45868D - Carolina Beach

❑CAMA / ❑ DREDGE & FILL
GENERAL PERMIT
❑New ❑Modification ❑Complete Reissue ❑Partial
Previous permit#
Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environment
and Natural Resources
and the Coastal Resources Commission in an area of environmental concern
pursuant to 15A NCAC 7 �-/ . 22
/
I '✓(z���
❑ Rules attached.
Applicant Name G c urn f r 'J
Project Location: County l ffft:,, 14 o,
Address PC 2 1 C-1 ,F 6k., Rl LC,
Street Address/ State Road/ Lot #(s)
City,,s<- %d, �, 13MI4 State C ZIP 18 1f C g
Phone # (J/ Pf"I / Fax # (_) �'
Subdivision
Authorized Agent 1-f. d
City ZIP
EW PTA El ES PTS
Affected ❑ CW ❑ D-
Phone # ( ) 7/-4 4-x River Basin
AEC s : ❑ 0EA ❑ HHF ❑ IH ❑ UBA ❑ N/A
O
Ad'. Wtr. Body ! ! •, r �; 1 �"
1 y . , ,/,n, ., r� .0 �� � (nat �n /unkn�
❑ PWS: ❑ FC:
ORW: yes /: no' PNA yes / no Crit. Hab. yes / no
Closest Maj. Wtr. Body / �p� -'l4mt-'A�-
Type of Project/ Activity 7.y 5 4j %f
Pier (dock) length
i
Platform(s) - ---'I
Finger pier(s)
i I
Groin length
number
Bulkhead/ Riprap length
-- --�
avg distance offshore
max distance offshore
Basin, channel
cubic yards
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing
Other,
y'X� ,
j
(Scale: �j )
Shoreline Len h ✓ 7 y�ji _. .. .. — t
SAM not sure es no — J -
I
Sandbags: not sure yes no
— _ —
Moratorium: n/a yes ;rid
Photos: yes 'rlb '
Waiver Attached: yes n'o
A building permit may be required by: �/y'(i fir, /, f l�(! ❑ See note on back regarding River Basin rules.
Notes/ Special Conditions % �f (/ S
Agent or Ap Ill Print �Nao
Signature P rea comp ' ce statement on back of permit
Application Fee(s) - Check #
9
k-7
Issuing Date S Expiration Date
Local PlanningJurisdiction Rover Name

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, certifythat this project is consistentwith 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 Quality. Contact the Division of Water Quality 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
Central Office
Mailing Address:
1638 Mail Service Center
Raleigh, NC 27699-1638
Location:
Parker -Lincoln Building
2728 Capital Blvd.
Raleigh, NC 27604
919-733-2293
Fax: [phone]
Elizabeth City District
1367 U.S. 17 South
Elizabeth City, NC 27909
252-264-3901
Fax: [phone]
(Serves: Camden, Chowan, Currituck,
Dare, Gates, Pasquotank and Perquimans
Counties)
Morehead City District
400 Commerce Ave
Morehead City, NC 28557
202-808-2808/ 1-888-4RCOAST
Fax: [phone]
(Serves: Carteret, Craven, Onslow -above
New River Inlet- and Pamlico Counties)
Washington District
943 Washington Square Mall
Washington, NC 27889
252-946-6481
Fax: [phone]
(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 -below New River Inlet- and
Pender Counties)
Revised 06/29/05

CAMA/ ❑DREDGE & FILL
1,ENERAL PERMIT Previous permit#
New ❑Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued
zed by the State of North Carolina,Department of Environment and Natural Resources 20
oastal Resources Commission in an area of envirpnmental concern pursu t to 15A NCAC a i 6/47 tee A4) 1-4,44,11:54,-, 0 Rules attached.
Name 1Q4,41 e9 P { r"piA At It' Project Location: County GfT/ OIAi
/1 Z I et // Ai"„, 1!M, Street Address/State Road/Lot#(s) t(4r 4 .� ,$'
2fe'/ii1,a lie t4 State AK ZIP zg`�2' ( J(//' 6itt CaPoria / r kR / `'jfat
9/fJ) efst• 2441 Fax#( ) ".—' Subdivision
Bd Agent ,�,C✓t tGi kSPvi City i! ZIP
❑CW PeW L 4'f ❑ES ❑PTS Phone# ( ) SG4►/ River Basin
❑OEA ❑HHF ❑IH ❑UBA ❑N/A Adj.Wtr. Body /D I"1A f3e liZest 4
`Q t
❑PWS: ❑FC:
i Closest Maj.Wtr. Body l'✓
yes /() PNA yes /V Crit.Hab. yes / no ,
' 5 7Project/Activity in f g, 71 ej/e l /[ GCS l/;Is�j doe/( /41
Piek S 1/i, s//e • a 6 / ///(Scale: An
ck)length l I
1(s) —. II I I i#
W
I i 1 I I I i
:ier(s) 1 � i ! _
Milli
{ ,A ►
_
;ngth I i i i � � i `.1,
mber / ! _
d/Riprap length _ i . ....' I 0 1- H. r._
g distance offshore _ !.__ ''..}''
ax distance offshore —
�5 ,
hannel
R ,
ibic yards �I t 3 __._.._ I ;..
mp Ai _ _
ex tend
use/Boatlift
. IIIII ! t d�k5
r y
3ulldozing / , ��
/rim 7/ .� / ' I
fD ' i I `
r
nh
1
r
ne Length :XJ(/
not sure yes 6!, • --t— "' 1 ; _..--_---
gs: not sure yes ��� �._. ® ' U _i
j .-I.—
>rium: n/a yes f-4' ..' I 1 1 IIIK I .... .
yesj .
•Attached: yes 6 Y I i II 1 i7C._.. .. 41 ;gr.I I 1 1 1 i
�. a . — /

