30349D - Young

0 CAMA / DREDGE & FILL N? 3O349-L
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 I5A NCAC 1+-' , Iwo .
C:Rules attached.
Applicant Name .J QK,e-t-_, `, T Ov, f\C Project Location: County f(,& f\ t)f C 1-
Address a+9() t�i'\ ill"U ry '\ tt r,i Street Address/State Road/ Lot#(s) 1 L}-{L
City Ca•,h .C:1',v'1\\... State N( )zip aiei 'o•err VIr\ `Jtr—e
Phone # (_ 1(:) 4 449-TlYlU Fax#(3N,) 21C1— 1" .,5.__< Subdivision
Authorized Agent *dad V\\r‘5`� - City Tl O t CC!'.-n --,E- 1' ZIP
D CW DEW D PTA *ES PTS Phone # ( ) ‘Jr\C -r L.tal River Basin '_..0 tnb r-
Affected
❑OEA ❑HHF D IN D UBA N/A
AEC(s): Adj. Wtr. Body � �A (nat �fiian'/unkn)
❑ PWS: ❑FC: p=��,V_ 1 -
ORW: yes / no PNA yes /'no Crit. Nab. yes /110 Closest Maj.W[r. Body ` t
Type of Project/Activity !\� ,&) but K--L f�a 1l6 11.) A '1(1 !t)(` . f -fld 3
(Scale: tit c>T To )
Pier(dock)length
Platform(s)
Finger pier(s)
Groin length C
number r
' I
Bulkhead/Riprap length Z(> .
avg distance offshore 21
max distance offshore 2.1 .
Basin,channel — - — — — --. — ---_ _--
cubic yards
Boat ramp - .
Boathouse/Boatlift --__,_--
Beach Bulldozing _
Other
+ -}
a i
Shoreline Length ._r"U 4
SAV: not sure yes no
Sandbags: not sure yes no - r:
11~
Moratorium: n/a yes no : f
Photos: yes no) I VI` (.i cc_ a . v,:N 0 .- —
Waiver Attached: yes no ----- r L — _ -cl--
A building permit may be required by: Ode.- L)CAl C.4\ . n See note on back regarding River Basin rules.
Notes/Special Conditions &11` \-\E. 1`(\� LOA 11 [`c\o` - 4, be 1 t\--t^A t i ,-e-r�' N\r+-r' -• 1(A`--S
r'-\ i1`=-`'.> ----7.4\--Ark •I''''. '—c4r-o-' ,' °°
Agent or Applicant Printed Name Permit Officer's Signature
I
Signature **Please read compliance statement on back of permit** Issuing Date Expiration Date
`A' U' t -0 ogg �'_I l'NC,A"
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:
P1 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 252-946-6481
Location: Fax: [phone] Fax: [phone]
(Serves:Camden, Chowan, Currituck, (Serves: Beaufort, Bertie, Hertford, Hyde,
Parker Lincoln Building
Dare,Gates, Pasquotank and Perquimans Tyrrell and Washington Counties)
2728 Capital Blvd. Counties)
Raleigh, NC 27604
919-733-2293 / 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: 9 I 0-350-2004
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 10/05/01

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Locality Permit Number
GENERAL INFORMATION
• LAND OWNER
Name 44,1,11(frULL 61 4. (4• yznalt
A'dress9 QJLL(
City Z�)� °?�1n1�LjtL State l C Zip 1i 2 yet Phone33(0 '/ '- /),59O
AUTHORIZED AGENT
Name
Address ey`1 C I�iJ1 ��1 - eJA , .
City /1 (A4t �1Q State )4 e Zip i 4 cPhone 9/0`8'G/r'a ~2 S
LOCATION OF PROJECT (beach address) / /La Y 1(L,'4 v di-L
(If not oceanfront,is waterbody natural or manmade?) P)61._/yvYtL4tA •
• DESCRIPTION OF PROJECT - �./iij> YuAx 4- 1 i, )
ks
AREAS OF ENVIRONMENTAL CONCERN (AEC) CLASSIFICATION
(To be filled in by the Local Permit Officer prior to completing application.)
Ocean Hazard Estuarine Shoreline ORW Shoreline Other
PROPOSED USE
Residential Commercial/Industrial Other
SQUARE FOOTAGE OF BUILDING FOOTPRINT AND OTHER IMPERVIOUS OR
BUILT-UPON SURFACES (such as driveways, etc.) within 75 feet of the shoreline (575 feiet
of an ORW shoreline)
SQUARE FOOTAGE OF TOTAL FLOOR AREA OF BUILDING
SQUARE FOOTAGE OF SITE
OTHER PERMITS MAY BE REQUIRED: Zoning, Drinking Water Well, Septic Tank
(or other sanitary waste treatment system),
The activity you are planning may require Burning, Electrical, Plumbing, Heating and
permits other than the CAMA minor Air Conditioning, Insulation and Energy
development permit. As a service we have Conservation, F[A Certification, Sand Dune,
compiled a listing of the kipds of permits that Sediment Control, Subdivision Approval,
might be required. We suggest you check Mobile Home Park Approval, Highway
over the list with your LPO to determine if Connection, and others.
any of these apply to your project.

