56069_BROWN, DANIEL_20100811

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C CAMA / El DREDGE & FILL
9 GENERAL PERMIT Previous permit #
DNew ElModification OComplete Reissue E]Partial Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environment and Natural Resources
and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC
0 Rules attached.
Applicant Name _I t (- 1 i \ (7 W— -
Address --:S1
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ORW: yes / no PNA yes / no Crit.Hab. yes 16-V
Project Location: County_
Street Address/ State Road/ Lot #(s)
Subdivision r
ZIP
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Phone # River Basin i i ?K1
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Agen.t`or Applicant Printed Namel %
Signre Please read compliance statement on back of permit
Application Fee(s) Check #
Permit 0 cer'spignature
100
Issuing Qate Expirdtion Date
/ Ve
Local Planningjuripiction Rover File Name

s
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 L 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 (252-946-6481) or the Wilmington
Regional Office (910-796-7215) for more information on how to comply with these buffer rules.
Division of Coastal Management Offices
Raleigh Office Morehead City Headquarters
Mailing Address: 400 Commerce Ave
1638 Mail Service Center Morehead City, NC 28557
Raleigh, NC 27699-1638 252-808-2808/ 1-888ARCOAST
Location: Fax: [phone]
2728 Capital Blvd.
Raleigh, NC 27604
919-733-2293
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

NCDENR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
Beverly Eaves Perdue, Governor James H. Gregson, Director Dee Freeman, Secretary
RECEIVED
Date us f b 20l D AUG 10 2010
� (�/ f�,. Morehead City DCIM
Applicant Name �6t �I �e/ 4/y Ie,tibet.-1! e 040,417
Mailing Address /.3� �L°1z d'04> ► '(ao /-)/'
I certify that I have authorized (agent) /��'IraC �/d �ns� to act on my
behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to
install or construct (activity) Q �/ ltGCQ� %�/r�=—�� 9
at (location) 11"� / v6gll ��
This certification is valid thru (date)
Signature
i
&t)A -74- IVG 2J5 70
400 Commerce Avenue, Morehead City, North Carolina 28557
Phone: [phone] FAX: [phone] Internet: www.nccoastalmanagement.net
An Equal Opportunity 1 Affirmative Action Employer - 50% Recycled 110% Post Consumer Paper

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/MOORING PILINGSBOATLIFTBOATHOUSE)
RECEIVED
I hereby certify that I own property adjacent to Stephanie A and Daniel R Brown's "AUG 10 2010
(Name of Property Owner)
Morehead City DCM
Property located at, 369 Ball Farm Road
(Lot, Block, Road, etc.)
On Harlow Canal/Clubfoot Creek, in Newport, Carteret County, N.C.
(Waterbody) (Town and/or County)
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.) 6" I ,�(
do not wish to waive
I do wish to waive that setback requirement.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
Build a dock 4' deep and 30' wide, a small deck, 10' X 20', on shore above the dock and a boat ramp 10'
wide and 30' long.
(Information for Property Owner Applying
for Permit)
Mailing Address
City/State/Zip
Telephone Number
Signature
(Riparian Property Owner Information)
ignature
Raymond M. and Stacey S. Luker
Print or Type Name
[phone]
Telephone Number
Date

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ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/MOORING PILINGSBOATLIFTBOATHOUSE)
I hereby certify that I own property adjacent to Stephanie A and Daniel R Brown's
(Name of Property Owner)
Property located at, 369 Ball Farm Road
(Lot, Block, Road, etc.)
On Harlow Canal/Clubfoot Creek, in Newport, Carteret County, N.C.
(Waterbody) (Town and/or County)
RECEIVED
AUG 10 2010
Morehead City DCM
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.)
qM I do not wish to waive
I do wish to waive that setback requirement.
---------------------------------------------------------------------------------------------------------
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
Build a dock 4' deep and 30' wide, a small deck, 10' X 20', on shore above the dock and a boat ramp 10'
wide and 30' long.
(Information for Property Owner Applying
for Permit)
Mailing Address
City/State/Zip
Telephone Number
Signature
(Riparian Property Owner Information)
p'ati
Stacy Wilson
Print or Type Name
252 725-2939
Telephone Number
Date

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CERTIFIED MAIL - RETURN RECEIPT REQUESTED
RECEIVED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM UG
10 2010
Name of Individual applying for Permit:�4�+«/ f'�S{ tici��� tgraus.2 WreheadCity DCM
Address of Property: 3 �69 i cvrm
�P�e�yrf' MC 2,?.5
(Lot or Street #, Street or Road, City & County)
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
they are pr posing. A description or drawing, with dimensions, should be provided with this letter.
I. have no objections to this proposal.
if you have objections to what is being proposed, please write the Division of Coastal
Management, 400 Commerce Avenue, Morehead City, NC, 28557 or call [phone] within
90 days of receipt of this notice. No response is considered the same as no objection if you
'have been notified by Certified Mail.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boathouse, boatlift or sandbags 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.
WI do not wish to waive the 15' setback requirement.
(Applicant Information)
Mailing Address
City/State/Zip
Telephone Number
Date
(Riparian Property Owner Information)
Si4nat 0- -
uc
Print orlrype Name
(262.)-725-2Q3r
Telephone Number
Date

2852
MJ CONSTRUCTION, INC. Wachovia
P O BOX 628 Wachovia Bank, N.A.
MOREHEAD CITY, NC 28557 wachovia.com
66-21 /530 J1611A
PAY TO THE %� iL1 iM 'n
ORDER OF
C DOLLARS
MEMO j�/ji3,�%� 3�
AUTHOR
SI NATUREv
11,00 285 2110 1:0 5 3000 2 L 91: 20000 264 70 5 5 7i..

NC bivision of Coastal Mgt. Habitat Impact Computer
Applicant: Daniel Brown
Date: August 11, 2010
General Permit #: 56069C
Describe below the HABITAT disturbances for the application. All values should match the name, and units of measurement
found in your Habitat code sheet.
TOTAL Sq. Ft.
FINAL Sq. Ft.
TOTAL Feet
FINAL Feet
(Applied for.
(Anticipated final
(Applied for.
(Anticipated final
DISTURB TYPE
Disturbance total
disturbance.
Disturbance
disturbance.
Habitat Name
Choose One
includes any
Excludes any
total includes
Excludes any
anticipated
restoration
any anticipated
restoration and/or
restoration or
and/or temp
restoration or
temp impact
temp impacts)
impact amount)
temp impacts)
amount
OW
Dredge ❑ Fill ❑ Both ❑ Other ®
100
100
HG
Dredge ❑ Fill ❑ Both ❑ Other ®
220
220
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