32845_BUENA VISTA HOA_20020927

CAMA / '`7 DREDGE & FILL
GENERAL PERMIT
❑New Modification F�Complete Reissue 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 I SA NCAC
Applicant Name
Address
A....ZIP
t
City_ 1 i�
j
; ' State
i
Phone #
Fax # (�)
Authorized Agent
I L,-c,
i
'
r 1 CW
'El EW
[I PTA ❑ ES
❑ PTS
Affected
AEC(): i_ OEA
❑ HHF
--I IH ❑ USA
❑ N/A
D PWS:
_;FC:
ORW: yes / no PNA yes / no Crit. Hab. yes / no
Previous permit #r
Date previous permit issued
❑ Rules attached.
Project Location: Countyc-
Street Address/ State Road/ Lot #(s)
Subdivision
City- > ZIP
--f ,
Phone # River Basin r i�
Adj. Wtr, Body I,�i� t-,( i� )t t (nat /man /unkn)
Closest Maj. Wtr. Body _
n length
. .No
MEWAMM01
.•
Permit Officer's
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Agent or Applicant Printed Name
Signature "Please read compliance statement on back of permit
Application Fee(s) Check #
Signa;uri-
Issuing Date f � 'ration D e
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
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 (910-395-3900) for more information on how to comply with thesebuffer rules.
Division of Coastal Management Offices
Central Office
Mailing Address:
1638 Mail Service Center
Raleigh, NC 27699-1638
Location:
Parker -Lincoln Building
2728 Capital Blvd.
Raleigh, NC 27604
919-733-2293 J 1-888-4RCOAST
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)
Morehead City District
151-B Hwy. 24
Hestron Plaza II
Morehead City, NC 28557
202-808-2808
Fax: [phone]
(Serves: Carteret, Craven, Onslow -above
New River Inlet- and Pamlico 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
910-395-3900
Fax:[phone]
(Serves: Brunswick, New Hanover,
Onslow -below New River Inlet- and
Pender Counties)
www.nccoastalmanagement.net
Revised 10/05/01

PAY
TO THE
ORDER OF
Y
0
L. ARDAN, INC. 11-93 - -
PH: 252-393-8676
1568
66-30/531
DATE- _moo ^ o a 342
_I $ %D0.
DOLLARS
FIRSTCITIZCNS.142 j
First -Citizens Bank $ Trust Company
j.,�">•t �>.� Capo Carteret, N.C. 28584
www.firstcitizens.com /
11100 15 68ii' IM 5 3 L00 3001:00 3 4 i 2 2 6 308 211'
0z

ADJACENT RIPA.RL-�N PROPERTY OWINTR STATE- ENT
(FOR A PIER/MOORING PILINGSIBOATLIMHOATHOUSE)
I hereby certify that I own property adjacent to ��� �� � il. �/ �� 's
(Name of Property Owner)
property located at ' -(� &" K' A , i � S�c�
(Lot, Block, Road, etc.)
on _ 5„ ,,/� , in N.C.
(Waterbody) (Town and/or County)
He has described to me, as s- own below, the development he is proposi::_ a_ tat location,
and, I have no objections to his proposal. I understand t,a_ a pier/mooring
pilings,,boadiiVboathouse must be se: back a minimum distance of frf'-Leen fee: (15') from my area
of riparian access unless waived by me.
I do nnt wish to wa:L-e the setback requirement.
I -Q wish to waive that setback re-uirement.
DESCRIPTION AN-D/OR DRAWD G OF PROPOSED DEVELOP`EE\T:
(To be filled in by individual proposzrz� development)
Print or Type Name
Teleuhone Number
Date: y 'P 6 a

Farm DCM-MP-1
APPLICATION
(To be completed by all applicants)
1. APPLICANT
a. Landowner: Z, 7 /a� lV`
' � J
Name Z;'
Address %(,) ; �-��! �t iJK! �'�;✓^ ,��
City C/State
l
Zip s � � Day Phone f
Fax
b. Authorized Agent:
Name
Address T-c`iA' kr
City State � '-
Zip Day Phone
FaxLV /, -- r o4
c. Project name (if any) nM 1'54
NO i e: Pearl: will be issued in name of Imsdawner(r), and/or
project nave.
2. LOCATION OF PROPOSED
PROJECT
1
a_ County . `/C (At- J'
b. City, town, community or landmark
c. Stre-* address or se^andary road number
_ 8v, ,4, UsrA
d. Is proposed work within city Knits or plank;-;
jurisdiction? Yes X_ No
e. Name of body of wafer nearer proje.� (e_g. rive-.
creek, sound, bav)asca iV,0
3. DESCRIPTION ACID PLA_'4�T_D USE
OF PROPOSED PROJECT
a. List all development activities you propose (e.:
building a home, motel, marina, buIkh d, pier,
excavation and/or filling activities.
b. Is the proposed activity maintenance of an ezisr:�._
projwL, new work, or both? IV ,,—,^ GC%'
c. Will *.he proje., be for public, private or commerZ:C_
use? /ffle L N
d. Give a brief description of purpose, use, methods cf
construction and daily operations of propose;.
proiect. If more spaces is need, please ate:"
additional pages. Pig Goi f%»r�at�2s
of 60F1 4 1//577¢ cSssA1Ji510,, , /QGGFSs T Sv✓ D,
, Ji1,T of Li3vA ,sc.
1WC- WZ)_5 a5F A/L l OvN/J
L%GFf 7 ioE .

