Coston, Nancy

36
`CAMA /❑ DREDGE & FILL N2 71 J A B C D
GENERAL PERMIT Previous permit#
lj=1New `'Modification ❑Complete Reissue El Partial Reissue Date previous permit issued
/ i
As authorized by the State of North Carolina, Department of Environmental Quality �(.� � ���` i r f V
and the Coastal Resources Commission in a area of environmental concern pursuant to 15A NCAC attached.
,/' Fes.
Aplicant Name i, ' f t " Project Location: County i - ,
p`�
Addressss3�
City t }}�I'r__`` r
C
Phone # ),
Authorized Agent
❑ CW
Affected ❑ oEA
AEC(s):
❑ PWS:
ORW: yes / no
a,a rifk(
StateZIP
Jtw:&
`f`fVC E-Mail j(
,L� .,,n PTA r I 'ES ❑ PTS
❑ HHF ❑ IH ❑ UBA ❑ N/A
PNA Yes, /
r
Street Address/ State Road/ Lot #(s)
Subdivisi
City r . r „r .�' • ZIP l /
t,-`
Phone # (_) r Basin '
Adj. Wtr. Body ' Ci `4 � na man unkn
Closest Maj. Wtr. Body
Type of Project/ Activity /f ,f
s X � / �"f /"U c, r (Scalel �' p )
Pier (dock) length
Fixed Platform(s) _
Floating Platform(s)
Finger pier(s)
Groin length
Bulkhead/ *rap length
r
aSg distance offshore
max distance offshore
Basin, channel f
cubic yards
Boat ramp _,
Beach
Other
Shoreline Length
SAV: not sure yes n
Moratorium: n/a yes n
Photos: yes no
Waiver Attached: yes i not
A building permit may be required by:
( Note Local Planning jurisdiction)
Notes/ Special Conditions
Agent or Applicant Printed Name
s �
Signature Please read compliance statement on back of permit
Application Fee(s) Check #
Issuing Date
Dee note on back regarding River Basin rules.
f" ' e
iPfhited Name
ration 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:
L-j 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
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)
http://porta.l.ncdenr.org/web/cm/dcm-home
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)
Revised 7/06/ 17

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit:
NANCY COSTON
Mailing Address: NI) S FIE1,D,5 r-1&t,
CNAPEt. Efl w-.0 JUC oi'75 / fo
Phone Number: 919-630-3795 / q/9- jig - o S3
Email Address:
I certify that I have authorized DENNIS & SONS MARINE CONST. LLC
Agent / Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development:
70' OF BULKHEAD W/6' X 6' PLATFORM & 8' X 20' FLOATING DOCK & GANGWAY
at my property located at 117 BROOKS STREET
in CARTERET '
County.
/ furthermore certify that / 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
Print o Type Name
olu ve.
Title
Date
This certification is valid through p / 31 / 2018

117 BROOKS STREET
C0'f)necA W/ 3 r is I V Rol f
tRtmov4l 4 Qxis�,%n5 Va.krnn w1 8' X 2D' IFloae.v) ocK
0210112017

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to
property located at
on ICW
117 RPnnKS STREET
(Waterbody)
NANCY COSTON
(Name of Property Owner)
I
(Address, Lot, Block, Road, etc.)
in ATLANTIC BEACWCARTERET N.C.
(City/Town 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 DEVELOPMENT
(Individual proposing development must rill in description below or attach a site drawing)
WAIVER SECTION
1 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)
(Adjacent Property Owner Information)
Signature
9119nature
NANCYCOSTON
N1C110LAS M. L•1vEN40CCr>
Print or Type Name
Print orType Name
'rA
130 S FIELDS CIRCLE
43 a 8 L COIT =fR .
Mailing Address
Mailing Address
CHAPEL hNLL. NC 27516
NC 2 7 705'
City/StatelZip
p►ty/ tate/Zip
919S8o - 710` _
Telephone Number/ email address
lreleIi5hone Number / email address
TuNE 18 , 2018
Date
Date*
(Revised Aug. 2014)
*Valid for one calendar year after signature`

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to
NANCY COSTON
(Name of Property Owner)
I
property located at 117 BROOKS STREET
(Address, Lot, Block, Road, etc.)
on ICW in ATLANTIC BEACH/CARTERET N.C.
e
(Waterbody) (City/Town and/or County)
The applicant has described to me, as shown below, the development proposed at the above
locatio�r.
i/ I have no objection to this proposal.
I have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(individual proposing development must rill 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.
v` I do not wish to waive the 15' setback requirement.
(Property Owner Information)
Signature
NANCY COSTON
Print or Type Name
130 S FIELDS CIRCLE
Mailing Address
CHAPEL HILL, NC 27516
City/State/Zip
919-942-0653
Telephone Number/email address
Date
*Valid for one calendar year after signature*
(Adjacent Property Owner Information)
Sign ure U_
Print or Type Na e
M ing Address
L4 y' � --- N t: 2,77 0-7
City/StatelZip
5 - 201 ` 7� S � •i iC if11 c4rA/dYed� �S 4
Telephone Number/email gb&ess Ce"ZS"-
Date *
(Revised Aug. 2014)