Bender, Phillip

CAMA DREDGE & FILL
GENERAL PERMIT
New Modification Complete Reissue Partial Reissue
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 15A NCAC
Applicant Name
Address
f-"L
State', zip
City
Phone #
-7 7E-Mail
Authorized
Agent
CW EW El PTA A ES F] PTS
Affected
OEA HHF DIH El UIBA D N/A
AEC(s):
PWS:
ORW: yes / no PNA yes / no
Type of Project/ Activity
No. 73343 A
Previous permit #
Date previous permit issued
Project Location: County - -
Street Address/ State Road/ Lot #(s)
—', Rules
B C D
Subdivision
c. ZIP --
Phone# River Basin
Adj. Wtr. Body A, (nat /man /unkn)
Closest Maj. Wtr. Body
(Scale:
Pier (dock) length
Fixed Platform(s)
Floating Platform(s)
Finger pier(s)
Groin length A. A
number
avg distance offshore
-4 -------
T
Bulkhead/ Riprap length
max distance offshore -3
Basin, channel
ubic yards
amp
use/ Boatlift
---T T
Bulldozing___
JH-- --------
ine Length T.
not sure yes no'
orium: n/a yes no
- -- ---- -- --
s: yes no
c
Boat r
Boatho
Beach
Other
Shorel
SAV:
Morat
Photo
Waiver Attached: Yes no
A building permit may be required by:
Note Local Planning jurisdiction)
Notes/ Special Conditions vlj ox
Agent or Applicant Printed Name
Signa PPlease readcomphiiiiii ce statement on back ofpermit
I-V
Application Fee(s) Check #
See note on back regarding River Basin rules.
Permit Officer's Printed Name
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 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 --- �' Tar - Pamlico River Basin Buffer Rules 'L— 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
Washington District
400 Commerce Ave
943 Washington Square Mall
Morehead City, NC 28557
Washington, NC 27889
252-808-2808/ 1-888-4RCOAST
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)
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