McDonald, James 80432C

AMA / ❑ DREDGE & FILL
NO 80432
NERAL PERMIT
A
Previous permit#
B
ew ❑Modification ❑Complete Reissue
El Partial Reissue
Date pre ious permit issued
As authon ed by the State of North Carolina, Department of Environmental Quality
and the Coastal Resources Commission in an ar a of environmental
concern pursu
n to 15A NCAC
—
ules ached.
Applicant Nam
roject Location: County
Address
Street Addr s/ State oad/ Lot #(
City Slate ZIP
Phone # b� E-Mail ��
Subdivision
Authorized Agent
City
ZIP
Affected ❑ Cw w tPTA ❑ ES ❑ PTS
Phone # ) River Basin
AEC(s): ❑ OEA HHF ❑ UBA ❑ N/A
Adj. Wtr. Body
na an unkn
❑ PWS:
ORW: no PNA yes /
CCe')
Closest Maj. Wtr. Body
Type of Project/ Activity
(Scale:
)
�
Pier (dock) length `� !'
_
Fixed Platform(s) '
--
i
Floating Platform{s� -'-"
l
Finger pier(sy- ,.--•
---
'-
- ---
-
-
--
-
I -
- -
Groin length
number
- --
-
i1
-
.....
.
- --
-
-
-
--
Bulkhead/ Riprap length
s._-_-_._.-._
--
-
-
i
- - --
- -
- -
-
f
- --'-
avg distance offshore
_.......
._... _.... --L
- —
max distance offshore
Basin, channel
- --
cubic yards -
Boat ramp
!
! I I
Boathouse/ o tlift (N
,
i
-
"-
-_-_...._. - --
-
. ........ . .
1 i
-- -
--- -
---
-
1
-- - -
- -
--
-
--
Beach Bulldozing
:
:
Other
Shoreline Length
;
i
SAV: not sure yes o
! - --
.
- r
;
;
Moratorium: n/a yes no
I
�..-
-.
l
-
- .. ; .
-
PN
Photos: yes n
r
,
Waiver Attached: yes o
A building permit may be required by:
❑ See no a on back regarding River Basin rules. ,
( Note Local Planning jurisdiction).
Notes/ Special
U-Zd�&
Conditions
to - --Fi
1
i
Agen or Applicant Printed Wine Pern
Signa re *_�* aseread compliance statement onbackof ermit ign
�p?plic;tionFee(s) Check# Issui
Expiration

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, certifythat 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 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 howto complywith 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/ 1-888-41RCOAST
252-946-6481
Fax: [phone]
Fax: [phone]
(Serves: Carteret, Craven, Onslow -
(Serves: Beaufort, Bertie, Hertford, Hyde,
North of New River Inlet- and Pamlico
Tyrrell and Washington Counties)
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)
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: wi _C , oyia ( %f / Tics & qc.MG O"Ct I
Mailing Address: 14 �3 6,rc.�i e ("C-c-
Iyewpor+ , 111C. �Y57U
Phone Number: `7,2 3 - 2 S .3
Email Address: P i� mai
I certify that I have authorized Day;'a micas w e u
Agent / Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: , ; n s F-a a i� e� �� f
Ck boa-i li- -+
at my property located at 143 A rCk (' C- P I a.0 C N e cA-� t2y r_ t , )QC- 23.5 `7,0
in Cox} e_v­et County.
1 furthermore certify that / 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:
Signature
C ')Oki Gk 1 U(
Print or Type Name
owkrr
Title
(1 -2�9 / ZOz (
Date
This certification is valid through l l�

CERTIFIED MAIL RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT -RIPARIAN PROPERTY OWNER-NOTIFICATION/WAIVER FORM
Name of Property Owner: _..., s
Address of Property: "-t f2 rt V'C-n r e r 1 L �•
(Lot or Street #, Street or Road, City &
Agent's Name #:
Agent's phone #:
Mailing Address:
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
42i" N Ti : -_. N INA1- IN&M
theyare proposing. srK .aorclra.-th. 'one
✓ I bane no objections to this proposal. I brie objections to this proposal.
If you ha ve-objections to what is being proposed, you m ust notifythe Divislon of Coastal Management
(DCM) in writing within 10 days of receipt of this notice, Correspondence should be mailed to 400
Commerce Ave., Morehead City, NC, 28557. D'CM representatives can also be contacted at(252) 808-
2808, No response is considered the same as no ob ectfon if Z.ouhaviq been notified b Certified Mail,
— -.—. - ------ --------------------WAIVER SECTION-
I understand that a pier, dock, mooring pilings, 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 reCtuirement.
I do not wish to waive the 15' setback requirement.
(Property Owner information) (Adjacent Property Owner Information)
�i' ature r Signature,
Print or Type Name print or Type Name
Mailing Address
New t -_a15_7_Q
City/Sta 1zip
-a ?-- -a-o - 0-a4
Telephone Number
Date
_a 305 WestF aCo�r,-RCZ, an rf 3057
Mailing address
City/State2ip
c96'o2 -- �30--
Telephone Number
Daft
Revised 6/18/2012

CERTIFIED MAIL • RETURN RECEIPT REQt1ESTED
DIVISION OF COASTAL MANAGEMENT
- - ADJACENT- RIPARIAN PROPERTY OWN8R-NOTIFIGATIONNVAIVER-FORM
Name of Property Owner: r_-x0 -�
Address of Property: _ q3 h c l Str�e'etorRoa�rihl�un�y�
(Lot or Street #,
Agent's Name* Mailing Address:
Agent's phone #:
I hereby certify that l own property adjacent to the above referenced property. The individual
applying for this permit has described to m11,1We as shown- on the attache awing the develo ment
they are proposing.
I ire s Q `l'sier� � ,.h � e
��I have no objections to this proposal. I ha.�ie objections to this proposal..
if you ha ve-objections to what is being proposed, you must notify0e Division of CoasW Managem ent
(DCM) in writing within 10 days of receipt of this notice, Correspondence should be mailed to 400
Commerce Ave., Morehead City, NC, 28557. DCM representatives can also be contacted at(I 808-
2808. No response is considered the same as no objection if .ouhave been notified b Gerfified Mail -- _ ----- ...---___-----------.--------WAIVER SECTION
I understand that a pier, dock, mooring pilings, 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.
(Property Owner Information)
------
Signature _
.J0.�nMC6 -B6ym /�'1CD0K16d0(=
Print or Type Name
I L4 3
Mailing Address
N�wleor--f-, Nc 256 70
city/statezip
,Psa-aaa- 0'56a 0
Telephone Number
41 23-z02-r
Date
(Adjacent Property Owner Information)
�(
Signature ,P r
��P�_1`�nu�Gt'sOn �Hcr� J
Print or-ype Name
.3 S8 -Oro ad Cr'ee �0�0 A ci .
Mailing ,address
/ orf Al 29970
city/staf Zip
Telephone Number
Date
Revised 6t18/2012

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