Form DCM-MP-1
4. LAND AND WATER
CHARACTERISTICS
a. Size of entire tract��
b. Size of individual lot(s)
c. Approximate elevation of tract above MHN or
NWL e ' T-� 3t4 / -
m. Describe existing wastewater treatment facilities.
Gn,v t1eW7'y
n. Describe location and type of discharges to water,
of the state. (For example, sutace runoff, sanitary
wastewater, industriallcommercial effluent, "wash
down' and residential discharges.)
d. Soil type(s) and texture(s) of tract n. Describe existing drinYing water supply source.
Si0/JOv/��K(1R623 �A� L��f�oxS4ND) WEST Gh27'E2t�%
e. Vegetation on tract
f. Man-made features now on tract
!,r/00�lOtir 8d�.�F�O �u�Ng So�,�O
g. What is the CAMA Land Use Plan land
classification of the site? (Consuk Lhe 10-1 Lar= =e P-= .)
Conservation Transitional
_ DeveIoped Community
Rural Other
h. How is the tract zoned by local government?
i. Is the proposed project consistent with the aoniicable
zoning? _�L— Yes No
(A=cn Zoning coTTLj ncr crri)iosre, if ®Pii=bIr)
j. Has a professional archaeological assessment bpin
done for the tract? _ Yes X No
If yes, by whom?
k. Is the project located in a National Registered
Historic District or does it involve a National
Register listed or eligible property?
Yeses. No
1. Are there wetlands on the site? _- - Yes No
Coastal (marsh) Other kV -
If yes, has a delineation been conducted? 'A-,-
-) -,4;r;r Cif S✓t ✓�
5. ADDITIONAL INNF'ORNIATION
In addition to the comple<-_-J application form, tue
following items must be submitted:
• A copy or the deed (with state application only) or
other inssument under which the applicant claims titre
to the alerted properties. If the applicant is net
claiming to be the owner of said proper-,y, the::
forward a copy of the de_-J or other instrument under
which the owner claims title, plus vr1itL5n pe=l lssion
from the owner to carry out the proje.µ.
• An acc=2te, dated work plat ('including plan view
and cross -sectional drawings) drawn to scaie in black
ink on an 8 1/72' by 11" white paper. (Re:er to
Coastal Resources Commission Rule 7J.0203 for a
detailed description.)
Please note that original drawings are preferre:d and
only high quality copies will be acc pted. Blue -line
prints or other larger plats are ac:eptable only if an
adequate number of quality copies are provided by
applicant. (Contact the U.S. Army Corps of
Engineers regarding that agency's use of large=
drawings.) A site or Ioca6on map is a part of plat
requirements and it must be sufficiently detailed tc
guide agency personnel unfamiliar with the area to the

Form DCM-MP-1
site. Include highway or secondary road (SR)
numbers, landmarks, and the Iike.
• A Stormwater Certification, if one is nec--zsary
• A list of the names. and complete addresses of the
adjac nt waterfront (riparian) landowners and
signed return receipts as proof that such owners
haYe jived a dopy of the application and plats
by ces-iilied mail. Such landowners must be advised
that they have 30 days in which th submit comments
on the proposed project to the Division of Coastal
Management. Upon signing this form, the applicant
fur -her certifies that such notice has been provided.
Name IF 5 F.'dvrT
Address Rf i ox/go z�38z
Phone 2 52 - 5IC5,8
Na.Tne�i�y�
Address
Phone Z ?, 7V% 9322,
Name
Address
Phone
• A list of previous state or federal pe.-mits issued for
work on the project tract. Include permit riurnbers,
permitter, and issuing dates.
• A chic for $250 made payable to the Department of
Environment, Health, and Natural Resources
(DEHNR) to cover the costs of proc°ssing the
application.
• A signed AEC hazard notice for projects in
oceanfront and inlet areas.
• A statement of compliance with the K.C.
Environmental Policy Act (N.C.G.S. 113A - 1 to
lo) If the project involves the expenditure of public
funds or use of public lands, attach a statement
documenting compliance with the North Carolina
Environmental Policy Act.
6. CERTIFICATION .AND PERIvII.SSION
TO ENTER ON LAND
I understand that any permit issued in response to this
application will allow only the development described in
tie application. The project will be subject to condition
and restrictions contained »i the permit.
I certify that to the best of my knowledge, the propose+.=
activity complies with the State of Noah Carolina's
approved Coastal Management Program and will b--
condu'ctedd in a manner core;rtent with such prog-am.
I certify that I am authors! d to grant, and do in fact,
grant permission to reps sentatives of state and fede-a'
review agencies to enter on the aforementione:'i lands in
conne.cucri with evaluating information relattd to th.s
permit application and follow-up monitoring of the
Project.
I further cer iiry that the inforMation provided in this
application,is truthful to the best of my kIlowl�Qe.
'iris is the day of
Print Name i't <,h ( ;!
Signature-
ja"Lrowner Cr �ulhcri '^ Azc-'
Please indicate attachments pe:-aining to your pro`OsE'
project
DCM MP-2
Excavation and FUI Information
DCM MP-3
Upland Development
DCM MP-4
Structures Information
DCM MP-5
Bridges and CuIver-s
DCM MP-b
Marina Development
NOTE: Please sign and dare each a_facr-ment in tr,2
space provided a: trw bosom of each form.
400 copies of this public document were printed at a total cost of S 52.48 or S .13 per copy.

