55225_DICKERSON, ROBERT_20100122

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WCi CAMA / EllkEUGE & FILL
GENERAL PERMIT Previous permit#
EINew ❑Modification ❑Complete Reissue El Partial Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environment and Natural Resources -7N . �� and the Coastal Resources Commission in an area of environmental concern pursuant to I SA NCAC 1
f) �Rules attached.
Applicant Name No ike r'j "C 6 f S uS Project Location: County C'' 3'0 VN:
Address - Op Street Address/ State Road/ Lot #(s) 11
CityVC5orJ'Af- State kC ZIP -2'f)6 IDS SGNC f9c, � �0
Phone # ( !(; }?]-3 Fax # (�) Subdivision �iA0�,�``� ��cft? f
Authorized Agent �„s u p 3 t n ; J City --J i �Ict1 ; 6: U ZIP
C
CW ❑ EW I�PTA ❑ ES ❑ PTS Phone # ( ) J315 v 7.r17 River Basin �� K
Affected OEA HHF ❑ IH UBA N/A 1
AEC(s): El❑ ❑ ❑ Adj. Wtr. Body PIS U ) C r Pn k (nai- /man /unkn)
❑ PWS: ❑FC:
ORW: yes Fro PNA 'ryes / no Crit.Hab. yes / no Closest Maj. Wtr. Body
Type of Project/ Activity
Pier (dock) length ' K�
Platform(s) ! (pY tp
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 ng
Other o) zi S
Shoreline Length
SAV: not sure yes no
Sandbags: not sure yes nn �3
Moratorium: n/a yes o J
Photos: yes �
Waiver Attached: yes Co ----
A
building permit may be required by:
Y1�
Notes/ Special Conditions
)
ent or Applicant Printecl Name
(Scale:
i
i
his facility is located within a Primary Nursery
-_` } __ _ _ _ __ ,rea, and is not for boating use. No slips are
ermitted for vessels -motorized, sail, or other. Anr_
king or prop wash will be considered a violation
this permit, and of the CAMA and D&F Act.
Signature Please read compliance statement on back of permit
200� Pi ' L
Application Fee(s) Check #
1122110 11hoIII
Issuing Date ! Ex iratio Date
�4
L�4\2�tZt�
Local Planning Jurisdiction Rover File Name

IL V
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 I) 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, certifythat 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/ 1-888ARCOAST
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 Citv 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 PIERIMOORING PILINGSIBOATLIFT/BOATHOUSE)
I hereby certify that I own property adjacent to f3t>zP i✓ 's
(Name of Property Owner)
property located at Z7� 2 3 S #t T C-zI-2& "r h ,
(Lot, Block, Road, etc.)
on /yft'LL'� C2Lz., in 161 N.C.
(Waterbody) (Town and/or County)
Applicant's phone #: 2104- 7 %- D3 3 Mailing Address: `a IW( tt:- 7- y)/?
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
I do wish to waive that setback requirement.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
(Information for Property Owner Applying
for Permit)
. ) �2- /fir
Mailing Address
j-lk, f'SUrvvi Li- �Al C_ �
(Riparian Property Owner Information)
Signature
f ////-'- i p >> v iG�?V
City/State/Zip
qlo- S - )- 3
Telephone Number
P, C l p .2 10
Signature Date
Print or Type Name
3 f.2 - // ��
Telephone Number
~7�-Zvly
Date

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/MOORING PILINGSIBOATLIFT/BOATHOUSE)
I hereby certify that I own property adjacent to �C, j3��'i l�/�/�f �?SG -✓ 's
(Name of Property Owner)
property located at '�/ 2 3 S 1'C--% /le'
(Lot, Block, Road, etc.)
on I- If in N.C.
(Waterbody) (Town and/or County)
Applicant's phone #: %�� `3%%-33�3 Mailing Address: %U 2- j/J
.71'9�,�S4�fiIGG C; ,.ti C.
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.)
41 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)
(Information for Property Owner Applying
for Permit)
/0 D/1.
Mailing Address
City/State/Zip
n OC X,
(Riparian Property Owner Information)
Signature
Print or Type Name
q10-y-)7. 3��53 --5 ;�//1) - //0 ��It-
Telephone Number l Telephone Number
Signature Date Date

e��
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 " C ) �l
Name of Property Owner Applying for Permit:
Mailing Address:
1CI-I7 L)R.
I certify that I have authorized (agent) / C's �� tis1<'y to act on my
behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to
install or construct (activity) % iQ- . i 1����/� ,
at (my property located at) -41 _S
This certification is valid thru (date) Ij /I I^j ";7-0/ /
C
Property Owner Signature
J "— .7-,U tb
Date
400 Commerce Avenue, Morehead City, North Carolina 28557
Phone: [phone] \ FAX: [phone] \ Internet: www.nocoastalmanagement.net
An Equal Opportunity 1 Affirmative Action Employer— 50% Recycled 110% Post Consumer Paper

Hp 6ori:5tructiovi, Inc.
Ph. ([phone]
326 6003e Greek Rd.
Hubert, NC 28539
1825
7 J'-7' - /� �) 66-7489-2531
Date a,-,
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