54125_BRANSON, SHILDA_20090601

16
CAMA / ❑ DREDGE & FILLLEI
GENERAL PERMIT evious permit #
[]New ❑Modification El Complete Reissue El Partial Reissue ,/l` Date previous permit issued
As authorized by the State of North Carolina, Department of Environment and Natural Resources.4
and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC
�I Rulec attarherl
Applicant Name .,�, t+a 1 � �0
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Address 1' j f �_ C' i_ 1 L a 7
City- j;r..-r<<, t Ott? State_1�ZIP'@t�
Phone # (`^.� 1) (��� - 11306 Fax # ()
Authorized Agent I �i 4 1 , t'
Affected ❑ CW O EW Z PTA ❑ ES ❑ PTS
AEC(s): ❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A
❑ PWS: ❑FC:
ORW: yes / no PNA yes no, Crit.Hab. yes / no
Project Location: County L'-- r<-'-
Street Address/ State Road/ Lot #(s)
Subdivision ` +x :,:
City `r,1^ ZIP Sri'
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Phone # River Basin,
Adj. Wtr. Body 1 S`,c-U? \' Gw�C1 Oat /man /unkn)
Closest Maj. Wtr. Body
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Agent or Applicant Printed Name
--
Signature Please read compliance statement on back of permit
Application Fee(s) Check #
Permit Officer's Si nature
Issuing Date . Ex i ion Date
Local Planningf urisdiction 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 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 Quality. Contact the Division of Water Quality at the Washington Regional Office (252-946-648 [)or the Wilmington
Regional Office (910-796-7215) for more information on how to comply with these buffer rules.
Division of Coastal Management Offices
Raleigh Office
Mailing Address:
1638 Mail Service Center
Raleigh, NC 27699-1638
Location:
2728 Capital Blvd.
Raleigh, NC 27604
919-733-2293
Fax: [phone]
Morehead City Headquarters
400 Commerce Ave
Morehead City, NC 28557
252-808-2808/ 1-888ARCOAST
Fax: [phone]
(Serves: Carteret, Craven, Onslow -above
New River Inlet- and Pamlico Counties)
Elizabeth City District
1367 U.S. 17 South
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 -below New River Inlet- and
Pender Counties)
Revised 08/09/06

MONITORING & COMPLE ION REPORT �
[LAMA Major Development & State Dredge & Fill Permits]
PERMITTEE'S NAME: ,�� 1� tcy�� uJ� PERMIT ##`� IZSC
LOCATION: lZ Cc��� M �, . ��` Cc�p , FIELD REP. IJ�
MONITORED BY
PHONE: Wk G o - q ;�CU DATE REPORTEDLY COMPLETE: '6 0I
DATE OF INSPECTION � ► 5 10S
1) Do the measured dimensions of the development differ from those indicated in the permit and workplat?
YES [circle one].
COMMENT:
A.
2) SEDIMENTATIO EROSION CONTROL: Has Permittee seeded, grassed, or otherwise stabilized all
disturbed areas? /NO [circle one]
COMMENT:
3) FUTURE MOW ORING & ENFORCEMENT ACTION: Is further investigation or enforcement action
needed? YES/ [circle one].
COMMENT:

..q... •:�.� 9Sc U:3'�arxnr ^m-"�` `ay..._. #�. s.k e
ISLAND MARINE CONSTRUCTION LLC 2810
1286 ISLAND RD 66-21/530
eanNCH 77513
HARKERS ISLAND, NC 28531
PHONE: [phone]
[ DATE
PAY TO THE s
--------------
WACHOvia
Wachovia Bank, N.g. c wachovla. om , U l 12 5�
FOR 1 �` _ — �J l —
i:0 5 3000 2 L 91: 20000 2 L 7 2 9 3 3 911' 8 10

ti
Y• C: 37 Oil19 Diosynth THC 09:07:42 a.m. 05-26-2009 2 /4
ADJACENT RIPARIAN PROPERTA OWNER STATEMENT
(FOR ,4 PII R1J100R11V(; PILIAWS/80 -f TLIFT/BOATIIOU S'E)
hereby certil'y that I :lawn property adjacent tos
(Dame of Property Owner)
property located m
on —2Q y c
(Waterbodi•)
LUt, MUCK, Koau, cic.)
_11_----- N.C.
(Town and/or Countv}
Applicant's phone �WaLA?&MailingAddress: !�=-e,
He has described to nlc, a-sshown below, the development he is proposfiig at that location, and, I
have no obiWiorEi to his proposal. I understarxf that a pier/mooring pilings / boatlitt i boathouse
must be set back a nlilllnitiln distance of fifteen teet (15') from my area of riparian access unless
waived by nlc. (If you wish to waive the setback, you must initial the appropriate blank
below.)
I do not wish to waive
_�k/ — I do wish to wzilve that setback requirement.
DESCRIP MV
(Toy
-------------------------------------------------------- ------------------
VA/OR DRAWING OF PROPOSED DEVELOPMENT:
. 11ed in by individual prolyosil,q development)
�'"'Tf i I
fa
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4
VA /it NS >h n► 4 S
---------------------------------------------------------------------
(Information for for Property Owner Applying
for Permit)
Mailing dr Ad!Ps
cif /State/^.i 1
Y I
-01M k-61[-
T c ne N 1)bcr
S9 _
Signature fate
(Riparian Property Owner Information)
Signature
Print or Type Name
Telephone Number
Date