Form DCM-MP-4
STRUCTURES
(Construction within Public Trust Areas)
Attach this form to Joint Application for CAMA Major
Permit, Form DCM-MP-1. Be sure to complete all
other sections of the Joint Application which relate to
this proposed project.
a. Dock(s) and/or Pier(s) F
(1)
— Commercial _Community _ Private
(2)
Number 1
(3)
Length 200,
(=>
Width (10'
(5)
Finger Piers Yes No
(i) Number
(ii) Length
(iii) Width
(6)
Platform(s) ✓ Yes No
(i) Number
(ii) Length to
(iii) Width
Number of slips proposed NOME
(S)
Proximity of strut ure to adjacent riparian
property lines PIER,15' - PGarFonm - (0'
(9)
Width of water body 5000 ' k
(i0)
Water depth at ware -ward end of pier at
MLW or NWL 1.0 ' f-
b. Boathouse
(including covert lifts) N/A
(:l
Commercal Private
(=)
Length
()
Width
c. Groin (e.g. wood, sheetpile, etc.) r!/k
(1) Number
(-) Length(s)
d. Breakwater (e.g. wood, shee;pile, etc.) MIA
(1) Length
(-) Average distance from MHW, NWL or
wetlands
(3) Maximum distance beyond MMW, NWL or
wetlands
e. Mooring buoys N/A
(1) _ Commercial Community ^ Private
(2) Number
(3) Description of buoy
(Color, inscription, size, anchor, etc.)
(4)
(5)
Width of water body _
Distance buoy(s) to
shoreline
be placed beyond
f_ Mooring structure (boatliit, mooring pilings, etc.) N/A
(1) _ Commercial ,Community _ Private
(2) Number
(3) Length
(4) Width
g. Other (Give corrplete descripnon)
_guZ-" � /' Isis¢ f2, <'
Applicant jest N
Signature
Date

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■ Complete items 1, 2, and 3. Also complete
item 4 if Restricted Delivery is desired.
■ Print your name and address on the reverse
so that we can return the card to you.
■ Attach this card to the back of the mailpiece
or on the front if space permits.
Article Addressed to:
oa.�� r3R,aocEy
3aiy �',aieU�Y �oAo
7i✓ss7
A. Received by (Please Print Clearly)
Delivery
C. Signature
X L% ❑ Agent
� ❑ Addressee 21
D. Is delivery address different from ite ? ❑ Yes
If YES, enter delivery address bel ❑ No
3. SServi Type
L�'C lied Mail ❑ Express Mail
❑ Registered ❑ Return Receipt for Merchandise
❑ Insured Mail ❑ C.O.D.
4. Restricted Delivery? (Extra Fee) ❑ Yes
2. Article Number (Copy from service label)
�oyy
I PS Form 3811, July 1999 Domestic Return Receipt 102595-99-M-1799

NNW _� 4
UNITED STATES POSTAL SERV � Eostago-&-Fees
a1 ss lylail^�
Paid
LISPS
Permit No. G-10 f
• Sender: Please print your name, address, and ZIP+4 in this box • `
Piejesrc6E L4N0 Sv,ev i��
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PRESTIGE LAND SURVEYING, P.A.
501 W. B. MCLEAN BLVD.
CAPE CARTERET, NC 28584
2nd NOTICE
RETURNED
1ai1//M7/44l %I'll
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7099 3400 0004 1450 9557
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■ Complete items 1, 2, and 3. Also complete
A. Received by (Please Print Clearly) B.
Date of Delivery
item 4 if Restricted Delivery is desired.
■ Print your name and address on the reverse
C. Signature
so that we can return the card to you.
El Agent
■ Attach this card to the back of the mailpiece,
X
or on the front if space permits.
❑ Addressee
\
D. Is delivery address different from item 1?
❑ Yes
MWI
1. Article Addressed to:
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If YES, enter delivery address below:
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❑ Insured Mail ❑ C.O.D.
4. Restricted Delivery? (Extra Fee)
❑ Yes
2. Article Num er (Copy from service label)
7, 2,V ooCx/ 9 5 S 7
PS Form 3811, July 1999 Domestic Return Receipt
102595-99-M-1789
i wu ununm U.S. POSTAGE
PAID
EMERALD ISLE.NC
28594
APRMOUNTOZ
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1

