Nelson, Pendon 80495C

®YCAMA / ❑ DREDGE & FILL N9 80495 A B /C /D
ENERAL PERMIT Previous permit# 6
lrlllNew DModification [-]Complete Reissue ❑Partial Reissue Date pre 'o s permit issued
As authoriAd by the State of North Carolina, Department of Environmental Quality
and the Coastal Reso ces Commission in an are o end nmental concern pursuant to I SA NCAC
ules a ched.
Applicant Name Project Location: County
Address /i Street Addres(p( State Rom Lot #(s)
City
Phone #qJ7
Authorized Agent
Affected ❑ cW
AEC(s): ❑OEA
❑EW ❑PTA ❑ES ❑PTS
❑HHF ❑IH ❑UBA El N/A
ORW: hs'/ no PNA yes
Type of Project/ Activity
Pier (dock) length ko AL U
Fixed Platform(s) U
Floating Platform(s)
Finger piers) �—
Groin length
number L/
Bulkhead/ Poprap length
avg distance offshore, _i
max distance offshore �•—
Basin, channel
Boat ramp
Boathouse/ Boadift
•—�`—�' I
Beach Bulldozing'
Other NO
Shoreline Length to,
SAV: notsure yesMoratorium: n/a yesPhotos: yesWaiver Attached: yes
A building permit may be required by:
( Note Local Planning jurisdiction) .�
1494es/ Special epnditions _IL_/I J►
Agetn or Applicant rnntea rrartte
urre !r a read compliance statement on b k f er **
-%pppl C, anon Fee(s) C eck#
Phone # UV4)
Adj. Wtr. Body,
Closest Mal. Wtr.
Permit
Q j
ZIP
/ I
(Scale:
J1
❑ See note on bask regarding River Basin rules.
Date

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 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, 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 ❑
❑ 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
400 Commerce Ave
Morehead City, NC 28557
252-808-2808/ 1-888ARCOAST
Fax: [phone]
(Serves: Carteret, Craven, Onslow, -
North of New River Inlet- and Pamlico
Counties)
Elizabeth Citv 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)
Washington District
943 Washington Square Mall
Washington, NC 27889
252-946-6481
Fax: [phone]
(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 Pander Counties)
httP:HPortal.ncdenr.org/web/cm/dcm-home
Revised 7/06/17

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit �•� '
Mailing Address: I/% 1eJ; "'A nrlE
Phone Number: 2q1. 1533 ov 0 f;
Email Address: I
I certify that I have authorized o(— )y1,)1h1,U c
Agent / Contractor 6C Ali -IV � en 6
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: >Lt I n cn cF Y/J-/�A; F
�Ii �iDrtTEh tic A��
at my property located at i Y Jt"A "nZrYcE zRTIe , 2LL
in 0 U -WeT County.
I 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:
Signature
Print or Type Name
Title
G 5 I�_I
Date
This certification is valid through 31 I ire I 20 �-I

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to Rendon and Stacy Nelson's
(Name of Property Owner)
property located at 125 Sea Trace Lane Newport North Carolina 28570
on Boque Sound in Newport (Carteret County)_, N.C.
(Waterbody)
(City/Town and/or County)
The applicant has described to me, as shown below, the development proposed at the above
loci
I have no objection to this proposal.
I have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(Individual proposing development must fill In description below or attach a site drawing)
The existing, dilapidated dock and roof structure will be completely removed and a new, similar
dock including new mooring pilings and concrete slats (i.e., "Hog slats") will be rebuilt, extending
-88 feet (or the length of the furthest existing piling). Due to existing trees and si' rubs along the
shore line, the new dock may be shifted west; however, in no event will the new dock encroach
on the 15' property setback of either adjacent property. A new roof (--10x20) will also be built, in
the same general location as the existing roof structure, with a sunbathing platform on the
sound side (beyond the roof).
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.)
1 do wish to waive the 15' setback requirement.
1 do not wish to waive the 15' setback requirement.
(Property Owner Information)
5'i,�nnture
Rendon & Stacy Nelson
Print or Type Name
125 Sea Trace Lane
Mailing Address
NewDort.NC 28570
City/State2ip
919-291-1533 or 919-618-4721
Telephone Number
File
(Adjacent Property Owner Information)
na! rre
J-0 5 cPrq W
Print or Type Name
Malling'ddress
/J/ -ZeAn.0 i 44f
City/State/Zip -
f/ P- 2-2
Telephone Number
Daly
(Revised 611812012)

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to Rendon and Stacy Nelson's
(Name of Property Owner)
property located at 125 Sea Trace Lane Newport North Carolina 28570
on Booue Sound in Newport (Carteret County)_, N.C.
(Waterbody) (Cityrrown and/or County)
The applicant has described to me, as shown below, the development proposed at the above
location.
L-" I have no objection to this proposal.
I have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(Individual proposing development must fill in description below or attach a site drawing)
The existing, dilapidated dock and roof structure will be completely removed and a new, similar
dock including new mooring pilings and concrete slats (i.e., "Hog slats') will be rebuilt, extending
-88 feet (or the length of the furthest existing piling). Due to existing trees and shrubs along the
shore line, the new dock may be shifted west; however, in no event will the new dock encroach
on the 15' property setback of either adjacent property. A new roof (--10x20) will also be built, in
the same general location as the existing roof structure, with a sunbathing platform on the
sound side (beyond the roof).
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.)
�l do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(Property Owner Info ation)
Signature
Rendon & Stacy Nelson
Print or Type Name
125 Sea Trace Lane
Mailing Address
Newport NC 28570
City/State/Zip
919-291-1533 or 919-618-4721
Telephone Number
_L57UL-L-(
Date
(Adjacent Property Owner Information)
6tw ( /
Signature
S, L>a.f.."
Print or Type Name
to Jca ir._� 6—
Mailing Address
A/cuFo•k A&- Zg57"
City/State2ip
910- 252. 357'10
Telephone Number
Date
(Revised 611812012)

10
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