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® CAMA / DREDGE & FILL •NC,' 319131 p
GENERAL PERMIT Previous permit #
) % New -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 /7 41 I2( .
❑Rules attached.
Applicant Name M •j- r D it t r Project Location: County j(-u/1 SW i C 1--
Address P d 8 U $ 86`( _ Street Address/State Road/ Lot#(s) 4.07 /.L
A)City ) L Ts 1 H+ CJ^C) State nJ ZIP r,611 S ,5-Gi1 c,)cl tt, , -f-rU•P'fi"
Phone#( ) Fax#( ) - _ Subdivision
Authorized Agent G-t-r� pr.J/A t City CA L TS 1,4-nd ZIP
CW W XPTA ❑ES C PTS Phone # ( ) River Basin F--U rn 6
Affected OEA ❑HHF ❑IH ❑UBA C N/A
AEC(s): Adj.Wtr. Body Lnai3 (,.r07" �.,�'�
1ri' I (nat A _'J/unkn)
PWS: ❑FC: '
eV
ORW: yes / PNA yes / no Crit.Hab. yes / no Closest Maj.Wtr. Body R�btl
Type of Project/Activity M we., F Jo/3 4 I^ f ci oc I-- tr.) o+i. r 6t Gt re Cl cx .
(Scale: No T 'T6, )
Pier(dock)length a
Platform(s) J0? ' A. i 4 1 I _---_ I
Finger pier(s) I x 1 2' 11 o A /
j pcu 15 d ,r1 eN 1
Groin length
number —_ i • i__- I
Bulkhead/Riprap length
avg distance offshore
max distance offshore
Basin,channel - — i -- ------ -r— t__ __T I
cubic yards —
Boat ramp - 1
Boathouse/Boatlift A '
Beach Bulldozing ,, ,Til -
Other
Y
Shoreline Length
a
SAV: not sure yes no __ _ --- ---_ _. _ -
,Sandbags: not sure yes { ` - ( ( l� [13u I� -(1dFd {
Moratorium: n/a yes 0n
!
Photos: yes na :. i . '' -.,o r n I', h; . ___.) j
Waiver Attached: (yes no - I i -
A building permit may be required by: t,i), #•- f ..5 I 6'71 ci . I i See note on back regarding River Basin rules.
� " ��
Notes/Special Conditions 7. -ki +ut C C1.^ re S i✓11 i`,i nU Tll r �Lr -<-r_� J/4 (A)i (T11h of'
,,-.-, ;�6:-A 1 Nip IN\Q_Es__) fire a. `..-3(. -I s r-,� `.. rv-,rx,r ,.(i
3 L1.r L\A f C__/
(-1 r f ,% f rP�A a- l-� Y� ,,d•9---
Agent or Applicant Printed Name Permit Officer's Signature
' Io- C-. -Q2 .)-G - ; -k,
Signature **Please read compliance statement on back of permit** Issuing Date Expiration Date
Application Fee(s) Check# 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 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:
I 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(252-946-648 I)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 252-946-6481
Location: Fax: [phone] Fax: [phone]
(Serves:Camden,Chowan,Currituck, (Serves: Beaufort, Bertie, Hertford, Hyde,
Parker Lincoln Building
2728 Capital Blvd. Dare,Gates, Pasquotank and Perquimans Tyrrell and Washington Counties)
Counties)
Raleigh, NC 27604
733 2293 / 1 888 4RCOAST Morehead City District Wilmington District
Fax: [phone] 15 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)
Revised 10/C

GENERAL PERMIT COMPUTER FORM
APPLICANT NAME: In \ l n errr
ADDITIONAL NAMES:
AEC DESIG: p T E1,0 DEVELOP AREA: ,0 1 PROJ DESC: P - I2
(Will only take 6) — (Will only take 1)
WORK: El- 2� (D I [�
(Will only take 4) M OJe 1 (o ev`T --
T� Ce-r
MAINT: OP Pt X'ed CIO Cr---
(Will only take 4)
IMP: Q A) ']2.
(will only take 6)
ACTION EXPIRATION
DREDGE&FILL REQUIRED: 1 2 -to -h 2 _ 3 -(o -O 3 ' .
CAMA MAJOR DEVEL REQUIRED: I.2-- to-O 2_ •

•
Dfl1Sifl\(1F ro.
cTA�.MANA�*T
An4Af'FAT RiP&RiAN PROPERTY O NFR NOT TWATiON/WATVFR FARM
Name Of Individual Applying For Permit: / 11
L.�G� O✓/'T r
Address Of Property: /l2 •5'GI/, .? V t 4
•
(Lot or Street I, Street or Road,City&County)
I hereby certify that I own property adjacent to the above-referenced property. The individual
applying for this permit has described tobie as shown on the attached drawing the development
they are proposing. A description or drawing, with dimensions, should be provided wwith this
letter.
I have no objections to this proposal.
if yn avr nhiersinnc to altar ie hero ..i
n—itt, .►L Ttyxtnn n,--��,t Man zaetnent 127 Nnrth C'�rrimal i>rnre Rtilmmvtnn Nnrth[`ar..i:..a
39Q0 within 10 d9vs of T i i.r of this i n r Nn n .is m =a
if you have been notified by('nrn{rci Mail
•
WAIVER sErruvN
I understand the a pier,dock,mooring pilings;breakwater,boat house,lift
or set back a minimum distance of 15'from myarea of ' sandbags must youbu
wish to waive the �°access unless waived by me. (If
setback, you mast initial the appropriate blank below.)
I do wish to waive the 15'setback requirement
I do_nmt wish to waive the 15' setback requirement.
A19°191PrA
Sig e Da
Print Nam NCDENR
Telephone Number with Area Code NORrht toosouxt Do nie:off or
Esovicrunorr.no Nam.Returnees

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SHORELINE MARINE CONSTRUCTION 67-7235/2532. 1 9 3 9 r ..• ; GREG PREVATTE 3zss000e72 _
i i P.O. BOX / C/ C Z i,
SOUTHPORT, NCC 28461 DATE / G
PAY TO THE /1� /1 I Za• 3 Op O :. L
K ORDER OF T !I/ _�J
g7'I4 rc e_ 1QV✓�- /€ -e IGL / ,5 DOLLARS e Y.e. ..
COASTAL FEDERAL BANK -
SOUTHPORT,NC 28461
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