DIVISION OF COASTAL MAN1} GENMNT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Individual applying, for Pexmit: L ARDAN DEy, Co . - G . A. `RFy,F
Address of Property: y: BIJENA
-�
(Lot or Street #, Street or Road, City & County)
I hereby certify that I own property adjacent to the above referenced property. The individual
applying for this permit has described to me as shown on the attached drawing the development
they are proposing. A description or drawing, with dimensions, should be provided with this
letter.
- I have no objections to this proposal_
I Y01, iwye objections to what is dieing proposed, please write the Division of Coastal
Manugernen% Heazron Plaza II, 151-B, Hwy. 24, Morehead City, NC, 28,557 or call. (252) 808-
2808 within 10 days of receipt of tliis notice. No response is considered the surge as no objection
{f you have been. notfiied by Certified Uail.
WAI rER SECTION
I understand that 4 pier, dock, mooring pilings, breakwater, boat house, lift or sandbags must be
m set back a tninimudistance of 15' from my area of riparian access unless waived by me. (If you
wish to waive the setback, you inust initial the appropriate Blank below,)
I -do wish to waive the 15' setback requirement_
I ado not wish to waive the 15' setback requirement_
Signature Date
Pxtrtt Name - - - -
Telephone Nurnbt r With Area Code^--

/A�P.e�u. �vl�rN NIGH U✓qrE��
GoaSTAL
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..,:� �_:�y;;_;z• rv�c rt�cmii� �v uty��vP !rr Nukrm CAROLINA'S COASTAL AREA
COMPLETETIHIS
FORM TO BEGIN
THE APPLICATION
PROCESS UNDER
THE LAWS llStD
BELOW-7 r�—
`;1, �~ STATE
Coastal Azp-a l ana t
...••,. N.C.G.S.113A-118
Dredge and Fill
r5 N.C.G.S.113-2 79
�Y�}��l�,,.�•t•ls; fit,,, Water Quality Certification
N.C.G.S.143-215
t+ J
Easements in Land
Covered by Water
N.C.G.S. 14-6-6; 146-12
'��•.::'�`'��`•', FEDERAL
•.tilt?".•' Y` ,`.,l Corstrlction<Dredgino
FMing, or Other Work in
Navigable Waters
Section 10 or the Rivers and
Harbors Act of 1899
Discharge Dredged
Fill Matemal into anv
Waters or Wetlands
_Section 4 C the
z ;';•1= ;= �� `�>> Clem Water Act
r'�.J' --►( fir,.
DIVISION OF
COASTAL
MANAGEMENT
NORT"rt CAROUNA
Heo''h and Natural
Resources
Forms DCM-MP-I—MP-b
i A a'f I A nv . -

v i .i ► y ALL LL8 V 111 V 11 L
Raleigh Headquarters
P.O. Box 27687
Raleigh, NC 27611-7687
Tel. [phone]
FAX [phone]
r
Pencer \
New
ar,,j :r
\ � E'uns•.vick
Elizabeth City District
1367 US 17 South
Elizabeth City, N.C. 27909
[phone]
FAX: [phone]
Washington District
1424 Carolina Avenue
Washington, N.C. 27889
[phone]
FAX: [phone]
.C7- •.=�
/ Herttnr0 '�• C, ~
/ genie
` , �.� Wasnington Yrrell
1
*k":
aulort
— Hyde
� Yar-Lccd'/
FIELD OFFICES
Morehead City District
Hestron Plaza II
151-B Hwy 24
Morehead City, N.C. 28557
[phone]
FAX: [phone]
Reserve Education
P.0 Drawer 1040
Beaufort, N.C. 28516
[phone]
F.A—X: [phone]
�•
O
Dara
Morehead Ct`y DI ic'
Wilmington District
127 Cardinal Drive Eat
Wilmington, N.C. 28405-3845
[phone]
F.4t: [phone]
Reserve Coordination
7205 Wrightsville Ave.
Wilmington, N.C. 28403
[phone]
FAX: [phone]

