55209_BEAUDREAULT, JAMES_20100217

❑CA / ❑ DREDGE & FILL C.
GENERAL PERMIT ,�� Previous permit# j
[]New ❑Modification ❑Complete Reissue ❑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 Project Location: County
Address Street Address/ State Road/ Lot #(s)
City State ZIP r'r(
Phone # ( ) Fax # () Subdivision
Authorized Agent , f' City ZIP
Affected ❑ Cw ❑ EW ❑ PTA ❑ ES ❑ PTS Phone # ( ) River Basin
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ORW: yes / no PNA yes / no Crit.Hab. yes / no
Closest Maj. Wtr. Body j
Type of Project/ Activity
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A building permit may be require/dy by: (' j 0
Notes/ Special Conditions P. Ir-4- 4o I T��
Agent or Applicant Printed Name
Signature ** Please read compliance statement on back of permit
Application Fee(s) Check #
See note on
C G 17
Ve l— , ,-i 0Cl\,
regarding River Basin rules.
Issuing, Date Expirati Date
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Local Flanningjurisdiction Rover File ame
1

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, 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 CAMA MINOR PERMITS
I hereby certify that I own property adjacent to SArV1r5 bEALA IM) IUL�'s
(Name of Property Owner)
property located at 300,4 SLD0? ,laml2. C� 21 .1EiJ'CWL (LOT 1t,♦ 17 SatLbiri $U6 .
Address, Lot, Block, Road, etc.)
on 1:4DC r?'Ehj CR-F-� EK in ?A CA- , N.C.
(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. i o v"Jad -Et- if c v`
Corv'pll 'K"2 CV19 Cll 2 i1 l «ppAcdu/' -M,-di.
(APPLICATION AND DRAWING OF PROPOSED DEVELOPMENT ATTACHED)
Fr: s{x0le.4 5kel�

NGDENR
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 ! l/
Name of Property Owner Applying for Permit:
f? " ` a_;I�
Mailing Address:
�GZtEk)T� L
I certify that I have authorized (agent) / r �reSICO I-t to act on my
behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to
install or construct (activity)
T 4A)O 14 �) 6 I TinA)74L.
at (my property located at) 00 O S O 0 %� � /2
This certification is valid thru (date)
Owner Signature
Date
400 Commerce Avenue, Morehead City, North Carolina 28557
Phone: [phone] t FAX: [phone] Internet www.nccoasUmanagement.net
An Equal Opportunity t Affirmative Action Employer - 50% Recycled 110% Post consumer Paper

ADJACENT RIPARIAN PROPERTY OWNER
STATEMENT FOR CAMA MINOR PERMITS
I hereby certify that I own property adjacent to SAMFS I-SL SAI,1 5EAt t VRt-AULT 's
(Name of Property Owner)
property located at 3004 SLR Q? 3)Z . MMU- A L (wT t t, + 17 .5QI Lnri § u8 .
Address, Lot, Block, Road, etc.)
on Roc_ ?Eg rk.-EK in ?AML'Icei h N.C.
(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).
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JAMES E OR SUSAN R BEAU®REAULT 620
3004 SLOOP DR.
PO BOX 369
ORIENTAL, NC 28571 date
PAY� l $ DO.00
-le order F �j -lt o
FIRST CITIZENS BANK
W W W. F IRSTCfTIZENS.COM
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