46284D - Holden

❑ CAMA / ❑ DREDGE & FILL
&NewENERAL PERMIT Previous permit#
❑Modification ❑Complete Reissue ❑Partial 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
Rules attached.
Applicant Name
<. s' f_ w,
Address
! V• C-
City
State . \" t ZIP . !
Phone # ( ) L/
7 / ;fax # ( )
Authorized Agent
❑ CW
ElEW C PTA UES ❑ PTS
Affected
❑ OEA
ElHHF ElIH [IUBA ElN/A
AEC(s):
❑ PWS:
❑ FC:
ORW: yes / no PNA yes / no Crit. Hab. yes / no
Project Location: County
Street Address/ State Road/ Lot #(s)
Subdivision
City ZIP ii %
Phone # ( ) River Basin c `z. 71j
Adj. Wtr. Body(gnat /man /unkn)
Closest Maj. Wtr. Body
Type of Project/ Activity
c ,
(Scale: 1 t )
Pier (dock) length
Platform(s)
Groi
Bulk
Boat
Beac
on back regarding River Basin rules.
Shor
SAV:
Sand
Mo
Phot
Waiver Attached. yes no
A building permit may be required by:
Notes/ Special Conditions
❑ See note
n
head/
I
r pier(s)
length
number
Riprap length '? � yV
�
1FJ
"
A
avg distance offshore
max distance offshore
Agent or Applicant Printed Name
Signature ** Please read compliance statement on back of permit
Application Fee(s) Check #
Permit Officer's Signature
Issuing Date` { ( Expiration Date
Local Planningjurisdiction Rover File 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, certify that 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 Elizabeth City District
Mailing Address: 1367 U.S. 17 South
1638 Mail Service Center Elizabeth City, NC 27909
Raleigh, NC 27699-1638 252-264-3901
Location: Fax: [phone]
Parker -Lincoln Building
2728 Capital Blvd.
Raleigh, NC 27604
919-733-2293
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/ 1-888ARCOAST
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
3ENERAL PERMIT Previous permit#
`New Modification iComplete Reissue _iPartial Reissue Date previous permit issued
>rized by the State of North Carolina,Department of Environment and Natural Resources
Coastal Resources Commission in an area of environmental concern pursuant to I 5A NCAC 7Ft , 1100
ules attached.
it Name /V(k IYl/4- '1 rrbL.IOEI\/ Project Location: County I/eLC.NSUJ/GK
Z 12 /'12/N k QK t V t Street Address/State Road/Lot#(s)
>0 VT tt('O f2T State AJ c ZIP 2A y I P' ,VA(fi-r dfi S/
) yS 7-Ss7Iax#( ) Subdivision
zed Agent City SOt777ViileT ZIP 2Stfk
i ❑CW I Gv P.PTA U.ES ❑PTS Phone# ( ) _ River Basin
❑oEA ❑HHF ❑IH ❑UBA ❑N/A
Adj.Wtr. Body Yitt C ft T 64$►A) at
❑ PWS: ❑FC:
yes / PNA yes /7 Crit.Hab. yes / no Closest Maj.Wtr. Body
if Project/Activity tV w &L I<t-Vp
(Scale: 1 �1
ck)length
n(s)
pier(s)
ength _
/1;1
r, ram'
R>ber COT '/ '
Riprap length 2.7 1 yVlg'Y, 11J l�l.l! f
`g distance offshore 2 1 ,
tt
lax distance offshore 2 ! _ + hew C t-K-{"i L(:- s,: ,;
:hannel 11(<9) 2`
ibic yards j .
mp
use/Boatlift I I
.)tf�fN
3ulldozing -- ,y� �
D p
Ilg
v �I
•
._-- - r.
1!
rr�� r � _
ie Length 47 t .y L '
not sure yes ( EMX -i (r 0It. E a
11.
gs: not sure yes `P 1...........i..
rwm: n/a yes 00 l
Attached: yes gi
i_- ...

•
At7A
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
lichael F. Easley,Governor Charles S.Jones, Director William G. Ross Jr.,
Authorized Agent Consent Agreement
$i Joet-&,/E MA�r,VE 4,05 e rc-rsa,J is nalualay-authorized to act on my be
(Printed Name of Agent)
)rder to obtain any CAMA permit(s) required for the property listed below. The authorization is limited
)cific activities described in the attached sketch.
CATION OF PROJECT:
ae' ' /i9Cf/T&?S.z,/ b,e,
-, f2/,�i/Pip-r, A/c 2R-VG/
OPERTY OWNER MAILING ADDRESS:
/h,e,r,AA/ 1/4LAI'A/
021 a 6.er,✓1 hoer✓E
- ,uTf/P©,eT/✓c- a7V / PHONE NO. 9/49-5/.S7-313'7.4/
THORIZED AGENT MAILING ADDRESS:
rAlo eELsA/E /49.es.,,/E evivSuc r.>
2 D. &)( /iG 7/
ot iliP 77 A/C- 07i V6/
PHONE NO. 9/4,-a79 302 9
nature of Property Owner: ti/h1,P
nature of Authorized Agent: yl) k ... '

DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Individual Applying For Permit: pie,,/At/
Address of Property:
(Lot or Street #, Street or Road)
T///93e; 4/ ag J// seu,tzgw��,e
(City and County)
I hereby certify that I own property adjacent to the above-referenced property. The indivic
applying for this permit has described to me as shown on the attached drawing the development I
are proposing. A description or drawing, with dimensions, should be provided with this lettei
I have no objections to this proposal.
If you have objections to what is being proposed, please write the Division of Coa
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 objectic
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
bck a minimum distance of 15' from my area of riparian access - unless waived by me. (If
wish to waive the setback, you must initial the appropriate blank below.)
pff I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
11-6J2- Wil-11 -/9-47
Sian Name Date

DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Individual Applying For Permit: /14,P,n,01/
Address of Property:
(Lot or Street #, Street or Road)
-J aT7//)z„e7 i✓C- real s Gsrc_fe'
(City and County)
I hereby certify that I own property adjacent to the above-referenced property. The indivi(
applying for this permit has described to me as shown on the attached drawing the development I
are proposing. A description or drawing, with dimensions, should be provided with this letter
OT) I have no objections to this proposal.
If you have objections to what is being proposed, please write the Division of Coa
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 objectic
you have been notified by Certified Mail.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boat house or boat lift must b(
bck a minimum distance of 15' from my area of riparian access - unless waived by me. (If
wish to waive the setback, you must initial the appropriate blank below.)
n
)14 I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
7
Sign•ame Date
arg•C PeiTLC T 1 1

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