THE MAJOR DEVELOPMENI'
PERNUT PROCESS
MAJOR DEVELOPMENT
The Coastal Area Management Act (CAMA)
authorizes the Division of Coastal Management
(DCM) to manage development in Area of
Environmental Concern (AECs) in Notch
Carolina's 20 coastal counties. These AECs
encompass oceanfront, soundfront and rive --front
areas, as well as some special water supply and
unique geologic areas. Any activity involving
construction, excavation, filling or other Iand
disturbance within an AEC is considered
development and requires authorization under
CAMA.
A project is considered major development if it
requires another state or federal authorization
(permit license, etc.), involves alteration of more
than 20 acres of land and/or waxer, or involves
the construction of one or more structures
covering a ground area greater than 60,000
square feet within an AEC. Projects usually are
considered major development if they involve:
excavation, filling or construction in public trust
waters or wetlands within an AEC; or activities
disturbing more than one acre of land. Such
projects must be authorized by a CAMA Major
Development Permit
MAJOR DEVELOPMENT PERMIT
The Major Development Permit process covers
application for authorization needed under
certain . state and federal laws. State
authorizations needed include: Coastal Area
Management Ac'� Dredge and Fill Act; Water
Quality Certinc=on; and Easement in Public
Trust Areas. Federal authorization include:
Rivers and Harbors A. (Section 10, Navigable
Waters) and CIean Water Act (Section 404,
Jurisdictional Wetlands). The state review is
coordinated by DCM and involves the divisions
of Environmental Management, Water
Resources, Land Resources, Marine Fisheries,
Environmental Health, Archives and History and
Community Assistance, as well as the Wildlife
Resources Commission, the Department of
Administration and the Department of
Transportation. The federal review is
coordinated by the Army Corps of Engineers
and involves the Environmental Protection
Agency, National Marine Fisheries Service, and
the Fish and Wildlife Service.
Each project also is reviewed for compliance
with local regulations and for consistency with
the local government's land use plan. The
CAMA land use plan sets forth the community's
policies regarding development and identifies
land classifications where certain activities may
or may not be allowed. A conser�a on land
classification for example typically is very
restrictive where developed or community
classifications are not.
The application review process begins the date
DCM receives an application that is temple*e.
That review talces approximately 75 days;
however, DCM is allowed an additioral 75
days, by law, ifmore time is An
application also may be put on hold, and the
review delayed, if more information is need to
complete the permit file.
A permit application will be denied if the project
is inconsistent with any state, fede a1, local
regulation, or the CAMA land use plan. If the
application is denied, the applicant may file for
an appeal within 20 days of the decision.
If the project is approved, a major development
permit will be issued. Typically, the permit will
list specific conditions or restrictions on the
development The project must be consmacted
according to the permit and any changes will
rewire modification of the permit.
Major development permits are valid for a
period of three years and typically expire on
December 31 of the third year. If the project is
not completed within that time, the permit may

be renewed at the applicant's request. Any
changes in ownership of the project will require
a transfer of the permit at the discretion of the
Director of the DCM.
THE PERMIT APPLICATION
An application package for a Major
Development Permit should consist of : I) a
completed application form; 2) a narrative
description of the project, including its proposed
use and construction methods; 3) detailed work
plat(s) that have been signed and dated and that
show a plan view and cross -sectional drawings;
4) a site map that shows the location and/or
gives directions to the project site; 5) a copy of
a deed or other proof of ownership for the
project site and authorization from the property
owner, if applicable; 6) a stormwater
management plan, sedimentation and erosion
control plan, sewage treatment plan or special
use permit, if applicable;. and ) a $250
application fee by check or money order made
payable to the North Carolina Department of
Environment, Health and Natural Resources
(DEHNR).
This application form consists of a basic
information section and specific subsections for
various types of development. The basic
information section should be completed by all
applicants. The appropriate subsection(s)
(Excavation and Fill, Upland Development,
Structures, Bridges and Culverts, and Marinas)
should be completed to provide information
about the proposed development. All of the
information in these sections should accurately
correspond with the submitted work plat(s).
Excavation and FM (DCM-MP-2) information
should include 0 dredging and excavation work
or filling in public trust waters or wetlands. All
excavation depths should be expressed in
number of feet below the elevations of mean low
water (MLW) or normal water level (NWL).
Any fill in water or wetlands should also be
clearly shown on the plat(s).
Upland Development (DCM-MP-3) includes all
land disturbing activities, such as grading, Riling
and construction of buildings. Critical issues to
be reviewed in this section are the amount of
impervious surfaces within the Estuarine
runoff and erosion on the project site. For
oceanfront development, you should show the
appropriate setbacks, any impacts to public
beach access, and indicate when the property
was plain.
Structures (DCM-MP-4) information includes
all structural development in public trust waters.
This includes piers, docks, boathouses,
bulkheads, groins, breakwaters and mooring
structures.
Bridges and Culverts (DCM-MP-5) section
should include all road crossings of public trust
waters or wetlands within the project area.
Impacts to traditional navigation or drainage
patterns will be carefuIIy considered in the
review of this type of development proposal.
Marina Development (I)CM-MY-6) section
applies to all facilities providing dockage or
mooring for more than ten boats. The area of
public tt:st waters impacted, the number of slips
provided, and the waste -handling facilities to be
provided will be carefully considered.
NOTE: Contact the appropriate Regional Once
(see map) for pre -application meetings and
assistance in completing any portion of this
application. Also, see DCM-MP-1, Section 5 of
the application form for other instructions.

