Henbro LLC

CAMA / El DREDGE & FILL N2 71606 A B C D
GENERAL PERMIT —Partial Rei L Date previous permit issued Previous permit #
-New DModification Complete Reissue ssue
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
Address -------
State 7
City zip_Mf.�7
Phone # —E-Mail
Authorized Agent
CW EW 'PTA E ES 0 PTS
Affected OEA HHF — 1H UBA El N/A
AEC(s):
L PWS:
nDw. — / nn PIMA Yes / no
I Type of Project/ Activity
r Ln Oy')
erit or Applicant Printed e
ure Please reaO.. pliance statement on back of permit
Application Fee(s) Check #
Project Location: County
Street Address/ State Road/ Lot #(s)
Subdivision
City -
Phone#
Adj. Wtr. Body
ClosestMaj. Wtr. Body —
ZIP
River Basin
_(nat /manlumkn)
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:
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

02-00-'15 13:55 FROM' T-017 POOO1J0003 F-056
y All
4C%"EIrR
No arolina Department of environment and Natural Resources
Division of Coastal Management
Pat McCrory Braxton C. Davis John E. Skvarla, III
Governor Director Secretary
Date
Applicant Name C'
Mailing Address o
I
I certify that I have autho i (agent),a-b to act on my behalf, for the
purpose of applying fora' o taining all CAMA pe its necessary to install or construct (activity)
at. (location)
This certification is valid a (date)
Signature ���. AM (114"aQ
Stu 8
a3Ai303a
400 Commerce Ave., Morehea Cit , NC 28557�
Phone: [phone] FAX: [phone] Internet www.nccoastalmanagement.net N lthCarohila
An Equal Oppactunity %Afmiatve Act Ern oyer j' ► a u aCL�

02 09-' 15 13:55 Fli M_
Name of Pi
Address of
Agent's
Agent's
T-017 P0003r0003 F-056
DIVISION OF COASTAL MANAGEMENT
'gIAN PROPERTY OWNER 14013FICATIf)N[WAI1iER FORM
"I�
(Lot or Street #,
S"3LI(.5'
or Road, City & County)
Mailing Address: p Z)
a t t(1=ii9r1� c-R'Y 14 C BSS 7
! hereby cart i own property adjacen to the above referenced property. The individual
a for s` a it has described to me shown on the attached drawing the development
ro A, descrt tion or dra 'n wi h di sions m t Vide with thisJett r
I h n objections to this pro �11- I have objections to this proposal.
If you have o to what is being propos , You must ao$iy the Division of Coastal. Management
(CCI�) in wrfii to-10 days of receipt of"s notice. Correspondence should be mailed to 400
C°mmenc®a ead City, NC, 2d567: A4 representatives can also be contacted at (252) 808-
28p$ No t 'cod the sa►n action If you have been notNied Py Certified Mail,
f understand WAN � SECTION
ler, dock, mooring pilin ,breakwater, boathouse, lift or groin must be set
back a minim 3 nce 'of 15' €rom my are of riparian access unless waived by me. (if you
wish to waiveack, youmust i,n" tN appropriate blank below.)
wish to waive the 15` set��ck requirement.
001,
not wish to waive the 1 Setback requirement. , <-
(property
rnnr or
)C
7
Ewe
(p+dJ party ner formation)
J /f •
�e L p tit/�}�l (`
��L. lttl,kS
Print or Type Npme
_Z5? � `4- - 6, �Y�r
Telephone Number
Date
Revised 6/16/2012

4
Mid
Pi
t
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e
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RECEIVED
JUL 18 2018
DCM-MHD CITY

02-09-' 15 13:55 FROM -I T-017 P0003r`0003 F-055
i
DIVISION OF COASTAL MANAGEMENT
`ADJACEf RIPARIAN PROPERTY OWNER NOTIFICATIONlWAIVER FORM
Name of Properi Owner:_
Address of Prop rty: r�—
1L t or�Street�Str�oroad, City & Couni )
Agent's Name t'fk5
Mailing Address: L
Agent's phone 5�;z-5 -3`i �' ITy ,Uc, ��55?
I hereby certify i at I own property adjacent' to the above referenced property. The individual
applyin21hav
ermit has described to me as shown on the attached drawing the development
they artg. A description or. drawing with dimensions, must be provided nth this letter
o objections to thisproposal. I have objections to this proposal.
It' you have objec ores to what is being proposed, you most podfy tine Division of Coastal Management
(DCM) in writing fithin -10 (lays of receipt of this notice, Correspondence should be mailed to 400
Comm evcd Ave., , orehead City, fiiC, 28557. DCM representatives can also be contacted at (262) 808-
a8p8 ` ova is cons
the sir»® s r►o otiiection i� vore have been rpotifind by c°aa,tf¢:pr1 rwm,i
WAIVICER SECTION
I understand tha: a pier, dock, mooring pilings; breakwater, boathouse, lift: or groin must be set
back a minimum istance of 15' from my area of riparian access unless waived .by me. (if you .
wish to waive the setback, youthe appropriate blank below.)
Ii o wish to waive the 15' setback requirement'.
do not wish to waive the 15' setback requirement.
i
(Proper Own 1, Information) (adjacent Pr perry Owner information)
Sign Iature Signature
Print or Type Na
Print or Type Name
Mallirig Address Mailing'Address
fy tate/zfp. City/State%zip
JUL 18 2018
Telephone Numbo Telephone Number DCM-1
i
Dade __
Date �
Revised 611812012