53655_CAIN, MILDRED_20090504

4 AMA / ❑ DREDGE & FILL b ={ = C
u. ..
ERAL PERMIT Previous permit #
ew UT lodification ❑Complete Reissue El 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 a of environmental concern pursuant to 15A NCAC
1 a at�ac
p C es 4
Applicant Name I / Project Location: County �
Address Street Address/ Roa / of #(s)
city
) ;
Ci n - State IP O2V
— fit
Phone #; (� a.J� � ? ( ) Subdivision c--
Authorized Agent City ZIP
❑ CW W A ❑ ES PTS Phone # O -"
Affected D OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A
AEC(s): ❑ pW ❑ FC: Adj. Wtr. Body
ORW: yes / o PNA yes / o Crit.Hab. yes / no Closest Maj. Wtr. Body
j7TIFTYpe of Project/ Activity
Pier I
Platfc
Finge
Groii
Bulk[
Basir
Boat
Boat
Beac
Oth(
Shor
SAV
Sanc
Mor
Phoi
Wai,
t
(Scale: � �� ) � )
M.
MIN
e Length
not sure yes
-,ags: not sure yes 1—
L/ _
A building permit may be required by:
Notes/'Special Cond' i s-�"
�-
A!H .Y?
r -)-e
Agent Qr Applicant Printed Name
1i
Signature e r ad com nce statement on back of permit
C
Application Fee(s) Check #
❑ See note on back egar tng River B in
r -- . 7' r
Local Planning Jurisdiction Rover File Name

��y1,

PERMITTEE'
LOCATION:
\V1111) v- 4/1
MONITORING & COMPLETION REP RT j �f
\ [CAMA Major Development & State Dredge & Fill Permits]
4
PERMIT #
FIELD REP.
MONITORED BY
Qkavfiaw'p�-573ATE
PHONE: REPORTEDLY COMPLETE:
DATE OF INSPECTION �71/107
1)
Do the sured dimensions of the development differ from those indicated in the permit and workplat?
VFC f1 f irrly nm-1 _ r
2) SEDIMENTATION & MSION CONTROL: Has Permittee seeded, grassed, or otherwise stabilized all
disturbed areas? YES O circle one]
COMMENT:
3) FUTURE MONkMWNG & ENFORCEMENT ACTION: Is further investigation or enforcement action
needed? YESt2-PO rcle one].
COMMENT:

LAMA / DREDGE & FILL
GENERAL PERMIT��� Previous permit# "
DNew El Modification Complete Reissue �JPartial Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environment and Natura R ources
and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC i r � •' )(A
Rules attached.
j Project Location: County
Applicant Name ! i
�__t'
Address t
i£ri ,l Street Address/ State Road/ Lot #(s)
City_ �` tY T}` State ZIPS
Fax #
} 1 ) Subdivision
Phone #
/ City 1 ZIP 5
Authorized Agent �'r s f l `'
I I CW i , EW --` pTA ❑ ES C PTS Phone # ( ) L ' : ' River asin
Affected { i l
A Affected
-1 OEA 1 HHF J IH ElUBA ❑ N/A Adj. Wtr. Body f'' nat: man unkn
❑ PWS: JFC:
Closest Maj. Wtr. Body
nRw- vPz / no PNA yes / no Crit.Hab. yes / no
Type of Project/ Activity
Pier (dock) length_ -
Platform(s)
Finger pier(s)-_
Groin length
number
Bulkhead/ Riprap length
avg distance offshore
max distance offshore
Basin, channel
cubic yards
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing -- — ---'
Other
Shoreline Length
SAV: not sure yes no 7-4-
Sandbags: not sure yes no
Moratorium: n/a yes no ;
Photos: yes no
Waiver Attached: yes no
A building permit may be required by:
Notes/ Special Conditions
Agent or Applicant Printed Name
Signature Please read compliance statement on back of permit
Application Fee(s) Check #
(Scale:
i -
- See note on back regarding River Basin rules.
PermitOfficer's Signature
Issuing ate Expiry on Date
Local Plann i ng jurisdiction R verFileName

q,
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 (252-946-6481) 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
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/ I-888-4RCOAST
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

APR 2 2 2009
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AVM AIa;IN1 K1YAKIAIN YKVYER 1 Y V W IN EA X N 1'A 1'LIVILIN f
(FOR A PIER/MOORING PILINGS/BOATLIFT/BOATHOUSE)
I hereby certify that 1 own property adjacent to Ai/Y/& Ca/y Is
(Name of Property Owner o nt)—\
Mailing address if different from location address 2 U-7 f-'SXAfs St. �/JC
(town, state and zip)
r
phone numbers you can be reached at 2 %04 - % 6 - S 77 3
property located at Z 913 S-"-
DD (Lot, Block, Road, etc.)
on /Jm o , in coje..,&I- 6-."j , N.C.
(body) (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. _ K
I do not wish to waive the setback requirement. 2009
im tals
I do wish to waive that setback requirement.
initials Morehead City DC
-------------------------------------------------------------------------------------------------------------------
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
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f Signature
Print or Type Name
Telephone Number
Date: 4 ` Zj • 0
www.nccoastalmanagement.net/PermitsIADJACENTRIPARIANPROPERTYOWNERSTATEMENT. pdf

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must'bc sp-t,b&4 o a&-dm= &tm= of fifteen fca (15) ICOM mar =9 of n4*d*n mess tm1am
waive. by mo-
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!do wish to wsive thst �otback regtl>reme�t
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and,1havzi10 objectiom W his PrOposai i �u�rs d�a� apicr�������oatti athous�
mast'be set back a raW== distance of fdt&--n fect (FS) fzzm ray aria of nip'arisn access unless
waived by Tne.
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i do wish to 'waive that Setback �!ftziremmt-
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'APR. 16. 2009 4; 52PM NO. 609 P. 1
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BLUE WATER MARINE
CONSTRUCTION INC,
MOREHEAD O BOX 93
CITY, NC 28557-0093
PAY
TO THE
ORDER OF
DATE /OC— ®G�
6127
66-112/531
Nam/
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• , , B'?nN 1.%%l NK BBr @g COMPANY DOLLARS com j oai:u: o
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FOR -co
If-UUU0V3 1 2 7u■ ,:0 5 3 (�• ��°i�_ 4969592111 _
10 1 1 2 0:0005 2
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