Hinson, Mark 88512C

o�oiCOM J EICAMA ❑ DREDGE & FILL N 0. 8851.2 A B C D
Previous permit
y§F-]
GENERAL PERMIT
Date previous permit issued
New ❑ Modification [-]Complete Reissue ❑ Partial Reissue
As authorized by the State of North Carolina, Department of Environmental Quality and the Coastal Resources Commission in an area of environmental concern pursuant to:
15A NCAC ❑ Rules attached. ❑ General Permit Rules available at the following link: www.deq.nc.gov/CAMArules
Applicant Name
Address
City State
Phone # ( )
Email
ZIP
Authorized Agent I i
Project Location (County):
Street Address/State Road/Lot #(s)'� / r
Subdivision
City
Affected ❑ CW ❑ EW ❑ PTA ❑ ES ❑ PTS Adj. Wtr. Body
AEC(s): ❑ OEA ❑ IHA ❑ UW ❑ SPIMA ❑ PWS Closest Maj. Wtr. Body
ORW: yes/no PNA: yes/no
Type of Project/ Activity
Shoreline Length _ / p`
Access Length
Pier (dock) length
Fixed Platform(s) _
Floating Platform(!
Finger pier(s)
Total Platform arez
Groin length/# _
Bulkhead/ Riprap I
Avg distance offish(
Breakwater/Sill _
Max distance/ lend
Basin, channel
Cubic yards
Boat ramp
Boathouse/ Boatlii
Beach Bulldozing_
Other
SAV observed:
Moratorium: n/
Site Photos:
Riparian Waiver At
A building permit/
Permit Conditions
(nat/man/unk)
(ScalgA q,
❑ See note on back regarding River Basin rules
❑ See additional notes/conditions on back
I AM AWARE OF STATUTES, CRC RULES AND CONDITIONS THAT APPLY TO THIS PROJECT AND REVIEWED COMPLIANCE STATEMENT. (Please Initial)
Agent or Applicant PRINTED Name
Signature "Please read compliance statement on back of permit"
Permit Officer's PRINTED Name
Signature
Application Fee(s)
Check #/Money Order Issuing Date
Expiration Date

Statement of Compliance and Consistency
This permit is subject to compliance with this application and permit 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 from the adjacent riparian property owner(s)
has been obtained, or proof of delivery of certified mail notification of the adjacent riparian property owner(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:
F1Tar - Pamlico River Basin Buffer Rules 1-1 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. If you have any questions, please contact the Division of Water Resources at the
Washington Regional Office (252-946-6481) or the Wilmington Regional Office (910-796-7215).
Notes/Additional Permit Conditions:
Please ensure all debris associated with the removal or construction of the permitted development is contained within the authorized
project area and disposed of in an appropriate upland location.
Division of Coastal Management Offices
Morehead City Headquarters
400 Commerce Ave Morehead City, NC 28557
252-808-2808/ 1-888-4RCOAST Fax: [phone]
(Serves: Carteret, Craven — south of the Neuse River, Onslow
Counties)
Elizabeth City District
Washington District
943 Washington Square Mall Washington, NC 27889
252-946-6481
Fax: [phone]
(Serves: Beaufort, Craven — north of the Neuse River, Hyde, Pamlico,
Tyrrell and Washington Counties)
Wilmington District
401 S. Griffin St. Ste. 300 127 Cardinal Drive Ext. Wilmington, NC 28405-3845
Elizabeth City, NC 27909 910-796-7215
252-264-3901 Fax: [phone]
(Serves: Bertie, Camden, Chowan, Currituck, Dare, Gates, Hertford, (Serves: Brunswick, New Hanover and Pender Counties)
Pasquotank and Perquimans Counties)
http://portal.ncdenr.org/web/cm/dcm-home Revised 6/01/2021

