71104_John & Stacy Barnes_20180821

� CAMA / ❑ DREDGE & FILL No 71104 0) B C D
GENERAL PERMIT Previous permit# L
It New C 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 J o k r.
Address I u S 13 o r �u 1-0 , •�
City .Tslc,'� State p L- ZIP a-4crSO
Phone # (I-n) (ol j - 4-40 1 E-Mail
Authorized Agent
❑ CW
[Y EW
[KPTA ❑ ES ❑ PTS
Affected
AEC(s):
❑ OEA
❑ HHF
❑ IH ❑ UBA ❑ N/A
❑ PWS:
ORW:
yes / &o
PNA
yes /Q
Project Location: County
Street Address/ State Road/ Lot #(s) 311-4 % mo b L Tr.r.&A�
1 ` t
Subdivision oyo 8c,L h
City CQ r 01`A ZIP -a-lei a'4
Phone # ( ) River Basin ..IL
Adj. Wtr. Body C.• 01 90 kr tt,.rsl,.•d da r (nat LSD/unkn)
Closest Mai. Wtr. Body k c
Type of Project/ Activity
(Scale:
Fixe
Float
Fing
Groff
Bulk
Basin
Boat
Boat
Beac
Othe
Shor
SAV:
Mo
Phot
Waiv
-i
■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■!1A■
length
number
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■■■■■■■■■■��i��li■■■■■■■■■■■■■■■■■■■■■■■■■
avg distance offshore_
cubic yards
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ramp
�et��!
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Bulldozing—,
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Ell��f�C�i■■■N■■■■■■■
■■■■■■■I
■■!fir■■■■■■■■■■■
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notsure yes
® yes no
■■S✓%■■■[VRR■■■■■■■■■■
■■■■■■■■■■■
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A building permit may be required by: , r V0,?v c (L
( Note Local Planning Jurisdiction)
Notes/ Special Conditions
--�0\,t,�-�,A(L Ti
Agent or Applicant Printed Name
Sign u ** Please read compliance statement on back of permit*
Ack)o.Oy loIv
Application Fee(s) Check #
❑ See note on back regarding River Basin rules.
Permit Of s Print me
S ure
V/.x1 0Iy la%a.l1aa/Q
Issuing Date' Expiration Date

NC Division of Coastal Mgt. Habitat impact Computer Sheet
Applicant: P7 a r n� 'S
Date: c6 j I. I f
Permit #: -4 1
Describe belo'i the HABITAT distu rbances'for the application. All values should match the name, and units of measurement
found in your Habitat code sheet.
Habitat Name
DISTURB TYPE
Choose One
TOTAL Sq. Ft.
(Applied for.
Disturbance total
includes any
anticipated
restoration or
temp impacts)
FINAL Sq. Ft.
(Anticipated final
disturbance.
Excludes any
restoration
and/or temp
impact amountL
TOTAL Feet
(Applied for.
Disturbance
total includes
any anticipated
restoration or
temp impacts)
FINAL Feet
(Anticipated final
disturbance.
Excludes any
restoration and/or
temp impact
amount
n
t^"
Dredge [IFill ElBoth [IOther
y U
Llv
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
252-808-2308 :: 1-888-4RCOAST :: www.nccoastaimanagement.net revised:02/03/10

■ Complete items 1, 2, and 3.
■ Print your name and address on the reverse
so that we can return the card to you.
■ Attach this card to the back of the mailpiece,
or on the front if space permits.
1. Articl�dressed 1p � �jI �' 1 L✓�
hoot-2-
111/11111 1111 II1111111 HE 1111111 I I I I1I I ill
9590 9402 1766 6074 2339 04
A. Sigrature
X ❑ Atent
❑ A dressee
B. eceived by (Printed e) C. Date of Delivery
D. Is delivery item 17 ❑Yes
If YES, ¢itt r deli�Ag Blow: [I No
3. Service Type "'�C? yD �p 23L'/ l Express®
❑ Adult Signature ---1'
MaiIT"
❑ Adult Signature Restricted Delivery
Mail Restricted
�D.Oiveq
❑ Certified Mails
❑ Certified Mail Restricted Delivery
❑ Return Receipt for
❑ Collect on Delivery
Merchandise
❑ Collect on Delivery Restricted Delivery
❑ Signature Confirmation^"
] Insured Mail
El Signature Confirmation
] Insured Mail Restricted Delivery
Restricted Delivery
(over$500)
pS Forr'J*IyMT5 Pswt!5tb-02-000-9053 Domestic Return Receipt,

John E. Barnes, III
105 Barnes Lane
Knotts Island, NC 27950
757 615-6701
July 18, 2018
Ms. Nancy Petree
139 Williams Dr.
Knotts Island, NC 27950
Dear Ms. Williams:
I own the property adjacent to yours in Carova, 2171 Mobjack Terrace. I am planning to build a 10'X4'
pier. Enclosed please find an Adjacent Riparian Owner Notification/Waiver Form as well as a drawing of
the proposed work.
Thank you in advance for your attention to this matter.
Sincerely
John E. Barnes, III

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