54667_BAREFOOT, BILLY_20091020

❑CAMA / [:]DREDGE & FILL
GENERAL PERMIT �G
❑New ❑Modification ❑Complete Reissue El Partial Reissue
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
Applicant Name
Address % � +�-tu` Da
City1 to f1 State
Phone # (.. a) Fax #
Authorized Agent` CYO!
Affected El CW D EW ❑ PTA [IES ElPTS
AEC(s):
❑ OEA ❑ HHF ❑ IH ElUBA ❑ N/A
❑ PWS: ❑FC:
ORW: yes / no PNA yes / no Crit.Hab. yes / no
N
Previous permit #
Date previous permit issued
546"
Rules attached.
Project Location: County
� 0.1
Street Address/ State Road/ Lot #(s)
Subdivision 'o,y-Ry �yt_ t't
'.� 7- _
City ZIP _
Phone # ( )' River Basin
Adj. Wtr. Body— 4 N- (nat /man /unkn)
Closest Maj. Wtr. Body
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Agent or Applicant Printed Name
Signature Please read cornpudO a sfatement on back of permit
Application Fee(s) Check #
PermitOfficer's Signature
Issuing Date, ,y Expiry ion Date
Local PlanningJurisdiction Rover File Name

14
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/ 1-888ARCOAST
Location:
Fax: [phone]
2728 Capital Blvd.
(Serves: Carteret, Craven, Onslow -above
Raleigh, NC 27604
New River Inlet- and Pamlico Counties)
919-733-2293
Fax:[phone]
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 PILINGS/BOATLIFT/BOATHOUSE)
hereby certify that I own property adjacent to is
(Na of Property Owner)
property located at -/&S Akltt�i--o
(Lot, Block, Road, etc.)
on , in N.C.
aterbody) (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 do not wish to waive the setback requirement.
I do wish to waive that setback requirement.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
PRo.PoskD IIEXTONSion
--t-r—v
�' , PROPOSED
L ADD11-1oN&L-
MQV� LIFT
EXISTING
�i o�(_�i�r, �• gOPj L'I FT
----------------------I --off ��_�i_�_o %------------------------------- - ------I ------------------------
Si ature
-�j 6fi� � %o,✓o ✓�4it/
Print or Type Name
—2Sa--7cFs` - �u3i
Telephone Number
Date: 9�//0

iWil
North Carolina Depal-tment of Environment and Natural Resources
Division of Coastal Management
Michael F. Easley, Governor Charles S. Jones, Director William G. Ross Jr., Secretary
[)ate
II
Applicant Name e--,2� ! l
Mailing Address/�
I certify that I have authorized (agent) _an-e—J. to act on my
behalf, for the purpose of applying for and obtaining all CANNA Permits necessary to
install or construct (activity)
at (location)
This certification is valid tliru (date)
Signature AllW4--
400 Commerce Avenue, Nlorehead City, North Carolina 28557
Phone: [phone] FAX: [phone] Internet: www.nccoastaimanagement.net
An Equal opportunity 1 Affirmative Actior, Employer — 50% Recycled 110% Pest Consumer Paper

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P.O. Box 268
Merritt, NC 28556
www.BroadCreekConstruction.com
"The Original Concrete Pier"
September 14, 2009
Nan Kollar
P.O. Box 706
Kernersville, NC 27285
Ms. Kollar:
Phone: [phone]
Fax: [phone]
N.C.G.C. License # 45686
I appreciate you taking a moment to speak with me on Monday, September 14, 2009. We have been contracted
by Billy Barefoot to add a boat lift and 40' extension to his pier at 465 Blue Heron Drive, Bayboro, NC. Per
CAMA regulations, we are required to inform riparian land owners or estate trustees of the proposed
construction. The work proposed is shown on the enclosed sheet. Please sign and date the enclosed form, and
mail it back to us in the enclosed stamped and addressed envelope. Thank you for your prompt attention. If
you have any questions, please do not hesitate to contact us at the above number.
Sincerely,
0—; Z �)
Ann Law
Enclosures

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/MOORING PILINGSIBOATLIFT/BOATHOUSE)
I hereby certify that I own property adjacent to 5's
(Na of Property Owner)
property located at � ,Q,r,�.Q Ap—� Iy) ,
(Lot, Block, Road, etc.)
ej�
on ► , in Q�w , N.C.
laterbody) (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 do not wish to waive the setback requirement.
I do wish to waive that setback requirement.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
PRo► OSED E7x7-E-NS►©r1
PROPosEb
1rtFT
EXI-STING
So T L-I FT
-E)Q`far_.�-_���.
---------t-------------�-- 3c�r�oo F---------------------------------------
Signature
Print or Type Name
Telephone Number
Date:

USA44
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ass � i

Page 1 of 1
START
ACCTNUM
FIRSTNAME
ADDR1
CITY
ZIP
NAME
CONTROLNUM
CLSCODE
INSERT
BLOCK
SITEADDR
SITUSROAD
Site: 465 BLUE HERON DR
J042-27-13 �
zzs?1 14
1943
J042-27-14
14056
20490
1877 MATTHEWS RD
CLAYTON
27520
BAREFOOT, BILLY RAY
J042
27
465 BLUE HERON DR
BLUE HERON DR
262.22
1863
roperty Details:
UNIQUEID
LASTNAME
CAREOF
ADDR2
STATE
PARRECNUM
MAPNO
PIN
DISTTOWN
DBLCIR
PARCELNO
SITUSADDR
T EXEMPT
Nuti
15
13786
BAREFOOT, BILLY RAY
ET UX TAMMY HOWARD
NC
3182
J042-27-14
D03
14
465
D04o�la, V,
LEGDESCI
11 SOUTH OFF SR 1218
JLEGDESC2
11 LOT 14 BAY RIVER ESTATES
TOTACRES
0
CRNTTOTUSE
0
CRNTTOTDEF
110
CRNTLANDVA
1169000
CRNTBLDGVA
96866
ICRNTOBLDGV
1119806
TOTCRNTVAL
11185672
FIRECODE
I V
HOUSECODE
II P
IISEWERGODE
SALEAMNT
166000
JISALEDATE
6/23l1999
SALEDATE2
I 72,495
SALECODE
C
ROADNUM
1218
PCTCOMP
100
WILLBOOK
IF
WILLPAGE
C
DB_PG
345l282
DEEDBOOK
345
DEEDPAGE
282
PLAT
13-Jul
MOBHOME
0
http://www2. undersys.comlscripts/testadv/usiwebi)c.dll/usi?formis=vtmap&MouseX=O&MouseY=O&z... 9/9/2009

BROAD CREEK CONSTRUCTION
PAYROLL TAXES
11 CREEKVIEW CT
MERRITT, NC 28556-9572
BRANCH BANKING AND TRUST COMPANY
I.800-BANK BBT BBT.com
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1029
66-112/531
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1 $ 4/00. 00
0 S 10 3 780 2 2 ?00
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