,Form DCM-W-1
APPLICATION
(To be completed by all applicants)
1. APPLICANT
a. Landowner: /�/L /ice 40`9� 11' C
Name ,� k r �; ±'� /y✓
Address /C.� Lf eL�v < �°! J �h: �,
City (f67h 44 %State N
Zips Day Phone E" 4' 7
(,
Fax
b. Authorized Agent:
Name
Address`-�-'
City tr,f�'�'✓� State
Zip '� Day Phone �WW/
Fax �LW 8'�v
c. Project name (if any),gLO_ 115�1r'"
NOr.• Fr-mi., will be issued in name of landowner(s), and/or
prnjea name.
2. LOCATION OF PROPOSED
PROJECT
a. County (A�2A-
b. City, town, community or landmark
c. Strert address or secondary road number
BUEitl�4. al.ST,O 1�l2ivE
d. Is proposed work within city Iimits or plann:
jurisdiction? Yes X No
e. Name of body of waxer nearest project (e.g. rive:.
creek, sound, bav),�v4 S,6ca NC
3. DESCRIPTION AND PLAN-NED USE
OF PROPOSED PROJECT
a. List all development activities you propose (e.
building a home, motel, marina, bulkihe:.d, pier,
excavation and/or Ealing activities.
1 nn
b. Is the proposed acdviry maintenance of an ezis--:-
projt=, new work, or both? A/e (C1
c. Will the project be fro public, private or comae: Z
use? 111,26 / N
d. Give a brief description of purpose, use, method e
construction and dairy ope:-arions of proposes'
project. If more space is needed, ple; se aria
additional pages. /I/E-)c `o IlemFo,_,� &n-s
of bU�,yq U/STi¢ S-)6D/J/5/0,1, 4ezfF5S T cSvv�1J�
BJ/LT of LiG�D �� / .41. ' alYS Jcr7v �0
/IiC �avS USE ,oi� i d���
�fiGfr ToE .f

Form DCM-MP-1
4. LAND AND WATER
CHARACTERISTICS
a. Size of entire tract
c.^ fact n t
b. Size of individual lot(s) ..;j
c. Approximate elevation of tract above NUHW or
NWL 8 T-o 32'
m. Describe existing wastewater treatme'Jt facilities.
Gd ni vl.�f �✓A �
V
n. Describe location and type of discharges to water-)
of the state. (For example, surface runoff, sanitary
wastewater, industriallcommercial eiiiuent, "wash
down" and residential discharges.)
d. Soil type(s) and texture(s) of tract �)
sa�vo — Xvt3 �KUR g �) _11A SaN%
e. Vegetation on tract
f. Man-made features now on tract ^ JJF-
a. What is the CAKk Land Use Plan land
classification of the site? (ConsuLr the local L=
Conservation Transitional
DeveIoped Community
Rural Other
h. How is the tract zoned by local government?
i. Is the proposed project consistent. with the an_ piicable
zoning?_ Yes No
(Arrads Lasing camplian- =rfl=e, if ®piicabie)
j. Has a professional archaeological assessment been
done for the tract? �', Yes A No
If yes, by whom?
k. Is the project located in a National Registered
Historic District or does it involve a National
Register listed or eligible property?
Yes_ No
Are there wetlands on the site? __�__ Yes No
Coastal (marsh) ✓ Other GOV-
If yes, has a delineation been conducted?
(Arracn documenrarion, if a„aiiabia)-A7-7,0�HeV S✓L✓ /
o. Describe existing drinking water supply source.
5. ADDITIONAL Ii�-FORKLATION
In addition to the completed application form, the
following items must be submitted:
• A copy of the deed (with state application oniy) or
other instrument under which the applicant claims title
to the alffacted properties. If the applicant is act,
claiming to be the owner of said property, then
forward a copy of the deed or other instrument under
which the owner claims title, plus written permission
from the owner to cagy out the project.
• An accurate, dated work plat ('including plan view
and cross -sectional drawings) drawn to scale in bla :k
ink on an S 112" by I1" white paper. (Re:-' to
Coastal Resources Commission Rule 7J.020 for a
detailed description.)
Please note that original drawings are preferred and
only high quality copies will be accepted. Blue -line
prints or other larger plats are actable only if an
adequate number of quality copies are provided by
applicant_ (Contact the U.S. Army Corps of
Engineers regarding that agency's use of larger
drawings.) A site or Iocation map is a part of pla*
requirements and it must be sufficiently detailed tr
guide agency personnel unfamiliar with the area to the