' y
S ATEMENT OF OWNERSHIP -
r-
I, e undersigned,an applicant for a CAMA minor development permit,begin either the owner of property in
a -area of environmental concern or a person authorized to act as an agent for purposes of applying for a z
C MA minor development permit,certify that the person listed as landowner on this application has a sig-
ni' ca)interest in the real property described therein. This interest can be described as follows: (check one)
an owner of record title,Title is vested in ,see Deed Book
page in the County Registry of Deeds.
an owner by virtue of inheritance. Applicant is an heir to the estate of
probate was in County.
if other interest,such as written contact or lease,explain below or use a separate sheet and attach to this
application.
r
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NI TIFICATION OF ADJACENT PROPERTY OWNERS
I f rthermore certify that the following persons are owners of properties adjoining this property. I affirm that I
ha e given ACTUAL NOTICE to each of them concerning my intent to develop this property and to apply for
a AMA permit.
(Name) (Address) I
(1) . < O A ' . Y�/,�.cn_nL. ��p " �3o c' • '. 0' /'n- a /l c �Y2�;
(2) ��. /ti 9 ?I/-/ D .ti
� C/2e0,12._ 4,A
(3)
(4):
Fa;R DEVELOPERS IN OCEAN HAZARD AND ESTUARINE HAZARD AREAS:
I a,t owledge that the land owner is aware that the proposed development is planned for an area which may
be .usceptible to erosion and/or flooding. I acknowledge that the local permit officer has explained to me the
pa icular hazard problems associated with this lot. This explanation was accompanied by recommendations
co.cerning stabilization and floodproofing techniques.
P -MISSION TO ENTER ON LAND
I f thermore certify that I am authorized to grant and do in fact grant permission to the local permit officer
an. his agents to enter on the aforementioned lands in connection with evaluating information related to this
pe 't application.
- application includes:general information (this form),a site drawing as described on the back of this ap-
pii ation,the ownership statement,the AEC hazard notice where necessary,a check for$50.00 made payable to
th-'Iocality,and any information as may be provided orally by the applicant. The details of the application as
de ribed by these,sources are incorporated without reference in any permit which may be issued. Deviation
fro these details will constitute a violation of any permit. Any person developing in an AEC without a per-
mi is subject to civil,criminal and administrative action.
. the /4 day of P1tUyi2i 3L/L_ asacut.
l/a:444-
1, g'eex4,4-
',Land owner or-pers authorized to act as his agent
for purposes of filing a CAMA permit application.

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2U:4? 11/1?/'02 PAGE 01
IAGEMENx
ADZACINT-.RIPARXAN PR,O�rpTY 9WWlR NO ON/WR1vZ11.. FORM
Name Of Individual Applying To:- Permit: 4:14L141„ iii0e.....
Address Of Property: 1
—
mil,
(Lot or Street e, Street or Roe , City & County)
I hereby certify ' that I own property adjacent to the above-
referenced property. The individual applying for this permit has
deacribed 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.
'- C:W I have no objections to this proposal .
- If ou have et r_r ctx to , a ' , b_ e n se the
anaaement l 7 CarJ1nel .�=iye_ tetsnjion..
V1.11riJ'atorl, -No= Cal'Q1j13LL ab441_0,r---call,_520 393.— Q1) withi4_12
o esPgnsC 1* cc
es rez ob1ect3�.if ys;u have bee ? ngtitl by Car;itye-d Ma_)
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!MVER cPcTIQN
1 understand that a pier, dock, mooring pilings, breakwater, boat
house, lift or sandbags rust be set back a minimum distance of 15,
from rty area of riparian access unless waived by me. (If you wish
to wave the setback, you must, initial the appropriate blank
below. )
I do wish to waive the lS'setba+ck requirement.
Ahs2W• , 1 ¢p not wish to waive the 15'setback requirement.
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