Jacobi, Charles & Doris

CAMA / '❑ DREDGE & FILL O
_ 71308
�' GENERAL PERMIT Previous permit# A B C D ;
New ❑Modification El Complete Reissue ❑Partial ReiSsu* Date previous permit issued-
7ia,thT,i.ed by the State of North Carolina, Department of Environmental Quality
and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCACt
1Y KuTeshe4.
)ff
Applicant Name 1 (y _ I f,tbProject Location: County
r
Address \, Street Address/ State Rop4/ Lot #(s)
i
City ° _-j State i ZIP , 1 , ZYn 9 d ; rd d/' 3�
Phone # ( Mail
Authorized Agent
CW *EWl PTA El ES ❑ PTS
AEC(s):
Affected `OEA ❑ HHF OH ❑ UBA ElN/A
❑ PWS:
ORW: yes /(no PNA es' no
Type of Project/ Activity L�.(,�- (�,(,_..
Pier (dock) IengthY_=`
Fixed Platform(s) if
Floating Platform(s)--
Finger pier(s) --
Groin length ------
number -
Bulkhead/ Riprap length ``—
avg distance offshore
max distance offshore
Basin, channel
cubic yards----"
Boat ramp
Boathouses Boa liftY
Beach
Shoreline Length I r
SAV: not sure yes no
Moratorium: n/a yes no
Photos: yes {,
Waiver Attached: yes /
A building permit may be required
( Note Local Planning Jurisdiction)
Notes/ Special; Conditions
Ak
Agent or Applicant Printed Name
A '1 sei ¢
S yture '" I .` ead compliance statement on back of permit
t � :u .`
Application Fee(s) Check #
Subdivisi?n r '> - -.
City }1': l -. ZIP 'r)
Phone #O River Basin
Adj. Wtr. Body! ( �./ l Ana /man /unkn)
Closest Maj. Wtr. Body
4 „U See note on back regarding River Basin rules.
R �t t
Permit Officer's Printed Nam
Signature
Issuing 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 I) 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 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 -
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)
http://pc)rtal.ncdenr.org/web/cm/dcm-home
(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 7/06/17

Jun 05 18 02:58p Tony McNeill 252 725 4965
p.1

Jun 0518 02:59p Tony McNeill 252 125 4y135 P. Z
XCAAAA D DREDGE A FILL
NERAL PERMIT -6 2
evw O-Modification
ElComplete Reissue Previous permit # A
C) Partial Reissue
--isources comrNssion in Date previous p9r and the COast4? r mit issued
As authorized by the State of North Carolina, Department of Environment and Natural Re -sources ---------
area of �envfronrnentaj concern
Pursuant to I SA NCAC -N
AP. .. . .. . .. . ..
plicant Name
/-7
Address.' I i ` t, ( ,� r . ..'L �'- -'•` y Project Location: County_
C.
Street Address/ State Ity. Road/ Lot
S P--:
ZI
Phone To,
-Authorized Agent -l 0": Subdivision
�h .1�i -i' i'': ..... ........
XCw ty
ZIP
�kTA' - 1 1.
Affected I C ES El PTS /I -
OOEA HHF Phone # 1--2
USA 0 N/A 13rn I i
.AEC(s): -1 1H L
C] F1
Adj. Mr. So t
man Junkr
ORW: yes
no Closest Maj. Wtr.
TYPO of e&./ AcOrity
Proje .4
Pier (dock) length
Fixed PWOrrn(s)
127
Floating Platform(,) ----
Finger pier(s
Groin iength
number-
, -.�-1114+4kheacl/Rlprap length
avg distance offshore
max distance offshore—,
Basin, channel
cubic yards
Boat ramp
Boathouse/ Boatiift
Shoreline Length
SAV not sure yes
Moratorium: n/a yes
Photos:
yes I
Waiver Attached; p
eS,no L
A building permit may be required
(, Note Local Planning jurisdiction)
Pern'OtOfficer's. Printed
(Scale:

