Gorham, Henry (2)

P/ 480
❑C,AMA / ❑ DREDGE & FILL N2 70 B C D
GENERAL PERMIT
Previous permit # ;,A � Y
E]New ❑Modification C.JLomplete Reissue ❑Partial Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environmental Quality ..+►) 1,f �jfN
and the Coastal Resources Commission in an area of environmental concern pursuant to 1 SA NCAC .�f
ules attached.
Applicant Name
Project Location: County
Address ,t l (� '/ Street Address/ State Roa� Lot #(s)
Ci State ZIP-"i
ry
Phone E-Mail Subdivision
Authorized Agent
Affected ❑ CW ❑ EW ❑ PTA ❑ ES ❑ PTS
AEC(s): ❑ OEA ❑ HHF ❑ IH ElUBA ❑ N/A
❑ PWS:
ORW: yes / no PNA nis / no
Type of Project/ Activity
Pier (dock) lei
Fixed Platforn
Floating Platfc
Finger pier(s)
Groin length
number
Bulkhead/ Rip
avg dists
max disl
Basin, channe
cubic ya
Boat ramp _
Boathouse/ B
Beach Bulldo
Other
Shoreline Lei
SAV:
Moratorium:
Photos:
Waiver Attac..__.
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"
1
Application Fee(s) Check #
ZIP y
City ,F ,P° r r J
Phone # ( ) River Basin
Adj. Wtr. Body✓ra— at an unkn
Closest Maj. Wtr. Body I' L""', '
(Scale: /,/ f )
❑ See note on back regarding River Basin rules.
Permit Officer's P#inted Name `
Signature;
Issuing ate 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 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
Washington District
400 Commerce Ave
943 Washington Square Mall
Morehead City, NC 28557
Washington, NC 27889
252-808-2808/ 1-888ARCOAST
252-946-6481
Fax: [phone]
Fax: [phone]
(Serves: Carteret, Craven, Onslow -
(Serves: Beaufort, Bertie, Hertford, Hyde,
North of New River Inlet- and Pamlico
Tyrrell and Washington Counties)
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)
http://portal.ncdenr.org/web/cm/dcm-home
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 7/06/17

Mr. Ryan Davenport
CAMA
Dear Mr. Davenport:
May 9, 2018
Please accept this as a written request to extend/reissue CAMA Permit #70287 for an additional 120
days. A copy of Permit 70287 is attached hereto along with a check in the amount of $200.00. Please
contact me at 919-805-5003 or my email address [e-mail] if you have any questions
or concerns.
Sincerely
Henry rham