For-rn DCM-MP-1
site. Include highway or secondary road (SR)
numbers, landmarks, and the like.
• A Stormwater Cer-tiFcation, if one is necessary.
• A list of the names . and complete addresses of the
adjacent waterfront (riparian) landowners and
signed return receipts as proof that such owners
have received a 6opy of the application and plats
by ce-rdried mail. Such landowners must be advised
that they have 30 days in which to submit comments
on the proposed project to the Division of Coastal
Management. Upon signing this form, the applicant
further certifies that such notice has been provided.
Nal-ne T#"/n r5 F A U rT
Address Rt•i Aox leo UA. Z(�382
Phone 252 - 3,5-8 -
N am e
Address 5014 F491v' N Zo .CPC Z85v
Phone 25Z- 7L 327-
Name
Address
Phone
• A List of previous state or federal per­rruts issued for
work on the project tract. Include permit numbers,
permirtee, and issuing dates.
• A che<lc for $250 made payable to the Department of
Environment, Health, and Natural Resources
(DEI?NR) to cover the costs of processing the
application.
• A signed AEC hazard notice for projec's in
oceanfront and inlet areas.
• A statement of compliance with the N.C.
Environmental Policy Act (N.C.G.S. 113A - 1 to
10) If the project involves the expenditure of public
funds or use of public lands, attach a statement
documenting compliance with the North Carolina
Environmental Policy Act.
6. CERTTFMCATION AND PERMLSSIO'�N
TO ENTER ON LAND
I understand that any permit issued in response to this
application will allow only the development described in
the application. The project will be subject to condition
and restrictions contained T-i the permit.
I certify that to the best of my knowledge, the proposec
activity complies with the State of North CaroIina's
approved Coastal Management Program and will be
conducted in a ma-mer, coasciste^.t WiLl} such pro=-
I certify that I am authorized to grznt, and do in fact,
grant permission to representatives of state and federa'
review agencies to enter on the aforementioned lands in
connection with evaluating infor:nation rtlza 5d to th:s
permit application and follow-up monitoring of the
project.
I further certify that the information provided in this
application -is truthful to the best of myowiedae.
This is the day of
.. X
Print Name ( '`� �lJ
Signature.-//
jms awrrr or Author.:•2 AzC7-1
Please indicate anac'nmeats per -,mining to your propose:.'
proje L
DCM MP-2
a cavation and Fill Information
DCM MP-3
Upland Development
DCM M94
Structures Information
DCM MP-5
Bridges and Culverts
DCM W-6
Marina Development
NOTE: Please sign and date each arracrurk'nt in try
space provided ar rLe bosom of each form.
400 conies of this public document were printed at a total cost of $52.48 or $ .13 per copy.

Form DCM-MP-4
STRUCTURES
(Construction within Public Trust Areas)
Attach this form to Joint Application for CAMA Major e. Mooring buoys N/A
Permit, Form DCM-MP-1. Be sure to complete all
(1)
_ Commercial _Community _ Private
other sections of the Joint Application which relate to
(2)
Number
this proposed project.
(3)
Description of buoy
(Color, inscription, size, anchor, etc.)
a. Dock(s) and/or Pier(s)
(1) _ Commercial _Community _ Private
(2) Number I
(3) Length Zoo'
(4)
Width of water body
(-') Width �'
(5)
Distance buoy(s) to be placed beyond
(5) Finger Piers Yes ✓ No
shoreline
(i) Number
(ii) Length
f. Mooring structure (boatlift, mooring pilings, etc.) N/A
(iii) Width
(1)
Commercial Private
(6) Platform(s) ✓ Yes No
(2)
_ _Community _
Number
(i) Number
(3)
Lenzrh
(ii) Length 10
(4)
Width
(iii) Width 1
(7) Number of slips proposed NONE
g. Ogler (Give corrplete descriprion)
(8) Proximity of structure to adjacent riparian
property lines Pifie- 15' — PLA''FmAA - tD'
(9) Width of water body S000' k-
(i0) Water depth at ware -
.ward end of pier at
MLW or NWL l ,o ' t
b. Boathouse (including covered lifts) M/h
(1) Commercial Private
(2) Length
(3) Width
c. Groin (e.g. wood, sheetpile, etc.) r( jA
(1) Number '
(2) Length(s)
d. Break -water (e.g. wood, sheerpile, etc.) N(Q
(1) Length
(2) Average distance from MHW, NWL or
wetlands
(:) Maximum distance bevond MHW, NWL or
wetlands
J�v�ly� 1i'iS%�• ij�
Applicant jest N
Signature
Date