Jun 0518 02:59p Tony McNeill 252 725 4965 p.3
hereby ce
fh$t I ..: :..__. .: _ : .: //'►►'// --
Y odn. proerfy adjacerit.to
Property locatE)d at. 1. � L-7�, . ; i ire of caner .
::....._
`�(Ia P,rdpety 0
.• ''� At3k,. ft
df�
1 h 1 100
- ---- - ---- -... ----�at�rbo��-_ --- •
_ -----_�'
- - - .4pit}Tlfbtivn:audlor_:C� -
Theja
apAiicar�t has described ..as sh
iocatibn : fo me,-00 below, eveloptner proposed of tf�e `above. l
-' - .. •~V
have no-obecti¢n to.#b`>s
proposal:
�----48A. ob)eetibne #o tliis propel.
w
' - • _: !3
_ }ESCRipTiON:;WD Qf Alli(1 IG Q ROP
. y - OS€11:[)EVELOPMENT: (fnyidual ProPOsg-dve=loPtit: m�it'Ilr in it
Pt�on 6elrow 6iafiach.& Mte dram_ g) -
_. _ ... -,...h wider to AVE
Vk SE4'TION
nd t#ta.t; a r':
AT
de,rVes
P! 9o::piliris;.biriater;: boathouse; tiff; or grad, must beset
_back a ri�iriirruii d�stne:otf';fiom=i_ area caf_�iRariaaccessIiAss waived by me.:(If ou
wistifo - ' waive the. f ci�l=you m rsi=int�iaTth6—'a late' bla ktielow. Y + -
•i dosi� t
_triraivO,tfe 15'ent. --`_
---_ __ I do not with to warve tfie 15' setback regwrgme.
. . ny Ovuii :.-.Irfvrin�tion . ••-� . : •. - � - - • • •- . •: '.;; .:,
`(AdA*-6t Property Owner information)
Q`x,e Q St
J/ l �d/2i �;1,gcu j .1.
py Name
7IAqdrsss
Ted Wp n� Number rea ane`Ntmber i
Date"
(,Revised B/IWX2 2) '

uun uo i u uz:5yp I ony McNeill
252 725 4965 p.4
AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: �cc,/)�
Mailing Address: ('4/1 IV x) r_—
Phone Number;
Email Address:
I certify that I have. authorized
Agent / Contractor
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 Vox L C3 C_Lk,�
in County.
I 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 Information:
Signature
34CD6 I
Print or Type Name
Title
l_l_ /
Date
This certification is valid through l

ony McNeill 252 725 4965 p.5
ADJACENT i�IPARIAN PROPERTY'QWfajBSTATEAAENT
,C
i hereby certify that 1 `ouvri. propcedy adjacent to
- --(�laitte of Property Ownerj .
pr�pe�f-aty located
_ _
on oo(Address,
. _ .(Citylfo>�r�r.aiidlor.County) �
7h$ appii t. has .described t' :
4 me,..as• thoW-h below, `the. devAlppment proposed at the `above,
•I•have no objection tolhis:proposat: -
taaue. objections #d this pro sa(,
P4
` ©ESCFiIPTION A IDS©RDF A_ i[Na JF I ROP-0 -DEVELOPMENT. '
- ` littivc�ual • co osm - `die% . °" ent must . • , ": _ :..: , . - � - '• i
P? : - •. 9 Pm` fif! °in descrrp#ion ffoW or a>aeh a :sie dratvirtg� _ : ._ ;
_ llk►[V�R SQTIDN.. _.
_ ... _--;,-.i•�riderstarid#iat:�• ro�.'c#odc •' oo�• i ..._ .. P. __ . ..._ :• ,'(�?..: g`p jin s; f lc±�iat2r: - boatheuse• •fift- or roin,inu t
9
bac(a mpni.dfstanc.o� t`iom _r `_arira of n: anaij:acce�s unless v�raived by me.'(lf you _
�. P.. `
w�sfi to viraiV6 theeibcfs, :you Mist �nitiaE the a rq riate blanlE below.} .
AP.• ;.
• I do vuisi. tQ lniaive. the 15'sethak recj uirecnent,'
I Cip riot Wv h to waive the 15 $etback re�]ulreme'rr
(Property bw eir. in 6tin�tion . i'
} :`(Adf scent pro arty Owner Information)_
tore . 1.
PrW.OrType N e pr,' br T —
Ma - car
_ s ;.
76 Crij'Sta%
Tephorie Numberre
Iephone�lTu7ii�er '
Date
.' (Revised 6118/20r2) T