56982_AYSCUE, CHARLES_20101202

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�. ❑CAMA / 0 DREDGE & FILL
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
`O� County ❑ Rules attached.
Applicant Name j/(`(V� J Project Location:
Address Street Address/ State Road/ Lot #(s)
City State ZIP
Phone # () Fax # ( )
Authorized Agent
Affected El CW El EW ❑ PTA ❑ ES ❑ PTS
AEC(s): OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A
❑ PWS: ❑ FC:
ORW: yes / no PNA yes / no Crit.Hab. yes / no
Subdivision
City ZIP
Phone # O River Basin
Adj. Wtr. Body (nat /man /unkn)
Closest Maj. Wtr. Body
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................
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Agent or Applicant Printed Name
Signature ** Please read compliance statement on back of permit*;
Application Fee(s) Check #
Permit Officer's Signature I
I
Issuing Date Expiration Da e
74 Local Planning Jurisdiction Rover File Name

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
iandowner(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/ 1-888-411COAST
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

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Aaplicant: c `w '�5 C (k��
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Date: %
1 LO �r
Describe below the HABITAT disturbances for the application. All values should match the name, and units of measurement
found in your Habitat code sheet.
Habitat Name
DISTURB TYPE
Choose One
TOTAL Sq. Ft.
(Applied for.
Disturbance total
includes any
anticipated
restoration or
temp impacts)
FINAL Sq. Ft.
(Anticipated final
disturbance.
Excludes any
restoration
and/or temp
impact amount)
TOTAL Feet
(Applied for.
Disturbance
total includes
any anticipated
restoration or
temp impacts)
FINAL Feet
(Anticipated final
disturbance.
Excludes any
restoration and/or
temp impact
amount
redge ❑ Fill g"'Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
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North Carahna De artm R+DEHR A ent Of En*OnM8nt and Natural Resources
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SaveeY Eaves Perdue, G►amp overnor t'i �
c oastal Management
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4 . (Ugson, alrector Dee Freemao, Secret&y
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Applicant Name f4v
�6
MaWnb AddreSs
P.2/a
P. 1 rage
t certify that I hAve Ratbarized (agent)
to act oa my
hch,alf, for the purpose Of aPp{yiug for and obtaining ail CAMA i*rrmjtic aeeaaasry to
tnsial7 or construct (activity)
of (1vcAttou) 5--3 '
This certif,,
date)�a� old
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Y
(FUx A .'1B#1MV VR1N(i P1L1N(?S1B0ATLJFT/BOAT110 USE)
l hereby certify that I own property adjacent to ,
ti (Nome of Property Owne? or Applicant)
Mailing addre;;s'if different from location address-,�,_f,,�/�C
(town, state; and zip) ,��li.'//�' /��i 7 JF'fV^�;
phone numbers you can be reached at ?2-K- 77 %7 -46�-�
property located at 2 - _ w�� k. Fa
I
(Lot, Block, rtoad; etc.)
on .{d��.sa alLE, ice, _ '
in
Materbo0y) , N,C,
(Town ancVor County)
He has described to me, as shown below, the devcIapment he is .proposing i0hat location, `
and, I have no objections to his proposal, I understand that a pier/mooring piling s/boatILMoathouse
must be set back a minimum distance of fif 6b feet (IMOM my area of riparian access unless
waived by mc.
Y do not wish to waive t
Initl�ls he setback requirement, '
.s
I do wish to waive that ietback requirement,
lnrtiila�
DkSCRXPTION AND/OR DRAWING OF PROPOSED D'LQNT
------------------------------�
(To be filled in by individual proposing developmen
Jer
...._.-- ....._...__ V .................... .... .... . ------
1 wpaturo
1 Prinf or Type Name
Telephone Number
Z 'd SLH 'ON Nf31NVI SSVH Md :L 0[0� 'Ll 'AIN,

(FUR A FIE NWORING PILINGSIBOATLIFTY,SOATHOUSL?
,I'
I hereby cer[ify that I own property adjacent to A.Ay
% (Name of Property owner or Applicant)
Mailing addre,,;s'if different from location address-o
(town, state and zip)Ii�'�%r�'o'._�
phone numbers you can be reached at
property located at S E— p�..._,L e AA '
(Lot, Block, Ra d; tic.)
on L f O Fh VR I in -- N.C.
(Waterboily) (Town And/or County)
He has described to me, as shown below, the devUOpment he is .proposing 0 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 fift��3f feet (151 rom my area of riparian access unless
waived by me.
tattlrS I do :not wish to waive the setback requirement.
.s
I do wish to waive that wee setback requirement.
DESCRIPTION AlY OR IAAWING Ole' PROPOSED .. .. ------ ,.
D�'YEI,pPh2ENx;
(To be filled in by individual proposing development)
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$lEnttutd
� Print of Type Name
Telephone Number
d SLH 'ON UTAV1 SSU9 WdZ�: L 00L l "ON

NORRIS MARINE CONSTRUCTION & LANDSCAPING
BILLY M. NORRIS, OWNER LLC 8616
B 252-393-8646 H 252-393-8810
377 NORRIS LANDING RD. i
SWANSBORO, NC 28584 DATPi 66-30/53
PAY
TO THE
ORDER OF
First Citizens
Bank
FOR
: 5 3 100 3001:00 3 4 1 2 2 9 2 2 1
t
342
DOLLARS s,
F