52624_CLUSE, BRYCE & ANNETTE_20080910

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❑CAMA / -']DREDGE &FILL
GENERAL PERMIT
Previous permit #
[]New ❑Modification ❑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 an area of environmental
concern pursuant to 15A NCAC
❑ Rules attached.
Applicant Name i
1� '. ��,. 1 j_; )+ �l
i_ _ Project Location: County
f
Address ? ` ! I �' 1' f ` (+ j �., ; j ! '
Street Address/ State Road/ Lot #(s)
City s State ZIP
Phone # ('�'' - �a Fax # O "�
Subdivision
Authorized Agent
City j ' ti j : ZIP r
dCW �� ©"PTA ❑ES ❑PTS
Phone # (-,'T.�..-�f ""� River Basin,
Affected
❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A
Adj. Wtr. Bod 1 : '.
feat /man /unkn)
❑ Pws: ❑ Fc:
Closest Maj. Wtr. Body
ORW: yes / rno PNA yes / no Crit.Hab.
yes / no
I
Type of Project/ Activity; i .ti' 1
(Scale:
Pier (dock) length 6-
Platform(s)
Fingerpier(s) _--------_._._ —_
Groin length
--
number
Bulkhead/ Riprap length --i
avg distance offshore -
max distance offshore --
Basin, channel
cubic yards
_-- ._ �_ i - - L
4-
Boat ramp - -- -- -- I i
Boathouse/ Boatlift
Beach Bulldozing
—I1
Other \
Shoreline Length
SAV: not sure yes no
I I
Sandbags: not sure yes no i T
Moratorium: n/a yes no
Photos: s no
Waiver Attached: yes no
A building permit may no
by:
Notes/ Special Conditions 1;
r
LAil
Agent or Applicant Printed Name
J
Signature "Please read compliance statement on back of permit"
Application Fee(s) Check #
❑ See note on back regarding River Basin rules.
:Officer's Signature
P J,
Issuing Date -' / Expiration Date►
Local Planning,lurisdiction ov`erFil ame

i
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 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

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/MOORING PILINGSBOATLIFTBOATHOUSE)
If rl ell 41� 6v ----
I hereby certify that I own property adjacent to / cce s
c� (Name of Pirolferty Owner)
property located at
(Lot, Block, Road, etc.)
on _��/l! /�fo� �'`� , in Glii r-�? I -do— , N.C.
(Waterbody) (Town and/or County)
Applicant's phone #-LZ?- Mailing Address: �i% !,� l/ 7
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
_kz/— I do wish to waive that setback requirement.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
J--7-
az� I
------------
(Information for Property Owner Applying
for Permit)
Mailing Address
City/State/Zip
Telephone Number
Signature Date
�k
(Riparian Property Owner Information)
Signature
2 Print or Type Name
Telephone Number
Date

r
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/:,VIOORLVG PILLVGS/BOA TLIFTIBOATHOLSE)
I hereby certify that I own property adjacent to e,
/�, /� (Name of Property Owner)
property located at / � / p �V'ti'-�"'�?�1 CA4
(Lot, Block, Road, etc.) r
on �� in 'j,! J Z S�cA1 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 a of riparian access unless
waived by me. yW` i "
I do not wish to waive the setback requirement. AH 2 8 2008
I do wish to waive that setback requirement.
Morehead City DCM
---------------------------------------------------------------------------------------------------------
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development) WAD
P0,4
f
u- ---------------------
(Applicant Information)
------------------- — p-----------------------
Mailing Address
Gf � i
City/State/Zip
Telephone Number
5F L,-) f;`76711?
Date
� � I
( ian^Prop rty Owner Information)
�QSignature
Print or Type Name
?— 2 - ?zs-
Telephone Number
Date
6?-ZS-- -va

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIE"IOORING PILIIYGSIBOATLIFT/BOATHOUSE)
I hereby certify that I own property adjacent to (yc@ d4,Clw.5cs
(Name of Property Owner)
property located at ��y /�►'�
�-1 (Lot, Block, Road, etc.)
on 1�"1 r�l , in/III rl S , 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.
i/ I do not wish to waive the setback requirement. _ '. �a� R ''
I do wish to waive that setback requirement. A U G 2 8 2008
----- ---------,-n---------
DESCRIPTION AND/OR DRAWING OF PROPOSED D ��:`iltY D(;tv
(To be filled in by individual proposing development)
(Applicant Information)
/02-1 C'-e4zJrSV1
MailingAddress
rV c . -A k Jr%
City/State/Zip
30 �l
Telephone Number
Date
c.
A;7°% Y'
N
----------------------- -----------------------
(Riip ian /PropertyI
Owner nformattiion)n)
, � � r
Aim/ I
ai 0WOMIre-
el I�lr
rint or Type Name
��- �//-)�32JV 6q)
Telephone Number
Date

NCDENR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
Michael F. Easley, Governor James H. Gregson, Director William G. Ross Jr., Secretary
Date 4
boyG� /I y.
Applicant Name C
Mailing Address �1�n C2P.� � AUG 2 8 2008
�)s z --)z S--- 070 9
I certify that I have authorized (agent) C L e v 1y Lett//'
to act on my
behalf, for the purpose of applying jjf''or and obtaining all CAMA Permits necessary to
install or construct (activity) i(Jac� J�p`
at (location) A
This certification is valid thru (date)
Signature
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

GLENN LEWIS
NCDL 8103698
252-729-1675
415 Star Church Road
Marshallberg, NC 28553
ORD R OFF —�
WACHOVIA
Waohovia Bank, N.A.
we(chola�2191:101008249
comv�_LtFOR `-1:053000
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L406ii' L567
1567
66-21/530
BRANCH 77585
DATE
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