Tester, Pat

V
4MA , DREDGE & FILL A B C, D
G;EN►ERAL. PERMIT Previous permit #
7New Modification ,Complete Reissue 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
a ul attached.
Applicant Name mr Project Location: County t _�°;".-
Address ;! r Street Address/ State Road/ Lot #(s)
vT City i Statelk ZIP s ` %� f✓`f ! J '�G
Phone # E-Mail Subdivision
r�
1 �t / ZIP I
Authorized Agent City ,C
'CW ENV lo!t FA ❑ ES ElPTS Phone # ( ) River Basin
Affected J, OEA ❑ HHF ElIH ElUBA El N/A
AEC(s): Adj. Wtr. Body na ` man unkn
L Pws. Closest Maj. Wtr. Body°
ORW: yes / no PNA � / no
Type of Project/ Activity
Pier (dockrleonrP�'
FF
Floating Platform(s)
Finger pier(s)
Groin length
num ber
avg distance offshore
SEES
max distance offshore
Mimi
0
—mom
Basin, channel
NUNN
�i
cubic yards______
1
CIMINO
No
Boat ramp
&
MOM
ZM�P�
bad
—mom
No
Boathouse/ Boatlift
No
mom
Beach Bulldozing
ME
Otherimom
ME
MEN
ME
M
Shoreline Length
SAV: not sure yes no
MMM
Moratorium: n/a yes no
Photos: yes no
i
Waiver Attached: yes no f
A building permit may be required by:
( Note Local Planning jurisdiction) f
Notes/ Special Conditions
Agent or Applicant Printed Name
SignatdIre Please read compliance statement on back of permit
Application Fee(s) Check #
❑ See note on back regarding River Basin rules.
{ A
Permit Offine s grime 14ac1e- -"
r
Signatue
Iss ing 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, certifythat this project is consistent with the North Carolina Coastal Management Program.
River Basin Rules Applicable To Your Project:
Tar - Pamlico River Basin Buffer Rules L 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
400 Commerce Ave
Morehead City, NC 28557
252-808-2808/ 1-888-4RCOAST
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)
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)
http://www.nccoastalmanagement.net/
Revised 08/27/ 14

C AISO
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ADJACENT RIPARIAN PROPERTY OWNER
STATEMENT FOR CAMA MINOR PERMITS
I hereby certify that I own property adjacent to��
(Name of Property Owner)
property located at ,,2 q S
�61C"
Jam,-p Address, Lot, Block, Road, etc.)
(�` r u
on �2 6 ► Cu�E1� .��� in_. N.C.
(Waterbody) (Town and/or County)
He has described to me as shown in the attached application and project drawing(s), the development
he is proposing at that location, and, I have no objections to his proposal.
(APPLICATION AND DRAWING OF PROPOSED DEVELOPMENT ATTACHED)
t
/ Sign re
�1 /1 Print or T ame
2, z I �.
Telephone Number
Date
RECEIVED
MAR 2 9 2018
®C�_ MHE) CITY
1

ADJACENT RIPARIAN PROPERTY OWNER
STATEMENT FOR CAMA MINOR PERMITS
I hereby certify that I own property adjacent to��j.p r, I`7-Q%Z S
(Nam Property Qwn/er) I
property located at _C%� I SU q j¢a
Addre%�-
Block, Road, etc.)
on 6�=u Cyk in 41!? N.C.
(Waterbody) I V (Town and/or County)
He has described to me as shown in the attached application and project drawing(s), the development
he is proposing at that location, and, I have no objections to his proposal.
(APPLICATION AND DRAWING OF PROPOSED DEVELOPMENT ATTACHED)
S ature
Print or Type Name
q�d 42-1--�4��
Telephone Number
-5 -- 2--3 `-/ $
Date
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a
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Adjacent Pro r caner
Mail' dre -�
City, State, Zip Code
Receipts for
Certified Mail
(Staple Here)
Dear Adjacent Property:
This letter is to inform you that I, 1 1:7'u I C, �::L t iJ . � K ve applied for a CAMA Minor
Property Owner
Permit on my property at ,--9-1 5 S ty ; Yl �` I�C� � p 19YA 4A in COUNTY
Property Address
County. As regWred by CAMA regulations, I have enclosed a copy of my permit application and project
drdwingfs) as notification of my proposed project No action is required from you or you may sign and return
the enclosed no objection form. If you have any questions or comments about my proposed project, please
contact m att � l �) Q- 4 ( 2- ? / � ,or by mail at the address listed below. If you wish to
Applicant's Telephone
G"4,1-
file written comments or objections with the LOCAL GOVERNMENT CAMA Minor Permit Program, you may submit
them to: L �� V CDA S �" F' )1%Pki
L
Sincerely, U y4 it
Property Ownerj REDEVED
�. '-7 ZL
.-M 'ling Address MAR 2 3 2018
City, State, Zip Code DCM� MHD

