Sanders, Chip

t�
-. ❑CAMA / ❑ DREDGE & FILL N2 70985 A B C D
GENERAL PERMIT Previous permit#
❑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
❑ Rules attached.
Applicant Name
Project Location: County
Address
Street Address/ State Road/ Lot #(s)
City
State ZIP
-
-
Phone # (_ )
E-Mail
Subdivision
Authorized Agent
_
-�. ZIP
City
❑ CW ❑ EW
❑ PTA ❑ ES ❑ PTS
Phone # O River Basin
Affected
AEC(s): ❑ OEA ❑ HHF
❑ IH ❑ UBA ❑ N/A
Adj. Wtr. Body
(nat /man f unkn)
❑ PWS:
Closest Maj. Wtr. Body-�-
---
ORW: yes / no PNA
yes / no
Type of Project/ Activity
(Scale: {
i
Pier (dock) length
Fixed Platform(s)
Floating Platform(s)'"
Finger pier(s) I,_._.
Groin length ..
number
Bulkhead/ Ripraplength_�- _
avg distance offshore
max distance offshore
Basin, channel
cubic yards ----�"
Boat ramp
1 i
Boathouse/ Boatlift
Beach Bulldozing
Other s i -1 X
Shoreline Length _ i,
not sure no
SAV: yes
K'
Moratorium: n/a yes �io
Photos:
�Uyt
yes
Waiver Attached: yes
Wp` (S
(t
A building permit may be required by: %GXi �� cC %
f, lam" isin rules.
( Note Local Planning jurisdiction)
Notes/ Special Conditions
Agent or Applicant Printed Name
Signature ** Please read compliance statement on back of permit **
Application Fee(s) Check #
Permit Officer's Printed Name
Signatur
Issuing Date 9xpitation 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 howto 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
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)
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://portal.ncdenr.org/web/cm/dcm-home
Revised 7/06/ 17

Stvron, Heather M.
Attached is the Agent Authorization and (2) Adjacent Riparian Property Owners
Teresa Brewer
Harber Contracting, Inc.
AER
—CONTRACTING INC. 252-393-TURF (8873) 1 EXT 226
NOTICE: This e-mail and any tjle3 tran3mittew with it are the property of Harber Contracting, Inc. The
proprietary information contained in this e-unil massage, and any files transmitted with it, is intended for the
use of the recipient(s) named above. if the reader of this e.maii is not the intended recipient, you are hereby
notified that you have received this e-mail in error and that any review, distribution or copying of this e-mail
or any files transmitted with it is strictly prohibited. if you have received this e-mail in error, Please
notify the sender immediately and delete the original messame and any files transmitted. The unauthorized use of
this e7mail or any files tLansmitted with it is Prohibited and disclaimed by HaMet Contracting, inc.

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: Ne � ,ayiUtr
Mailing Address: �3 Iq �- [ A
Phone Number:
Email Address:
I certify that I have authorized
95�- 7-2 s- Y z 7s
dei(ber-O
Agent / Contractse
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development:
at my property located at ai �� CI Pa; Al
in f County.
1 furthermore certify that l 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 In ormation:
Signature
W 7 LL j7Yt S /9�'vf)"Y -S , jW
Print or Type Name
Title
3 , 3 , l8
Date
throu h ( � / ) j / l '"
This certification is validg

• __
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to t i✓ S(� d e rs 's
1�' 9 C � I- � � r �ame of Property Owner)
property located at '� �! }
Q� (Address, Lot, Block, F oad, etc
on 'y(J u e C�c-iVL� in �f 6�P At" t�(i° N.C.
( aterbody) (City own and/or County)
The applicant has described to me, as shown below, the development proposed at the above
location.
I have no objection to this proposal.
I have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELUFMI--N i
(Individual proposing development must fill in description below or attach a site drawing)
Pee &Ce&+I I I -P f
WAIVER SECTION
I understand that a pier, dock, mooring pilings, boat ramp, 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)
Signature
Print or Type Name
Mailing Address
City/StatelLip
Telephone Number/email address
Date
'Valid for one calendar year after signature'
(Adjacent Property Owner Information)
Sig51aki f� /�o
me
Print
1'Z ML a ,6 Pf D%r 1)9
City/State/ZipV/� Vk S— ,7 g
Telephone Number/email address
Date*
(Revised Aug. 2014)

ADJACENT_ RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to ~e s
JName of Property Owner)
property located at` TJ e",
(Address, lot, Block, Road, etc.) +
on �OU out,, in _off VJlo 67af4t' N.C.
aterbody) (City/Town and/or County)
The applicant has described 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.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMEN I
(Individual proposing development must fill in description below or attach a site drawing)
WAIVER SECTION
I understand that a pier, dock, mooring pilings, boat ramp, 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 lnform tion) (Adjacent Property Owner Infor tion)
1/Z A It"
Sigyn Lure Sigr7ature* `
Print or Type Name Prr r Type Name
Mailing Address
Cit lstatelZip
Teleph Number I email address �&-T"'�4-
P3 f� e-,--
r ale
`Valid for one calendar year after signature'
Ma�fin ddre s u
City? tate?Zi
2.6-11 3q.3
Telephone u er?email address
3
Dale
(Revised Aug. 2014)