Braswell, Mike

CAMA / DREDGE & FILL
No. 73224
GENERAL PERMIT A B C D
- Previous permit #
-New - 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 15A NCAC
Rules attached.
Applicant Name Project Location: County
Address
-- Street Address/ State Road/ Lot #(s)
City _ _ — — State ZIP
Phone # ( ) _ E-Mail Subdivision
Authorized Agent — - City _ ZIP
Affected CW ❑ EW ❑ PTA ES -7�TS Phone #
( —) River Basin
AEC(s): - OEA ElHHF ❑ IH UBA ❑ N/A
PWS: Adj. Wtr. Body nat /man /unko)
ORW: yes / no PNA yes / no Closest Maj. Wtr. Body
Type of Project/ Activity
Pier (dock) length
Fixed Platforn
Floating Platfc
Finger pier(s)_
Groin length
number
Bulkhead/ Ripi
avg dista
max dist;
Basin, channel
cubic yar
Boat ramp _ _
Boathouse/ Bc
Beach Bulldozi
Other
Shoreline Leng
SAV: no
Moratorium:
Photos:
Waiver Attache
A building per
( Note Local Planning jurisdiction)
Notes/ Special Conditions
Agent or Applicant Printed Name f
Signature Please read compliance statement on back of permit
Application Fee(s) Check #
(Scale: ) I
r , - new vrr uat-rc regar-urng miver t5asm rules. I
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 thatthis 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
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)
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)
http://portal.ncdenr.org/web/cm/dcm-home Revised 7/06/17

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to _77/4;t/4/ ///I/
property located aa9 ki yc
40
(Address, Lot, Block, Road,
N.C.
(Waterbody) -
(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 fill in description below or attach a site drawin )
7n- dJtP6&- 6ld- &o4i- K4mp ub-2�11 a�tj I
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.)
1--� I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
iooperty owner information)
l//,0,/ ✓C' L��SIr'�
Print or? e ame
Mal in Addre
t�zJ�-��,���
C►ty/State p
�r�
T phone Number/email addre
(Adjacent Property Owner Information)
Signature*
TtfF d2 ! Al L7 t?1.f�6alL
Print or T pe Name
601-kcad-
ling Ac/draes 7n"I k) - C � a
Ci /State2i
,S_-2,4°7J
Tele hone N mber/email address
ok
�g ao
Date*

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT J
1 hereby certify that I own property adjacent to 1VIbx1e 44 ,s-s
Property located ��J �j P`ro, jy,Owne) �� 1
p (Address, t, Block, R ad etc.
on %�,� L t,�.S� /1 /�lL )
(Waterbod in &.<A� ,b0s`z� , N.C.
y) (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 fill in description below or attach a site drawing)
-o e, ID5e D/d -3ov-& /?79/� f W/ �sz , Ulf!/ 4-
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.
I do not wish to waive the 15' setback requirement.
(Property Owner Information) (Adjacent Property Owner Information)
Signatu
Print or rye ame Ptint or T pe Name
Marling Address,`� , ,G--L L _ ' �iP � ��T; // 4
Mali g ddress r
City/St�epp
'
�� c City/State)2p
- 'J ��i �, �-_2 3)-X 14 .bwAboyci1e co-)
Telephone Number/email addvoss Tel hone umber/email address
Date -y
Date