I?�c u n�
I in Mrs'PhrtaL (' 4-y / (r,r fNr-r'f , N.C.
(Waterbody) (City/Town Xndlor County)
The applicant has describes to me as shown below. the development proposed at the above
locatio
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. 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) (Adjaipnt Property`Oydner Information)
,5igna r �
rt
ry e Nan e Print or Type ame
Dr,nt or
it. Cr'' P5 hrr�' �+ �
Maiiing Addre sr Ma�!irg%�A/d%dress �L -
CiiyrState,'Zip Crty/Stat&Z,/l
Teiephone N.rmber Telephone Ni,mber
iVia:: Dare
iPev;sPd 6/' 8120 t 1

GPERMIT
PreYous permit
Z
ew ! .Modcaren I _ Complete Reissue Port:al Reissue Date previous permit issued
As authorized by e State cf North Carolina, Departmert of Environment and Narura: Rescurces + �:
and the Coasm; Resources Commission Fn an area of environm.ertal concern, pursuant to l 5A Nac:
F.Ules ate+
Applicant Name � {����"!1��p��� .� Project Location: County_ t , � --- --
Address_ _ _ C- _ Street Address! State Road/ Lot #(s'
Cit' State 7V ZIp
Phone # ." r� L W I�+U�C� Fax # Subdivision
-----------
AutJ ori<ed Agentffecte
PTS Phone �# (} '_! a� ^ J — CW EW - PTA f . FS C River Basin 4 , _ rr
AEC(s)d `OEA [ HHF `IH ';USA ❑H/A +(
AEC(s): Adj. WV. Body.� 'l✓ _ "� Lman iunkn
�J PWS: CFC:
r
ORW: yes / rfo j PNA yes! :c(: Crit.Hab, yes if no Closest Maj. WIT. Body ---- -
Type of Project/ ActivityUCdr-l� ,
(Scale: t Ill
Pfer(dock)ler)gdr--'--- — ---- ----- -- — -- — ---
Platformis) 1"l J - . .- ...- - - - - -L�-`` `-j
-inter peeCis) �i �Z
Gran 1en4p
Bulkhead/ Riprap length_ \Nr !` `'"1•
avg distance offshore"— _ I - -- -- - -- -- -
max dsance offshore'!
63. rn.
Boataouse Boathft; _- — 1 ---
Beach Bulldozing
Shoreline Length
SAV: not sure
i • +��:i� ,'..ice,^_�t'_,-r71"--. (ck _ - -
Sandbags: not :,tire
Moratorium: nJa yes—
Phatcs: Yes
Waiver Attached: yes
A buiid:ng permrt maybe required by: t��/v 5 •s gee-L� G — See note on back regarding River Basin ruffs.
Notes/ Special Conditions �� 6 jw'D'tr LLB t�%j t i • l L i� '�•� �' ( (L f l r��t
- l zant Primed r lame
Signar re 'rPlc a;e read coca ancestateme' t on back of permit''' —
Application Fee(s ( eck
.2
_1
Slata ip r -- Exp tion�Dat ��—
_
Loca(Pfannir+g urisdc2ion Rover Filer a-ae