J1 9';;37 0919 Diosynth THC
09:07:55 a.m. 05-26-2009 3 /4
ADJACENTRIPARIAN PROPERTY' OWNER STATEMENT
(FUR :1 PIER/,'MOORING PILINGS/B0.4 TLIhT/BOATHOC-SE,)
I hereby ccrtil'\! that I own property iidjacent tohl
(Name of Property Orune )
property located at q l a Cane, l_.L1 $'1�►. __ d_
(Lot, Block, Road, etc.)
N.C.
v (Waterbody) (Town and/or County)
Applicant's phone #fiq.) Mailing Address:
He has described to me, as shown below, the development he is proposing at that location, and, I
have no objections to his proposal. I understand that a pier/mooring pilin ;s ' boadilt / boathouse
must be set brick a minimum distance of fifteen feet (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 not wish to waive
I do wish to wane that setbaci; requirement.
DES(`RIPTIM! AND/dR DRAWING OF PROPOSED DEVELOPMENT:
(To NOYed in bt• individual priposing development)
(Information for VroperIN Owner :-pplNing
for Permit)
`a I ( 4 c�- . --
Mailing Address
1+ 1 � &tea __
City/State/Z i p
Tel hone Nit i iiI 'r
Signature Date
5
------------ ----- t �---------------
(Riparian Property Owner Information)
Signature
Print or Type Name
I-clephone Number
Date

J19'�37 0�19 Diosynth THC
09:08:09 a.m. 05-26-2009 4 /4
- .wrFA
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
Beverly Eaves Perdue, Governor James H. Gregson, Director Dee Freeman, Secretary
Date 0 Jam'
Name of
of Property Owner Applyin,, for Permit:
Niailinn Address:
y I Z__ Cct/�� rvtPXcc l � Uo�---
�rV1P.�rQ.��S(�J_� _�359�J
1 certify that I haN a authorized (agent) L�-K c',,.�, r� _ to act on my
behalf, for the purpose of applying for and obtaining all CANIA Permits necessary to
install or construct: (activity)
at (my propert- located at) _� 12
LoU
This certification is valid thru (date) �2 ro
) -
Property Owner Signature
D 52c-_U-
Date
400 Commerce Avenue, Morehead City, North Carolina 28557
Phone: [phone] FAX: [phone] Internet: www.nccoastalinanagement.net
An E;1ual Opportonity t Affirmative Action Ernp.oyer — 50% Recycled t 10% Post Cons::mer Paper

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ADJACENT RIPARIAN PROPERTY OWNER ST ENT
(FOR A PIER/MOORING PILINGSIBOATLIFT/BOAT a
,v
I herebycertify that I own property adjacent toh
fY p p Y J ar71,4 iu So N is
(Name of Property Owner') J b LUU9
property located at 4 1 1- 0.4<0& Nerrxt � a► �goU i4ioreheari C, ®CM
(Lot, Block, Road, etc.) (
on112!o seu-,gyp , in 6 i� e " - I o & r , N.C.
(Waterbody) (Town and/or Co nty)
Applicant's phone #:914- `01-V3 0 o Mailing Address: 1 2 L p-e- Y�era �aQ (oo�
r W,era U �s(� IyC
as5q
He has described to me, as shown below, the development he is proposing at that location, and, I
have no objections to his proposal. I understand that a pier/mooring pilings / boatlift / boathouse
must be set back a minimum distance of fifteen feet (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 not wish to waive
GCIV I do wish to waive that setback requirement.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
o
b
(Information for P operty Owner Applying (Riparian roperty Owner Information)
for Permit)
`T i 2' U4.,� P G �^'� cy u_� aQ L two e
Mailing Address
t 3 C 2$ 5 014
City/State/Zip
- (e 01 - 430 0
Te hone N er
Signature Date
Signature
U Print or Type Name
q!0 �2/7
Telephone Number
% — /5 - ©� Date