Southern Salt Seafood

No 73153 .11,
CAMA / DREDGE & FILL
A B D
�. GENERAL PERMIT
Previous permit #
New __ Modification _'Complete Reissue Partial Reissue
Date previous permit issued
As authorized by the State of North Carolina, Department of Environmental Quality
n
and the Coastal Resources Commission in an area of environmental concern pursuant
to 15A NCAC .:
Rules attached.
Applicant Name- 41h`
�jD
Project Location: County '��('�' _711-6
s'"'
Street Address/ State Road/ Lot #(s)
Address •
State ZIP l
71U''`
City
Phone # _~ `l I ` ` E-Mail
Subdivision
ZIPS:- % >
Authorized Agent
City !
r
River Basin
❑ CW [jWfW [+TA ❑ ES ❑ PTS
Phone # ( .r'
Affected ❑ OEA C HHF ❑ IH ❑ UBA ❑ N/A
AEC(s):
f
Adj. Wtr. Body [s E i�i`U � nat /man /unkn)
❑ PWS:
Per" tiri3
WBy.
Closest Maj. tr. od
PNA VPK �' n
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IS
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Agent or Applicant Printed Name
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Signature ** Please read compliance statement on back of permit
ApplicationFee(s) W i/, , f fChecck#
PermitOfficer's Printed Name
Signature/
i?
Issuing Date- Expi tion 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/ 1-888ARCOAST
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://portal.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

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
e_J �t-/' I hereby certify that I own property adjacent to pit,/I irk_r�
- — (Name of Property Owner)
property located at
(Address, L ,Block, Ro d, etc.
on �.�� �r ��2 , in , N.C.
(Waterbody) (City/Town and/or County)
The applican as described to me, as shown below, the development proposed at the above
location.
I have no objection to this proposal.
I. have objection-s to this_pr_oposal-
_ _
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(Individual proposing rdevelopment must fill i�escrip;tlon below or attach a site drawing)
r�s .D
�7 Y //t2l`
,J/
AIVER_ SECTION -
I understand that a pier, mooring pilings, - breakwater, boathouse, lift, or groin must be set
c,
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) (A III
cent PropertyOwnerInformation)
005
Si re - Signat ;
Prime-ef T�rpe N e Print or Type Name
Maili ddress Mailing Address
City/State2ip
Tel ho e lyumber
Telephone Number
Date Date 0,
(Revised 6/18Z400
9G

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT "
.O
hereby certify that I own property adjacent to �C,� t 0(1 of /`5,14 s
(Name of Property Owner)
property located at
on
�1
(Address, Lot, Block, Road, etc.)
�� � 9� N.C.
in
(City/Town and/or County)
The applica . has described to me, as shown below, the development proposed at the above
location
I have no objection to this proposal.
objections to this_proposal. - -- ---- -- ---- --- -- - ----- -- - -
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(Individual proposing development must fill in description below or attach a site rawing)
— -- - — — d
AIVER SECTION
I understand that a pier, dock, mooring pilings, 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.
IPrnnarty Owner Infnrmationl
Telepho umber
Date
(Adjacent Property Owner Information)
CIA
Sign t e
::[�v�
Print or Tye Na
7Iriv- Sf"
Mailing Address
me � P. J T� N C R255 7
City/State/Zi
a5a - lac -5c� 3 �x� �1 • �
Telephone Number
yid/I`i
Date
(Revised° 6% � C,�11
OGO18/201