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DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
610,,t,(..3 C . Sc 4_00i)wvt k c4
Name of Individual Applying For Permit: 1`.e rs b,L_ c A S i r ip if C,J
Address of Property: c, .4-14)41 DA-r ac-
(Lot or StrieYp Street or Road)
C� r,'4- ge P, a d C,0 A
(City and County) I
I hereby certify that I own property adjacent to the above-referenced property. The individ
applying for this permit has described to me as shown on the attached drawing the development t
are proposing. A description or drawing, with dimensions, should be provided with this letter
_.,144/L____.....) have no objections to this proposal.
If you have objections to what is being proposed, please write the Division of Coa5
Management, 127 Cardinal Drive Extension, Wilmington, NC 28405 or call 910-796-7:
within 10 days of receipt of this notice. No response is considered the same as no objectio
you have been notified by Certified Mail.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, break-water, boat house at lift must be
bck a minimum distance of 15' from my area of riparian - unless waived by me. (If
wish to waive the setba - mus itia t e appropriate blank below.)
I do wish t i e e 5' setback requirement.
-7
I do not wish to waive the 15' setback requirement.
ii 4 1444__ _ 0 iii 0 "1
i` ► am 6e,t.U , a �.
mem
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Print me © • FA

DIVISION OF COASTAL MANAGEMENT
' ADJACENT RIPARIAN PROPERTY 0 R NOTIFICATION/WA1VER FORM
C� le-$ C ( Scl l,00,-
4.ame of Individual Applying For Permit: Do ti. of S 4-6
��,J vt- C.a-n.o (kw A p.�.4-c_. tl-t►{C,/ •f{ 6)O cki
Address of Property: c4 " "
(Lot or Street 17-, Street or Road)
Ce-7t-0 fry it, ac pe-4 Ner.J .v-J ede C®v,J
(City and County)
I hereby certify that I own property adjacent to the above-referenced property. The individi
applying. for this permit has described tome as shown on the attached drawing the development th
are proposing. A description or drawing, with dimensions, should be provided with this letter.
I have no objections to this proposal.
If you have objections to what is being proposed, please write the Division of Coas
Management, 127 Cardinal Drive Extension, Wilmington. NC 28405 or call 910-796-72
within 10 days of receipt of this notice. No response is considered the same as no objectior
you have been notified by Certified Mail.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boat house or bo• ' t must be
bck a minimum distance of 15' from my area of riparian acc c ss waived by me. (If
wish to waive the setback, you must initial th priate blank below.)
I do • to waive t`i e.' 1 requirement.
I do not wish to waive th 15' setback requirement.
167.. ./ ik....(itli_____
gA2
Sian Name fr
P&J c 9 10 (A) €,Pd-,
0 7:PrA
Print Name

CERTIFIED MAIL - RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
The purpose of this form is to provide proper notice to you as an adjacent riparian property owner to the individual or
individuals listed below. The CAMA General Permit application procedures require that applicants provide the Division of
Coastal Management confirmation that a written statement has been obtained signed by the adjacent riparian property owner
indicating that they have no objection to the proposed work or that the adjacent riparian property owners have been notified
by certified mail of the proposed work. Often these forms are submitted to the adjacent riparian property owners by a marirn
contractor or other individuals acting as an authorized agent on behalf of the applicant.
This form was sent to you by the following individual or company designated by the applicant as an
authorized agent:
Authorized Agent's Signature Date
Name of Individual Applying For Permit:
Address of Property:
(Lot or Street#. Street or Road)
(City and County)
I hereby certify that I own property adjacent to the above-referenced property. The individual applying for this perm
has described to me as shown on the attached drawing the development they are proposing. A description or drawin
with dimensions, should be provided with this letter.
I have no objections to this proposal.
If you have objections to what is being proposed, please write the Division of Coastal Management. 12
Cardinal Drive Extension,Wilmington,NC 28405 or call 910-796-7215 within 10 days of receipt of this notic
No response is considered the same as no objection if you have been notified by Certified Mail.
WAIVER SECTION
I understand that a pier. dock. mooring pilings, breakwater, boat house or boat lift must be set back
minimum distance of 15' from my area of riparian access - unless waived by me. (If you wish to waive tt
setback, you must initial the appropriate blank below.)
I do wish to waive the 1 5'setback requirement.
I do not wish to waive the 15' setback requirement. VA