53360_COYLE, MIKE_20090319

-2
0 CAMA DREDGE & FILL U 0 1-
GENERAL PERMIT Previous
L] New UModification ElComplete Reissue Ll Partial Reissue 4 I Date previous permit issued
As authorized by the State of North Carolina, Department of Environment and Natural Resources � 2 -- ( -L J, l.
and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC C,
LJ Rules attach6cl—
Applicant Name
Address -k A
City i \.i State zip Y,
Phone # Fax #
Authorized Agent tj
Affected r] Cw [I EW D41-TA F] ES [I PTS
AEC(s): LJ OEA DHHF EIIH El U BA [-1 N/A
0 PWS: El FC:
ORW: yes no PNA yes / no Crit.Hab. yes no
Type of Project/ Activity
Pier
Platf,
Fing(
Groi
Bulk
Basir
Boat
Boat
Beac
Oth(
Shor
SAV
Sanc
Mor
Phoi
Wain
I
Project Location: County
Street Address/ State Road/ Lot #(s)
Subdivision
AA
City ZIP —
Phone # River Basin A—
Adj. Wtr. Body Kat,man /unkn)
Closest Maj. Wtr. Body
(Scale:
UULK) ItH InU I
,rm(s)
r pier(s)_
i length
number
iead/ Riprap length_
J
avg distance offshore
distance offshore
max
,channel
cubic yards
ramp
iouse/ Boatlift
7774
I I
L
Bulldozing
i
r
T- 1--
(line Length I
till,
not sure' yes no
gags: not sure yes no
a / torium: nyes no
as: yes no
Pr Attnrhpci-
T
A building permit may be required by:
Notes/ Special Conditions
Agent or Applicant Printed Name -
Signature *'Please read coroiance statement on back of permit"
Application Fee(s) Check #
See note on back regarding River Basin rules.
)L
PermitOfficer's Signature
U L- I li ! 11 1-1
Is n6ate

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 consistentwith 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 howto complywith 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/ 1-888-4RCOAST
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

A�a_
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 - / V o Z
Applicant Name
Mailing Address
ad City CCM
I certify that I have authorized (agent) ljdtxex-�to act on my
behalf, for the purpose of applying for and obtaining all CANIA Permits necessary to
install or construct (activity) De, C k
at (location) 3 D %
This certification is valid
Signature
ate)
400 Commerce Avenue, Morehead City, North Carolina 28557
Phone: [phone] FAX: [phone] Internet: www.nccoastalmanagement.net
An Equal Opportunity 1 Affirmative Action EnIployer — 50% Recycled 110% Post Consumer Paper

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ADJACENT RIPARIAN PROPERTY OWNER
STATEMENT FOR CAMA MINOR PERMITS
I hereby certify that I own property adjacent to IM I% /
(Name of Property Owner)
property located at
Address, Lot, Block, Road, etc.)
I
on��i! :54ii��t4 d , in -� Cp
(Waterbody) � z , �
(Town and/or County) 8 nog
He has described to me as shown in the attached application and projectMOrehead Gf G
development he is proposing at that location, and, I have no objections to his proposal.
APPLICATION AND DRAWING OF PROPOSED DEVELOPMENT ATTACHED
i
Signature
�i J we, v�,-
Print or Type Name
Z�-L 29Uzo��
Telephone Number
3/1/c L
Date

ADJACENT RIPARIAN PROPERTY OWNER
STATEMENT FOR CAMA MINOR PERMIT'S
I hereby certify that I own property adjacent to��
(Name of Property Owner)
property located at 30
Address, Lot, Block, Road, etc.) 4QQS
on i3oS�c �jl , in Cti,— ��v� f �a . 0`e'�'
(Waterbody) (Town and/or County)
He has described to me as shown in the attached application and project drawing(s), the
development he is proposing at that location, and, I have no objections to his proposal.
APPLICATION AND DRAWING OF PROPOSED DEVELOPMENT ATTACHED
2LJ�4,0Qe-
Signature
Print or Type Name
_-7ZC- 3gSv
Telephone Number
r ZIo�
Date

'S
HEVERLY CONSTRUCTION
[phone]
7306 CANAL DR
EMERALD ISLE, NC 28594-3007
PAY
TO THE
ORDER OF
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1742
66-30/531
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