Friend, Steve 76374C

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AMA / ❑ DREDGE & FILL l0, / 63 14 q g C D
NERAL PERMIT Previous permit #
I'1ew ❑Modification ❑Complete Reissue [-]Partial Reissue Date previous perm/it issued I ."
As authorized by the State of North Carolina, Department of Environmental Quality �/� l f 6
and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC [ l
S-� f:;-
`"dccu1e attached.
Applicant Name C � (eProject Location: County
Address (0 C/C70'L L--
City OG State/'I IP
Phone # 0 f 3 J zJ - ail
Authorized Agent &-4 /'�-�/
�V ram' �
Affected 1 'z" " PTA ❑ ES ❑ PTS
❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A
ORW: ( yes # no PNA yes// no
Street Address/ State
7Road/ Lot(#(s)
Subdivision
City ZIP
Phone # ( ) Riv�Basin z
Adj. Wtr. Body` t man unkn
Closest Maj. Wtr. Body L` o', —"
I
01
■■■■ ■■■■■i■■ �■.111■■►1■■■■■■■■■■■■IL/�1■
.■■■■■■■■■■�[!�M■Jii�iit■■■■■■■■■■■■!�=0
Finger pie• , �l f■■■■■■■■■■■■!■■■■M■!■■■■■■■■■■■■■■■
Groin length■■■■■■■■■■■■■/�!lI�R!lrial ILA■■■■■■■■■■■■■■■■
er
rap
■■■■■■■■ ■■■�■■ '�E7 ❑■■■■■■■■■■■
. ... ■■■■■■■■■■■■■■■■ ■ ■■■ 7■■■®■■■®■■
.. ■■■®■■■®■■■■■■■■ it ■ ■■■ ti■■■■■■■ME IMMIMEME
■■■
Basin, channel wLV-5rA—�01N
cubic yards /
Boat ramp
Boathouse Boatlift
Beach Bulldozing
Other
Shoreline Length / ilk II I I! "
SAV: not sure yes no .-- --«-- ---
- - _-
j_
Moratorium: n/a yes n
Photos: yes n (_
Waiver Attached: yes no lM l
A building permit may be required by: �� 1/" ❑ See note on back re arding River Basin rules.
( Note Local Planning Jurisdiction)
Notes/ Special Conditions
Agent or Applicant Printed
re . "Please read compliance statement on back of permit"
pplication Fee(s) Check #

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 ❑ 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
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 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)
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 Pender Counties)
http://portal.ncdenr.org/web/cm/dcm-home
Revised 7/06/ 17

AGENT AUTHORIZATION FOR CA VIA PERMIT APPLICATION
Name of Property Owner Requesting Permit: v/_=
Mailing Address: (4 C 4AADFIj --
Phone Number: -3 0 { 57
Email Address: �' "� ' ` ' �lud 6t r ��
I certify that I have authorized-��—
Agent i Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessa for the following propose development:
at my property located at�'��
in ounty.
l furthermore certify that 1 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:
_ i1_Z6�A_1e_—
Signatul-e
Fr-1
Print or Type Name
Title
-2/ 1 1 y l Z, 0
Date
I-ZV-r, 6. Frr��
This certification is valid through _' 1 r 1 C -2,C)

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
°{ hereby certify that I own property adjacent to f Pro arty Owner}
property located at j D ! e t" o p
(Address. Lot _Block. Road, etc.)
on
9DCuE Sczt�., ,n - � .—>> 15 4— N
(Waterbody) (City/Town and/or County)
The applicant has described to me. as shown below the development proposed at the above
location.
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)
C 5-e-,f- C-� d14,)
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.,',
r ^_ I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement
(Property Owner information) (Adjacent Property Owner information,
S: ,c
Print or T e Na„^je Print �Z�,7yree N2A7 l�C
g ^✓]ailing Adoress
11in dre s
City'sta elzio
Cityistate/Z/p f G Ct),04
Oss
Teleono7e Number: email adarsss AJ i e,'ep cn-- 1i{:'?l�e' 'rryui; 2. r
��� _ � _ ..— _ �cb .•_ate ------- -- ---- --
[Inc
D��tt;K
'Valid `or one calendar year after sianat:re'

s Complete items 1, 2, and 3.
■ Print your name and address on the reverse
so that we can return the card to you.
■ Attach this card to the back of the mailpiece,
or on the front if space permits.
1. Article Addressed to:
"(z - S &I,,y PA-"-*7 K
3ooa7
IIIlIIIlI 1!{! I!I{III{II{II II II II II IIII II I II lil
9590 9401 0190 5234 4302 80
2. Article Number (transfer from service label)
18 0040 0001 0845 8471
PS Form 3811, July 2015 PSN 7530-02-000-9053
USpg_TRAQMG l
9590 9401 0190 5234 4302 80
A. Signature .
C. Date of Delivery
D. Is delivery address different from item 1? ❑ Yes
If YES, enter delivery address below: iJ,44—
3. Service Type
C Priority Mail Express©
C Adult Signature
Signature Restricted Delivery
Registered Mail"
_ Registered Mail Restricted
eultrtified Mail@>
'C "Certified Mail Restricted Delivery
Del very
Return Receipt for
Merchandise
C Collect on Delivery
C Collect on Delivery Restricted Delivery
E: Signature Confirmation"'
r : Signature Confirmation
Insured Mail
:i Insured Mail Restricted Delivery
Restricted Delivery
lover SSW)
Domestic Return rtecelp,
First -Class Mail
Postage & Fees Paid
USPS
Permit No. G-10
United States ° Sender: Please print your name. address. and ZIP+4'in this box*
Postal Service 57�4p Zc--1,) t J E AA1+1Z J Al E.
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