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�'CAMA / DREDGE & FILL I!
GENERALii:1-1:11
PERMIT I! �' n
Previous permit#
New Modification E1Complete Reissue Partial Reissue Date p evious permit issued
As authorized by the State of North Carolina, Department of Environm (it and Natural Resources '
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and the Coastal Resources Commission in an area of environmental conc rri'pursuant to 15A NCAC 7 GY=
.J F l,`QRules attached.
Applicant Name CAC r /CS VeaCh COA Project Loca>ri i:ECountYT r, ;, /
Address i //U ,Jc c,It i// f,(jl L/ Street Add ress/State Road/ Lot#(s) 92 6"/, _
City ,c.00. n l5 (C 5CcCc6 State/VC ZIP -, . f �,, t..._�� L. I : ►'c
Phone# (?id 75 / ,32 5O Fax#( ) Subdivision _
Authorized Agent City Sr (r .c /" ben c/ ZIP
Affected 0 CW EW APTA ❑ES ❑PTS Phone # ( ) River Basin c, , , ; r r
❑OEA HHF 0 IH ❑UBA O N/A / r.c�C c (nat m /unkn)
AEC(s): Adj.Wtr. Body /-/ ( ary
❑ PWS: ❑FC:
ORW: yes / no PNA rig)/ no Crit.flab. yes / no Closest Maj.Wtr. Body ' / /,JC c
Type of Project/Activity c,c. • ; --/ - -
o (Scale: / c )
Pier(dock)length 1 1O ' .
1
Platform(s) %U X ZO - -4.,---'•' •-",/- )L) .-+'-ir --
Finger pier(s) /L%X 2 0 ; 1 �
Groin length o I ' Joe IA i'7d`�
number I (
Bulkhead/Riprap length O , r! le) ��e 1_._
avg distance offshore , I
-<j J _ i -
max distance offshore j P.Y_. wry- --I— .
C. ' '.2.r
Basin,channel : -
- 1la' 5 iI i 2'
cubic yards / ej� { I Z 1.._. j._.-...
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/ 3i .. I
Boat ramp — t —. i I ,
Ili' 1
Boathouse/Boatlift ' I d"i
BPS t -t „ , J'-470-Cn`o '
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Beach Bulldozing ( j 1 I i
Other fi 1, t 4 w I l 4 .
Y re ' L. v r' vv
Shoreline Length ,/ V' ty r !-" - . 4_,,r,,,,., ti,-.,. :. - • ._ - _�. , .
SAV not sure yes no _ __:__�__, � / ly
Sandbags: not sure yes (no 7S <YG�� r I 1
Moratorium: •
n!a yes (no I i✓ci L.,r� G —I
Photos: yes To Pt i ----
Waiver Attached: yes' /ono I ' j
A building permit may be required by: '//5 C Zj&lr C/) . L See note on back regarding River Basin rules.
Notes/Special Conditions f--i , C'a->i cl/lh C),/S c-IL 7//. /Z o< /4:4pp/`1 . Vic, r-K-:'
01t 5-e k1 ' €r7CizXC('' i ac jaCF/ it. yt / c,rtivi ; dG-s 6r' ,1- L4)lctt/CG/
/S ' ✓t►t ► 1L< v'i 5t1 baC;E'S , -Ri rGtl. C6-vr ((Jc' 75lrfr,.Cc/ 1,7c 1e-ctiiCd t a CI,ra( reties,
el,0,-- /"95 !/ c/!7 (i; :- r.- c. -!-4
Applicant Printed Name Agent or Permit Officer's Signature
/7-/o� E/2 7/(I/
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gnatu Si G�se re compliance statem back of permit** Issuing Date piration Date
7CUGV : 6: _ / (/) cf- {,Jc�.GC17 ^/cT//Wi/[_
Application Fee(s) Check# Local PlanningJurisdiction Rover File Name

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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 I)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 consistent with 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(9 I 0-395-3900)for more information on how to comply with thesebuffer rules.
Division of Coastal Management Offices
Central Office Elizabeth City District Washington District
Mailing Address: 1367 U.S. 17 South 943 Washington Square Mall
1638 Mail Service Center Elizabeth City, NC 27909 Washington, NC 27889
Raleigh, NC 27699-1638 252-264-3901 252-946-648 I
Location: Fax: [phone] Fax: [phone]
Parker Lincoln Building (Serves:Camden,Chowan,Currituck, (Serves: Beaufort, Bertie, Hertford, Hyde,
Dare,Gates,Pasquotank and Perquimans Tyrrell and Washington Counties)
2728 Capital Blvd. Counties)
Raleigh, NC 27604
9I9 733 2293 / 1 888 4RCOAST Morehead City District Wilmington District
Fax: [phone] I5 I-B Hwy. 24 127 Cardinal Drive Ext.
Hestron Plaza II Wilmington, NC 28405-3845
Morehead City, NC 28557 910-395-3900
202-808-2808 Fax: [phone]
Fax: [phone] (Serves: Brunswick, New Hanover,
(Serves:Carteret,Craven,Onslow-above Onslow-below New River Inlet-and
New River Inlet-and Pamlico Counties) Pender Counties)
www.nccoastalmanagement.net Revised 10/05/01

