Midland IRA Inc.

IV
11 CAMA / DREDGE & FILL
-. GENERAL PERMIT
❑New -Modification -]Complete Reissue —Partial Reissue
No 7093 5 A B
Previous permit #
Date previous permit issued
fD D
As authorized by the State of North Carolina, Department of Environmental Quality
and the Coastal Resources Commission in an ai ea of environmental concern pursuant to I SA NCAC
_Rules attached.
Applicant Name VVI , ''; a �J Project Location: County_
Address ' Streetld ss/ State Road/ Lot #(s)
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City f State _ ZIP
Phone # ( ) E-Mail Subdivision
Authorized Agent
Affected ❑ CW ❑ EW ❑ PTA ❑ ES ❑ PTS
ElOEA ElHHF ❑ IH ElUBA ElN/A
AEC(s):
❑ PWS:
ORW: yes / no PNA yes / no
City )1 (' t- A I L ZIP 7
Phone # ( ) .<` `fir River Basin
Adj. Wtr. Body_ i f• . - 1 a ' - (nat /man /unkn)
Closest Maj. Wtr. Body;
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Agent or Applicant Printed Name
Signature * Please read compliance statement on back of permit
i
Application Fee(s)
l
Permit Officer's Printed Name
Signature
Check # 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:
Ii 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 Washington District
400 Commerce Ave 943 Washington Square Mall
Morehead City, NC 28557 Washington, NC 27889
252-808-2808/ 1-888ARCOAST 252-946-6481
Fax: [phone] 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)
(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

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: Ro FU
Mailing Address:
Phone Number:`?
Email Address: (p "f rrJ c
I certify that I have authorized
Agent d Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: Wgk_�'
at my property located at � ! �
in CkA'eM County.
I furthermore certify that l am authorized to grant, and do in fact grant permission to
Division of Coastal Management staff, the Local Permit Officer and their agents to enter
on the aforementioned lands in connection with evaluating information related to this
permit application.
Property Owner Information:
Signature 61
Sacha Bretz
-�� Print or Type Name
Title
Date
IRA Administrator
This certification is valid through 0- 1 3 j 1 201 8
JAN 3 0 2018
DCM- fWHD CITY
R E C
JAN �
©CM -

i 4

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to --Nn �tqj _� 1prik aLfr„e,, F';,gu; Is
property located at � i � K_•e�: �, ..�_t y P 1 v c V. (Name of Propdfty Owner)
(Address, Lot, Block, Road, etc.)
on 4JC5'KC Sc,., , in N t' ari , N.C.
(Waterbody) l(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 flll in description below or attach a site drawing)
S� C' %�� �rie �, t a �r� L �C.t..%�-�- � L w: •�rawt
C?k, Sc,+'1. , d' C e L� � j � 1 � , � t •S UJu-t V e r`
Pxciust,d -7�)
RECEIVED
JAN 3 0 2018
DCM— MHD CITY
WAIVER 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 to7.7do
he setback, you must Initial the appropriate blank below.)
wish to waive the 15 setback requirement.
I do not wish to waive the 15' setback requirement
(Property Owner Information) (Ad_jaaent Property Owner Information)
Signatu ,
G, re., _i 4w1 Sacha Bretz, IRA Administrator
Pti t or a Name
Lo 9,-x1 to 84
Ming Ad `iss
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city/5tatallip
51 � —(-3 t- (4171
Telephone Number
f -16.1
Date
Print or
(Revised W &2012)

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*" DECEIVE
JAN 3 0 2018
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-► i.. :.L. J.� L� �* �Jlil.�► ��t�
I hereby certify that I own Wvperty a4acent to MA" 's
(Name of P Owner)
Ply toasted at 41 b ke � Pl�.�
Address, Lot Block, Road, etc.)
on Q tt a S in N'c a N.C.
(Wate+rbody) I (City/Town and/or County)
The applicant has described to me, as shown below, the development Proposed at the above
location.
x I have no objection to this proposaij
I have objections to this proposal.
DESCRIPTION ANDIOR DRAWING OF PROPOSED DEVELOPMENT
ual proposing development must fill in description below or attach a site wing)
WAIVER UoQtj
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.)
Aiwl do wish to waive the IS setback requirement.
I do not wish to waive the 16 setback requirement. FRONT PORCH INVESTMENTS, LLC
6000 FAIRVIEW RM
(Property Owner information) (Adjacent rl�"M)
KS Sacha Bretz, IRA Administrator
Name
" Z
Date
stir elcz<,i eo .
Print or Type Naft A` r-� & fjl
?,Got �q wu.� �d�54-,+c 1Wo Zfi1� 5i�-1&�
Ue�WAddr8ss y210
citylsW8020
Telephone Number
Dote
(Revised WIM012)