' r
Receipts for
Certified Mail
(Staple Here)
Dear Adjacent Property:
This letter is to inform you that I, "i have applied for a CAMA Minor
Property Owner
Permit on my property at `1 `� �� 1 % S , �r �, # t'T', in COUNTY
Property Address
County. As required by CAMA regulations, I have enclosed a copy of my permit application and project
drawing(s) as notification of my proposed project. No action is required from you or you may sign and return
th ed no objection form. If you have any questions or comments about my proposed project, please
('" � `1— or mail at the address listed below. If you wish to
contact me at . V f1.� j - . �� ,, y
Applicant's Telephone
file written comments or objections with the LOCAL GOVERNMENT CAMA Minor Permit Program, you may submit
them to: y,
/��- yk i1
0 o ESS
Sincerely;
Property Owner?
Mail' Address
City, State, Zip a pF C E
IVED
MAR232018

r
Locality
Permit Number
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 '
Ocean Hazard Estuarine Shoreline ORW Shoreline Public Trust Shoreline Other
treatment system), Building, Electrical, Plumbing, Heating and Air Conditioning, Insulation and Energy Conservation, FIA
(For official use only)
Certification, Sand Dune, Sediment Control, Subdivision Approval, Mobile Home Park Approval, Highway Connection, and
others. Check with your Local Permit Officer for more information.
GENERAL INFORMATION
STATEMENT OF OWNERSHIP:
LAND OWNER - MAILING ADDRESS
I, the undersigned, an applicant for a CAMA minor development permit, being either the owner of property in an AEC or a
Name f 11l p D �G�tO
h /Z i t�' /4 + E' S 2 /2
person authorized to act as an agent for purposes of applying for a CAMA minor development permit, certify that the person
T—
��
listed as landowner on this application has a significant interest in the real property described therein. This interest can be
Address ( M Cl.�l I n aag
City
/1 p
\�f l71 �', Y �l 1 Yt �i
State V L Zipahone %"t 1 —� 3 'y6
described as: (check one) t
'
£ �
of
an owner or record title, Title is vested in name of tC� !�- 2�
/7/) /)/t „�
.n
see Deed Book f page J in the o•— County Registry Deeds.
Erna il--So(5GL! h
/ /�� F �.!/ m
_ of
AUTHORIZED AGENT
_
_an owner by virtue of inheritance. Applicant is an heir to the estate of
Name ►� (� '(�
- `
I may' QR�
probate was in County.
P . 1 �
Address �e
= I
if other interest, such as written contract or lease, explain below or use a separate sheet & attach to this application.
City
Email
LOCATION OF
State Zip Phone
streetlnefu d/or directions to site; name of the adjacent waterbody.)
LIM
DESCRIPTION OF PROJECT: (List all
--Jl D,_t 'J - .t
C•I
construction and land disturbance.)
SIZE OF LOT/PARCEL: square feet / t '-- acres
PROPOSED USE: Residential (Single-family Multi -family ❑) Commercial/Industrial ❑ Other ❑
COMPLETE EITHER (1) OR (2) BELOW (Contact your Local Permit Officer ifyou are not sure which AEC applies
to your property):
(1) OCEAN HAZARD AECs: TOTAL FLOOR AREOF PROPOSED STRUCTURE: square feet (includes
air conditioned living space, parking elevated above gro�atuL level, non-condi d space elevated above ground level but
excluding non -load -bearing attic space) ll ��
(2) COASTAL SHORELINE AECs: SIZE OF BUILDING FOOBPAINT OTHER IMPERVIOUS OR BUILT
UPON SURFACES: square feet (includes the ar the fou'rM ion a buildings, driveways, covered decks,
concrete or masonry patios, etc. that are within the apple AEC..Wch yMalculations with the project drawing.)
Go
STATE STORMWATA MANAGEMENT PERMI the prcM locat an area subject to a State
Stormwater Mana eme trait issued b the NC Divi of En Mine d Land Resources (DEMLR)?
YES_ NO �1 pp M
If yes, list the total built upon area/impervious surface \l ed for your lot 0
0e1: square feet.
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.
(1)
(2)
(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.
A This the day o,� 1�20 Zr
or person authorized to act as his/her agent 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 the locality, and
any information as may be provided orally by the applicant. The details of the application as described by these sources are
incorporated without reference in anypermit 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 administrative action.
I

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 _ Filial Inspection Fee Received
Site Inspections
Date ofAction: Issued Fvcnipwd _ )cnied Appeal Deadline (20 days from permit action)
APPLICATION FOR
All CAMA MINOR
Coastal Management DEVELOPMENT
ENVIRONMENTAL QUALITY 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.
DCM Form EB 1952-2015/Revised
Coastal Resources Commission
Division of Coastal Management
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3' high, 3'v7Me, 45' long
dock with a 4'x4' platform
,J295 Dills Point Rd Dock---13'
Platform
4'x4' - f 26'
19,
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295 Dills Point Road,
Beaufort NC 28516
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