y1+01COAS ❑CAMA ❑ DREDGE & FILL NO 88512 A B C D
f GENERAL PERMIT Previous permit
Date previous permit issued
❑ New ❑ Modification ❑ Complete Reissue ❑ Partial Reissue
As authorized by the State of North Carolina, Department of Environmental Quality and the Coastal Resources Commission in an area of environmental concern pursuant to:
15A NCAC ❑ Rules attached. ❑ General Permit Rules available at the following link: www.deq.nc.gov/CAMArules
Applicant Name _
Address
City
Phone # ( )
Email
State ZIP
Authorized Agent
Project Location (County):
Street Address/State Road/Lot #(s)
Subdivision
City
Affected ❑ CW ❑ EW ❑ PTA ❑ ES ❑ PTS Adj. Wtr. Body
AEC(s): ❑ OEA ❑ IHA ❑ UW ❑ SPIMA ❑ PWS Closest Maj. Wtr. Body
ORW: yes/no PNA: yes/no
Type of Project/ Activity
Shoreline Length.
Access Length _
Pier (dock) length
Fixed Platform(s) .
Floating Platform(s)
Finger pier(s)
Total Platform area
Groin length/#
Bulkhead/ Riprap length
Avg distance offshore
Breakwater/Sill
Max distance/ length
Basin, channel
Cubic yards
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing
Other
SAV observed: yes no
Moratorium: n/a yes no
Site Photos: yes no
Riparian Waiver Attached: yes no
A building permit/zoning permit may be required by:
Permit Conditions
P
(nat/man/unk)
(Scale: r )
❑ TAR/PAM/NEUSE/BUFFER (circle one)
❑ See note on back regarding River Basin rules
❑ See additional notes/conditions on back
I AM AWARE OF STATUTES, CRC RULES AND CONDITIONS THAT APPLY TO THIS PROJECT AND REVIEWED COMPLIANCE STATEMENT. (Please Initial)
Agent or Applicant PRINTED Name
Permit Officer's PRINTED Name
Signature "Please read compliance statement on back of permit"
Application Fee(s)
Signature
Check #/Money Order Issuing Date
Expiration Date

Statement of Compliance and Consistency
This permit is subject to compliance with this application and permit 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 from the adjacent riparian property owner(s)
has been obtained, or proof of delivery of certified mail notification of the adjacent riparian property owner(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:
1-1 Tar - Pamlico River Basin Buffer Rules 1-1 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. If you have any questions, please contact the Division of Water Resources at the
Washington Regional Office (252-946-6481) or the Wilmington Regional Office (910-796-7215).
Notes/Additional Permit Conditions:
Please ensure all debris associated with the removal or construction of the permitted development is contained within the authorized
project area and disposed of in an appropriate upland location.
Division of Coastal Management Offices
Morehead City Headquarters
400 Commerce Ave Morehead City, NC 28557
252-808-2808/ 1-888-4RCOAST Fax: [phone]
(Serves: Carteret, Craven — south of the Neuse River, Onslow
Counties)
Elizabeth City District
401 S. Griffin St. Ste. 300
Elizabeth City, NC 27909
252-264-3901
(Serves: Bertie, Camden, Chowan, Currituck, Dare, Gates, Hertford,
Pasquotank and Perquimans Counties)
Washington District
943 Washington Square Mall Washington, NC 27889
252-946-6481
Fax: [phone]
(Serves: Beaufort, Craven — north of the Neuse River, Hyde, Pamlico,
Tyrrell and Washington Counties)
Wilmington District
127 Cardinal Drive Ext. Wilmington, NC 28405-3845
910-796-7215
Fax: [phone]
(Serves: Brunswick, New Hanover and Pender Counties)
http://portal.ncdenr.org/web/cm/dcm-home Revised 6/01/2021

ANENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
r
Name of Property Owner Requesting Permit: °
Mailing Address: l /2 6�*,yUr
Phone Number;
Email Address: la bartvc-,e •
I certify that I have authorized f
Agent I Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: /AeV ,1( B oa-7 /�'�
at my property located at ®S" 2. 6"tS
in ac. County.
xle 1 jw,
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:
ignature
Z Ye2t'l
Print or Type Name
Owiue,e,
Title
1 20 1 407-0-
Date
This certification is valid through /2- 1 3 ( 18 o Z.-

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I hereby certiiv that 1 ov!tin nroperLy adiacen'i to
Mae. pro, rper-bf 4-dnqre�
property located at 04 Xd�
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i tie applicant has described to r ne, as shDkvn beloku .the development proposed at the ahokre
location.
I have no objection to this proposal_
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i .under stand that a pier, dock, mooring pilings, bre21K\jilater, boathouse, In-t, or groin must be set
back a minimum distance of 15' From my area of riparian access unless �iiTaived by me. (If you
\luish to waive the setback, you nmi zt�!���ea the appropriate blank belovii. )
I do wish to }rlieive the `i 5' setb2ck requirement.
I y?o A>>Tish to v�!ai�!e the 15' setb2clX requirement.
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Date Date
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I her ebv certifv th2t I ovYn oropery 2djacent to /044
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property located at
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1 he applica! ` ias described to me, as shown belovii, the development proposed at the above
I have no objection to this propoS21.
_ I have_obj�ctioos
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i underSMnd that a pier, dock mooring pilings, bre2lkwater, bo thouse, lief, or groin must be set
lack a minimum distance of 5' from my area of riparian acc s unless waived by me. (if you
wish to waive the setback, you mt s� niiflai� the appropriate blan , belovv. )
i do wish to waive the 15' setb2ci; requirement.
1 -do. v> fish to waive the 15' seth2cl� requirement.
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Print or' TV e -Vame Frri6i or e hfar�
iv7 ' ing ddress ivlailing Address
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Telephone Number Telephone iVumber
Date Date
RIevised 6113/?012)

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