Carteret Co. 78314C

®.�LCAMA / ❑ DREDGE & FILL N9
78314 A B c D
GENERAL PERMIT Previous permit#
I211ew ❑Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environmental Quality �'% IJ�U
and the Coastal Resources Commission in an area of environmental concern pursuant to I SA NCAC f /
t ❑R'f les attached.
Applicant Name ��'✓ I �/ / Project Location: County/�
Address ''/ I ny % l /' Street Address/ State RRo`ad/ %ot #(s)
City 77 State NC ZIP % J (PCs el —
Phone # (' ) s� �' ,Gf• S E-Mail Subdivision
Authorized Agent
❑ GW
MEW .�fyi TA
DES ❑ PTS
Affected
A
Affecte
❑ OEA
❑ HHF ❑ IH
❑ UBA ❑ N/A
PWS::
ORW:
�--❑i
yes/ / jj/y�
PNA ( yes
Type of�Prrojecct/ Activity
J XJ
Pier (dock)length
Fixed Platform(,)
IaatingPIatform(s)
Finger pier(s)
Groin length
number
Bulkhead/ Itiprap length
avg distance offshore
max distance offshore
Basin, channel
cubic yards
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing
Other
Shoreline Length
SAV: not sure
yes o
Moratorium: n/a
yes
Photos: yes V
Waiver Attached: es no
A building permit may be required by:
( Note Local Planning jurisdiction)
Notes/ Special Conditions
el
Agent or Appli an Printed Name ^ _�
(I A
Si r • le" ereadcomplia cestatem tonbackofArmits'*
y�
lr lication Feels Check#
16,
City ZIP) %(
Phone # O River Basin—
Adj. Wtr. Body
Closest Maj. Wtr. Body
(Scale: /,,/ 1)
...
❑ See note on back regarding River Basin rules.
Permit Officers Printed Name
Signatu e
Issuin Date Expiration ate

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 isinspected 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, certifythatthis 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 Resources. Contact the Division of Water Resources 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
Morehead City Headquarters Washington District
400 Commerce Ave 943 Washington Square Mall
Morehead City, NC 28557 Washington, NC 27889
252-808-2808/1-888ARCOAST 252-946-6481
Fax: [phone] Fax: [phone]
(Serves: Carteret, Craven, Onslow -
North of New fiver Inlet- and Pamlico
Counties)
Elizabeth City District
401 S. Griffin St.
Ste. 300
Elizabeth City, NC 27909
252-264-3901
Fax:[phone]
(Serves: Camden, Chowan, Currituck,
Dare, Gates, Pasquotank and Perquimans
Counties)
(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 - South of New River Inlet -
and Pender Counties)
http://portal.ncdenr.org/web/cm/dcm-home
Revised 7/06/ 17

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: / ti
Mailing Address:
Phone Number:
Email Address: , t< rt�tit i �(�cti�C�vn�u aC `c��✓
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: t . (<f ,ESzi
at my property located at .2 ;
in County.
l 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 Owner Information:
Title
/ I 05 l .Oz
Date
This certification is valid through I /

I hereby certify that i own property adjacent to
property located at ZL u �S a 1- 6
on
in
N.C.
The applicant has described to me, as shown below, the development proposed at the above
location
i, I have no objection to this proposal.
I have objections to this proposal
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMEfiJT
(individual proposing devolopment must fiif in description below or attach a -site drawing)
Q� of \ I
�t�3
�-- l Gxts};�13�.IEhu�J
WAIVER SECTION
I understand that a pier, dock, mooring pilings; be - p, breakwater, boathouse, lift, or groin
must be set back a minimum distance of 1 ' r a of riparian access unless waived by
me. (if you wish to waive the setback, y=sequirement.
appropriate blank below.)
)C_
�/ , � I do wish to waive the 15'
I do not wish to waive the 15' setback requirement.
Print or Type Nam
U-0Cr L-' ICnJ l�
Mailing qri�- ss JI fJ 1V C'
Citylstatelzip l D.5� F �I.LIT"
Telephone Number email address Date
(Revised Aug, 2014)
"Valid for one calendar year after signature*

ADJACENT f e8WAN PROPERTY OWNERSTATEMENT
i hereby certify that I own property adjacent to Carteret County/Harbor of Refuge ,s
oY
property located at 2726 Cedar Island Road Ceda((teP tsafanad N(property Owner)
(Address, Lot,
on Core. Sounc in
(Waterbody)
N,C.
The applicant has descrlbed to me, as_shown,below,,the, ¢evelppment proposed at..the above,_... _
location.
1 Z I have no objection to this proposal.
I have objections to this proposal.
DESCRIPTION ANDIOR DRAWING OF PROPOSED DEVELOPMENT
(individual proposing development must Pill in description below or attach a site drawing)
}� II'
of �
.�y
WAIVER SECTION
I understand that a pier, dock, mooring pilings, boat ramp, 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.
I do not wish to waive the 15' setback requirement.
(Revised Aug. 2014)
*Valid for one calendar year after signature*