GENERAL PERMIT COMPUTER FORM
APPLICANT NAME: Cat ti� S ��P L< < (�
ADDITIONAL NAMES:
AEC DESIG:67-4-) / ' DEVELOP AREA: O 2- PROJ DESC: P -/2-
(Will only take 6) (Will only take 1)
WORK: l�r� S / )
(Will only take 4)
(0/ ZU i E /22 l Z
MAINT:
(Will only take 4)
IMP: ( )
(will only take 6)
ACTION EXPIRATION
DREDGE&FILL REQUIRED: 5/27 fay $ ! 27 t o+
CAMA MAJOR DEVEL REQUIRED: 5/27 J O y S '27/ott

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MAY 2 ' 2004 -
DIVISION OF
COASTAL MANAGEMENT - -

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DIVISION OF COASTAL MANAGEMENT
• ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Individual Applying For Permit: (5 a t less E. V eci k G
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Address of Property: qMO Ptkcui,d— -Dr.(vt_ kp l ipta
Lot or Street#, Stre
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and County)1.% tu.rist Bc-tc,k C b Li _ (i t y
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n\S \ 12��1iI hereby certifyttiat jn property adjacent to the above-referenced_property. The individual
• �Qapplying for this permit has described to me as shown on the attached drawing the development they
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are proposing. A description or drawing,with dimensions, should be provided with this letter.
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I have no objections to this proposal.
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If you have objections to what is being proposed, please write the Division of Coastal
Management, 127 Cardinal Drive Extension, Wilmington, NC 28405 or call 910-395-3900
within 10 days of receipt of this notice. No response is considered the same as no objection if
you have been notified by Certified Mail.
WAIVER SECTION
1 I understand that a pier, dock, mooring pilings, breakwater, boat house or boat lift must be
set bck 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.)
jI do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
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1 Name /
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Date.
0-g,/V�" 013 /S dN
Pnnt Name it?'
7 7� 3 - s o NCDENR
Telephone Number with Area Code
S:\camalshellslriparianproperty.frm

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DIVISION OF COASTAL MANAGEMENT
• ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Individual Applying For Permit: (Thar S k. V ea C h
Address of Property: CIAO -Peak Wood Dri 5411sei ci N C. Irur c;ck et5uoty
(Lot or Street#, Street or Road)
` YASe Bee,cik_ — rUhSW Q1 wki
(City and County)
I hereby certify that I own property adjacent to the above-referenced_property. The individual
applying for this permit has described to me as shown on the attached drawing the development they
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 Coastal
Management, 127 Cardinal Drive Extension, Wilmington, NC 28405 or call 910-395-3900
• within 10 days of receipt of this notice. 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 bck a minimum distance of 15' from my area of riparian access-unless waived by me. (If
you ' h t 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.
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Print Nam CA
Cio _ 6 _ D ECETV}4DENR.
Telephone Number with Area Code MAY 2 4 20G4 1 AND
S:\cama\shells\riparianproperty.frm
OF
COASTAL DIVISION
MANAGEMENT

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SENDER: COMPLETE THIS SECTION • COMPLETE THIS SECTION ON DELIVERY
E■ Co▪mplete`i ems i 2 and 3 Also complete t A Signature , 6r I
item 4rf Restricted Delivery�is desired X J/ 0 Agent F
? ■ Printayour name and.address on the reverse G4 Addressee
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SENDER: COMPLETE THIS SECTION COMPLETE TFliS SEC i ION ON DELIVERY
■▪Complete ittems i 2,.and 3 Also complete A Sig ® rl i
, item 4 rf Restricted Delivery is;desired X� ® r Agent ,
■ Print your name and address on the reverse 3 J ■ Addressee
so that we can return'the Card to you g eceive,by(Printed Name) C at Delivery I
■{Attach this:card to the backof the mailpiece t L0
or ,on the fro_nt rf space permits - �
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