King, Donnie

❑CAA / � DREDGE & FILL
M
No. 75279 A B C ~ D
®--.
GENERAL
PERMIT
Previous permit#
❑❑N2w ❑Modification ❑Complete Reissue
❑Partial Reissue
Date previous permit issued
As authorized by the State of North
Carolina, Department of Environmental Quality
-711
and the Coastal Resources Com
is 'on in an area o(environ
tal concern pursuant to I SA NCAC
❑Rules $ttached.
Applicant Name
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Project Location:
County (a rv' / ^
Address r'
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( i Street Address/ State Road/ Lot #
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City
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State(ZIP�,i
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Phone # )
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Subdivision
Authorized Agent
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Affected gOw' qEw
O'PTK- ❑ES ❑PTS
Phone # (
) River Basin
AEC(s): ❑OEA ❑HHF
❑IH ❑UBA ❑N/A
Adj. Wtr. Body
(nat/man /unkn)
❑ PWS:
ORW: yes / 1 o / PNA
yes 40.
Closest Maj. Wtr. Body
R�rr
Pier (dock) length_
Fixed Platform(s)r~
Floating Platform(s):
■ ■■■■■■■■■■■■■■■■■■■■■■■■■
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Finger pier(s)
Groin, length
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0
MINEMBEEMEN
Bulkhead/ Piprap length_
NOON■■ONE■■
MISS
EN:::::::
avg distance offshore
■ENE■■■■Emm■■■■■
::::::mmmmm
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NOON
max distance offshore—
Basin, channel
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VA
MENEM
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cubic yards
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■■■NOON■
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OMENS
■■■■■■■■■Boathouse/
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Boat ramp i i
Boatlift ■■■■■■■■■■■■
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SAV: not sure yes
Moratorium: n/a yes • SIMMONSOO■
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Agent or Applicant Printed
back of permit"
Check#

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: Donnie King
Mailing Address: 190 White Oak Bluff Road E
Phone Number: 252-269-0389
Email Address: [e-mail]
I certify that I have authorized Harber Marine Construction Inc
Agent I Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: Hogslat dock. boathouse, and
in Carteret 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
nnnip inn
Print or Type Name
Title
Date
This certification is valid through 12 1 31 I 19

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-Property Line
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15' Riparian Setback
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Donnie King
Boathouse

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ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to nnnnip uin� ,s
(Name of Property Owner)
property located at 1 PQ INhit Oak Rh •f° Road Stella
(Address, Lot, Block, Road, etc.)
on White nak rivpr in Stplla N.C.
(Waterbody) (City/Town and/or County)
The app !cant has described to me, as shown below, the development proposed at the above
locatio .
I have no objection to this proposal.
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)
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 reguirement.
I do not wish to waive the 15' setback requirement.
Print or Type Name
Mailing Address
City/StatelLip
Telephone Number/email address
Date
*Valid for one calendar year after signature*
Information)
Print or Type Name
192 White Oak Bluff Road
Mailing Address
Stella HC 2958?
City/State2ip
Telephone Number/email address
Date"
(Revised Aug. 2014)

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