50202D - Martin

!CAMA / I DREDGE & FILL
.EI I ERAL PERMIT Previous permit#
4 ew ❑Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued
rized by the State of North Carolina,Department of Environment and Natural Resources U
2oastal Resources Commission in an area of environmental concern pursuant to 15A NCAC 21 • /2 G G
[Z}RGfes attached.
it Name n%7 ,�Ny P7/'r2 1..,/ Project Location: County 81 ii.4S wrc k
. . .} `emu r.,hl , ,:/:,, f f i, Street Address/State Road/Lot#(s) I a f //J
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:ed Agent ' City Sif n'SC j Bt/jCfl ZIP 2 Y V6
L CW _EW PTA ES _PTS Phone# ( ) River Basin Z te ray
❑OEA 1HHF IH UBA ❑N/A
Adj.Wtr. Body 7Cu,615 7.ii e/ (rip
❑ PWS: FC: Q/ !,/ts/
yes I, no PNA yes / no Crit.Hab. yes I no Closest Maj.Wtr. Body 6
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ax distance offshore 17' NM U
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ling permit may be required by: ....)4 tiS F r- Re- 9 t Al I See note on back regarding River Basin I

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ATA,
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
gaol F. Easley,Governor Charles S.Jones,Director William G Ross Jr, Seci
Authorized Agent Consent Agreement
J-rif �y Varmam is hereby authorized to act on my behal:
.! (Pi(oU Ntunh of Apont)
ler to obtain any CAMA permit(s) required for the property listed below The authorization is limited to tt
fic activities described in the attached sketch,
‘TION OF PROJECT:
43 VO<15hIve ,/- . (s()f
'ERTY OWNER MAILING ADDRESS:
lriwiri( €_Rd /aye ILE 0 .3C1
PHONE NO. q/e) - � -0 -3?S
ORIZED AGENT MAILING ADDRESS:
`/ nkaAier 114 rs1
,21y Nc is//.;_
__, PHONE No 9i0 IN 3 liz;
Lure of Property Owner '
"I/.,. I/ . - - -

DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER. FORM
fame of Individual Applying For Permit: ,fi lhe kt 1 t t al` )f i
.ddress of Property: Lo -1-- �-�3 fJO, '?i3jity 6Poc h flf('.
(Lot or Street#, Street or Road)
(City and County)
hereby certify that I own property adjacent to the above-referenced property. The individua
pplying for this permit has described to me as shown on the attached drawing the development the:
re proposing. A description or drawing, with dimensions, should be provided with this letter.
I have no objections to this proposal.
I you have objections to what is being proposed, please write the Division of Coasta
Zanagement, 127 Cardinal Drive Extension, Wilmington, NC 28405 or call 910-395-3904
(ithin 10 days of receipt of this notice. No response is considered the same as no objection i
ou have been notified by Certified Mail.
WAIVER SECTION
understand that a pier,dock,mooring pilings, breakwater,boat house or boat lift must be se
fck a minimum distance of 15' from my area of riparian access- unless waived by me. (If you
vish 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.
Sign Nam Date
�., V-t I �� r t )<''4/) AIMA

A7A
NCDENR
North Carolina Department of Environment and Natural Resources
t McCrory, John E. Skvarla,
;ovemor Secretary
June 3, 2014
CAMA Field Staff Training,New Bern
Check Handling Policy Change
DENR Controller's Office requires removal of copies of checks from permit files.
Date removed: �J ' I`►
Check number: 5 37 I
Amount: 600
Check date: J al -6?
Staff initials: 161-41i

STATE OF NORTH CAROLINA
Department of Environmental and Natural Resources
127 Cardinal Drive Extension
Wilmington,North Carolina 28405
[phone]
FILE ACCESS RECORD
SECTION _ k)\P c p,t
TIME/DATE 10 ', - ,� ( - I l - r+-/
NAME C�3".-
c, .-.
REPRESENTING "
Guidelines for Access: The staff of Wilmington Regional Office is dedicated to making public records in
our custody readily available to the public for review and copying. We also have the responsibility to the
public to safeguard these records and to carry out our clay-to-day program obligations. Please read
carefully the following guidelines signing the form:
I. Due to the large public demand for tile access. we request that you call at least a day in
advance to schedule an appointment to review the tiles. Appointments will be scheduled
between 9:00am and 3:00pm. Viewing time ends at 4:45pm. Anyone arriving without an
appointment may view the files to the extent that time and staff supervision is available.
2. You must specify files you want to review by facility name. The number of tiles that you
may review at one time will be limited to five.
3. You may make copies of a tile when the copier is not in use by the staff and if time permits.
Cost per copy is$.05 cents. Payment may be made by check, money order,or cash at the
reception desk.
4. FILES MUST RE KEPT IN ORDER YOU FOUND THEM. Files may not be taken from
the office. To remove, alter, deface. mutilate,or destroy material in one of these files is a
misdemeanor for which you can be fined up to$500.00. No briefcases, large totes. etc. are
permitted in the file review area.
5. In accordance with General Statue 25-3-512,a$25.00 processing fee will be charged and
collected for checks on which payment has been refused.
FACILITY NAME COUNTY
2. ?79 lr, � iti� 3 `177`, =��IC�� ')I mil'`/
3. 3 S'.5 a� y ? 41 7-77
4. s 1 -
•.i

SENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY
• Complete items 1,2,and 3.Also complete :.Zaiture •
item 4 if Restricted Delivery is desired.
■ Print your name and address on the reverse Agent
so that we can return the card to you. C3ressee
■ Attach this card to the back of the mailpiece, B eceived (Printed Name) IC. of.Def �y
or on the front if space permits. &fir't! L/`t/, )/rj /-
1. Article Addressed to: D. Is deWery address different from item 1? ❑Yes
If YES,enter delivery address below: ❑ No
61,al, &vat_
�l0 t Lune,
WWW
I !ry athien �I� C 3. Service Type
I `� ❑Certified Mail 0 Express Mail
n 0 Registered 0 Return Receipt for Merchar'fise
I L)(i ❑Insured Mail 0 C.O.D.
4. Restricted Delivery?(Extra Fee)
❑Ye:
2. Article Number
(Transfer from servic 7006 0100 0002 6658 3028
PS Form 3811, February 2004 Domestic Return Receipt
102595-02-M-1540
0/3d013AN3 d0 d011 f N3313LLS 30y1d
SENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY
• Complete items 1,2,and 3.Also complete A. Signature
item 4 if Restricted Delivery is desired. Agent
• Print your name and address on the reverse X 7 '�� ❑Addressee
so that we can return the Card to you. eive!, anted Name) C ate of pelivery
• Attach this card to the back of the mailpiece, 'YtY /��� G'
or on the front if space permits. A
D. Is deliv-• address different from item 1? 0 Yes
1. Articleti Addressed� � J to:w �/��j� If YES,enter delivery address below: f�?No
T W1U`ILt.C.I k+ d
6mA/or Pora
3. Service Type
A ,{ ( .) (tti 14 ❑Certified Mail ❑ Express Mail
��" ❑Registered 0 Return Receipt for Merchandise
❑ Insured Mail 0 C.O.D.
4. Restricted Delivery?(Extra Fee) 0 Yes
2, Article Number
(Transfer from sr 7006 0100 0002 6658 3011
1o259s-oz-M-154o
PS Form 3811, a ruary 2004 Domestic Return Receipt