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LJ CAMA / C DREDGE & FILL No 71689 A
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
and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC
-_1 Rules attach
Applicant Name ,�� , } , Project Location: County
Address 1 �' ,) i`;= L, Street Address/ State Road/ Lot #(s) Yv;
— A.V.
City f . � State 0" 1P
Phone # ( _ _) E-Mail
Authorized Agent
Affected ❑ Cw p EW ❑ PTA ❑ ES ElPTS
AEC(s): ElOEA ElHHF ElIH ❑ UBA ❑ N/A
❑ PWS:
ORW: yes / no PNA yes / no,
Subdivision
B C D
City ZIP - --
Phone # ( ) River Basin
Adj. Wtr. Body (`� i �'�` l , {'1 ! tnat /man /unkn)
Closest Maj. Wtr. Body —
Type of Project/ Activity
Z 3 (Scale: f )
Pier (dock) I gth
Fixed Platform(s)
Floati
Finger44-
Groin
Bulkh
Basin
Boat
Boat
Beac
Othe
Shor
SAV:
Mor
Phot
Waiver Attached. yes no r
A building permit may be required by: S% See note on back regarding River Basin rules.
( Note Local Planning jurisdiction)
Notes/ Special Conditions
Agent or Applicant Printed Name
Signature ** Please read compliance statement orlback of permit **
r� -r ._'•. f� l Lei 'a1f'� �~�UL�J I � j
ApplicationFee(s)� Check#
Permit Officer's Printed Name
rJ _
Signat4re C l
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/ 1-888ARCOAST
Fax: 252-247-3330
(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: 252-264-3723
(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: 252-948-0478
(Serves: Beaufort, Bertie, Hertford, Hyde,
Tyrrell and Washington Counties)
Wilmington District
127 Cardinal Drive Ext.
Wilmington, NC 28405-3845
910-796-7215
Fax: 910-395-3964
(Serves: Brunswick, New Hanover,
Onslow - South of New River Inlet -
and Pender Counties)
Revised 7/06/ 17
CAMA /DREDGE a FILL No 70971 A B CC
G NERAL PERMIT Previous permit #
ew L7Modification JComplete 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 r / ✓�''C
les attached.
Applicant Name J 5 __ Project Location: County 1!: ► /�
Address Aewller,Street Address/ State Road/ Lot #(s)
City
Phone #
StateA(G ZIP
Authorized Agent
Affected ❑ CW PTA ❑ ES ❑ PTS
AEC(s): ❑ OEA ❑ HHF ❑ IH ❑ UBA �] N/A
❑ PWS:
Subdivision �� <
I&"
City ZIP
Phone # () River Basin
Adj. Wtr. Body it)
nat
Closest Maj. Wtr.
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❑ See note on back regarding River Basin rule
JUL 13 2018 PermitO fiver's Printed Name
Date
,lk
Date: 3X2_/1 Y Section 4 -7 Lot#__3 S ( Permit Numbers Q
THIS PERMIT IS TO BE DISPLAYED IN FRONT WINDOW AND BE VISIBLE FROM
THE STREET — FROM DATE PERMIT IS RECEIVED UNTIL WORK IS COMPLETED
Fairfield Harbour Property Owners Association
PERMIT
This Permit is Valid for Six (6) Months from Date of Approval
For: 1) 2 E-11, G 1 N
Property Owner _& 1'�(s -S-
Address .s& 2 n N V Ll C1 Z Phone Number 3 3y— 2 `f Z_ 2"] S C
Contractor eR + L C p "S Ry ci?,,J License Number C3 r4 CL I—E
This permit has been approved by the Fairfield Harbour Property Owners Association Property
Control Committee
Date of Ap roval: 3 22 .2 I A
Signed
ember
PCC Memb
PCC Member
Upon completion of the project contact the Property Control Committee to schedule a Certificate
of Occupancy or Certificate of Compliance inspection.
Issuance of this permit by the Fairfield Harbour Property Control Committee is to regulate
development pursuant to the Fairfield Harbour Declaration of Restrictions and Architectural
Guidelines. It in no way implies that any other governmental requirements or regulations have
been met or satisfied. Any other required permits are the responsibility of the Property Owner.
INITIALS OF PCC MEMBER HANDLING THIS PERMIT
RECEIVED
JUL 13 2018
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JUL 13 2018
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