Wiley, James

❑CAMA / DREDGE & FILL No. 75946
-. �
GENERAL PERMIT Previous permit# A B C D
❑New ❑Modification ❑Complete Reissue El Partial Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Envirp*ental Quality
and the Coastal Resources Commission in an area of environmeltal concern pursuant to 15A NCAC
IJRules attached.
Applicant Name ' ---,Pr9 ject Location: County
I p
Address 1 I \ : j �^(� Street Address/ State Road/ Lot #(s)
City( .L State
Phone # `041 (f L�r "'� t4 Mail Agent ubdivisi' n i
� y
Authorized l% ri ll-LC.c�-Clty 1 _: LL ZIP
i�� r 9wJ f E`
Affected � CW 71_�Ew PTA S El Phone # ( ) _ River Basin' � f
OEA ❑HHF IH ❑ ❑UBA N/A i
AEC(s): ❑❑Adj. Wtr. Body ) nat,%man /unkn)
ORW: yes / o PNA yes / Closest Mal. Wtr. Body \�
Type of Project/ Activity f�) C, J''-- ". I , %` i'
Pier (dock) length_
Fixed Platform(s) _
Floating Platform(s)
Groin length
ny ber
Bulkhead/Npmp leng
Javg distance offs
max distance of
Basin, channel -
Boat ramp _
Boathouse/
Beach
Other
Shoreline Length
SAM notsure yes o j — -- -- -
i
Moratorium: n/a yes no
Photos: yes no
Waiver Attached: yes o \ ,
I
A building permit may be required by: I �,
( Note Local Planning Jurisdiction)
Notes/ Special Conditions
Agent or Applicant Printed Name ..
(Signature * Please read compliance statement on back of permit `*
Application Fee(s) Check #
(Scale: I
u See note on back regarding River Basin rules.
Permit Officer's Printed Name
Signatur
�! 'Date
Issuing Date Expiration Date

ADJACENT RIPARIAN PROPERTY LR STATEMENT
I hereby certify that I own property adjacent to J Amas �./• w i L z `J ,s
(Name of Property Owner)
property located at !£Oa JXoNZ 5;t2EE7
(Address, Lot, Block, Road, etc.)
on Ayl rO eRt ele in I&SHuFoizT N.C.
(Waterbody) (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.
typ I 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)
v-
Al Z) I t
WAIVER SECTION 11
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.
N'p I do not wish to waive the 15' setback requirement.
(Property Owner Information)
Sign ure
.TAMES ll. AldiFV
Print orTVpe Name
Dale
(Adjacent Property Owner Information)
lk4- Ae-
Signature
Gunkhole Investments / William Procter
Print or Type Name
2207 Front St
Mailing Address
Beaufort, NC 28516
City/state2ip
2524224822
Telephone Number
Date
(Revised 611812012)

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
i 1
Name of Property Owner Requesting Permit: Jl�"mg3 pK• d
Mailing Address:
���q r�L2aQ�na�"1
Phone Number:
Email Address:
1
I certify that I have authorized
Agent / Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development:
ee� rn✓�' - Sea. w64l ralace
at my property located at �,7U� /%D�/I �7�•
in County.
I furthermore certify that I 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 caner Information:
C
rn I
1✓
Signature
.J p,-m6, K, nl
Print or Type Name
D(A"Al
Title
Date

This certification is valid through ( / V / I -

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to J AMFS l!. (nl l LE `� 's
(Name of Property Owner)
property located at /SDI F"-NT St2aE7
in
'j 2`s t Cl� ;
on Y�n
(Waterbody)
and/or County)
N.C.
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 fill In description below or attach a site drawing)
WAIVER SECTION 11
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.)
do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(Property Owner Information)
Sign ure i9. as
-TAmEs k. YW IEY
Print or TVDe Name
Date
(Adjacent Property Owner Information)
SignSign ture
Litt . A, �'� I al
Print or Type Name
P, J_ '0' 1 L 41
Mailing Address
V-%y.rb , e-f. C. ZES13
City/state2ip
ZS'r-- 56o—+fr,52
Telephone Number
Date
(Revised 6/16/2012)