r- Article Sent To:
Ln
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Postage $ D
Certified FeeIq
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�/ Return Receipt Fee H e
I11Endorsement Required) ! 2py0
C ri''iiii 7n
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C3 Total Postage & Fees $ 8 A
� Name (Please Print Clearly) (to be completed by mailer)
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Restricted Delivery Fee
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(Endorsement Required)
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Total Postage & Fees ,$
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Form DCM :MP-1
APPLICATION
(To be mmpieted by aII applicants)
1. APPLICANT
a. Landowner:
Name zf� P
Address iG� Lii C�y S f .� J:�.�: 4k(
City (f ':tk ? C%+ A /State /V r
Zip �`� c) Day Phone ��✓�� � 7
Fax
b. Authorized Agent:
Name ��
Address R,: AS"
Ciry State
Zip Yf Day Phone s W&I --���
Fax -'3;:'Z K' v C6
c. Project name (if any),9,tLSO 1/1377/4
NOr: Pmr: wiU be urur-d in name of la ndcwnrr(s), and/or
prvjea name.
2. LOCATION OF PROPOSED
PROJECT
a. Counry
b. Ciry, town, community or landmark
" l
c. Street address or secondary road number
6V, iW,4-. ///Sfa Q2 ✓E
d. Is proposed work within city limits or plaan n_
jurisdiction? Yes _X No
e. Name of body of water nearest project (e.g. rive-.
creek, sound, bay) B«Ty� - aca tua
3. DESCRIPTION AND PLAN-NED USE
OF PROPOSED PROJECT
a. List all development activities you propose (e.
building a home, motel, marina, bulkhe d, pier, azz.
excavation and/or filling activities.
b. Is the proposed activiry maintenance of an exist
project, new work, or both? &,-,- a,)
c. Will. the project be for public, private or comme, c:a:
use?
d. Give a brief description of purpose, use, methods c:
construction and daily operations of proposes'.
project. If more space is needed, please a=:--
additional pages. Go i ff�r►rFa �n s
oG 641FW4 UiSTi¢ cS,)A"J/S/o.- , AccFSS T Sa,�,.�D
_B✓iaTof V40,0 b��ie•se. -4oNSTx✓env,�0
/1%C= ffovS (/SE D.411,4.1
ob Jn T ��ss;(may Fsfti� or

Form DCM-MP-1
4. LAND AND WATER
CHARACTERISTICS
a. Size of entire tract
b. Size of individual lot(s)"'" r
c. Approximate elevation of tract above NEW or
NWL 8 T-o
d. Soil type(s) and texture(s) of tract
SAND — Kea (K4rR" - ) La /ZoAl SaN
e. Vegetation on tract 5&to — TI,�S , .PSG
f. Man-made features now on tract i ��L 7AE
g. What is the CAMA Land Use Plan land
classification of the site? (Consult $se 10c:1 L=—d =e pi.=..)
Conservation Transitional
DeveIoped Community
Rural Other
h. How is the tract zoned by local gove-.=e:.t?
k -- )
i. Is the proposed project consistent with the ?=liable
zoning? -.4- Yes No
(A=cn zoning crnrmpfi-- =rTi i=e, if appucbie)
j•
Has a professional
done for the tract?
If yes, by whom?
archaeological assessment been
Yes X_ No
k. Is the project located in a National Registered
Historic District or does it involve a National
Register listed or eligible property?
Yeses No
Are there wetlands on the site? _X,_ Yes No
Coastal (marsh) _� Other A0V-
If yes, has a delineation been conducted?
(A=ch docunYJlm on, iravailable) -Ar7,aeyM 7
m. Describe existing wastewater treatment facilities.
6,w vlw f v,a 1-
n. Describe location and type of discharges to waters
of the state. (For example, surface runofr, sanitary
wastewater, industriallcommercial eriiuent, 'warn
down' and residential discharges.)
o Describe existing drinking water supply source.
WeSr CWAEACL
wA I
5. ADDITIONAL FiN-FORIVLATION
In addition to the completes application form, the
following items must be submitted:
• A copy of the deed (with state application only) or
Other instrument under which the applicant claims tit-1 e
to the affected properties. If the applicant is not
claiming to be the owner of said propery, then
forward a copy of the deed or other instrument under
which the owner claims title, plus written permission
from the owner to carry out the project.
• An accurate, dated work plat (including plan view'
and cross -sectional drawings) drawn to scale in black
ink on an 8 1/2' by 11' white paper. (Refer to
Coastal Resources Commission Rule 77.0203 for a
detailed description.)
Please note that original drawings are preferred and
only high quality copies will be accepted. Blue -line
prints or other larger plats are acceptable only if an
adequate number of quality copies are provided by
applicant. (Contact the U.S. Army Corps of
Engineers regarding that agency's use of larger
drawings.) A site or Iocation map is a part of plat
requirements and it must be sufficiently detailed tc
guide agency personnel unfamiliar with the area to tht

Form DCM-MP-1
site. Include highway or secondary road (SR)
numbers, landmarks, and the like.
• A Stormwater Certification, if one is ne=sary.
• A list of the names.and complete addresses of the
adjacent waterfront (riparian) landowners and
signed return receipts as proof that such owners
have received a dDpp of the application and plats
by cErtif ed mail. Such landowners must be advised
that they have 30 days in which to submit comments
on the proposed project to the Division of Coastal
Mana., ent. Upon signing this form, the applicant
further certifies that such notice has been provided.
Name Ty,01"F5 L 'Burr
Address Rt i A-xieo G27y9_61«GEE, vA. ZgMz'
Phone 2 5 Z- 13ag - 02 3.1
Name
,0/J!/✓6
0411a46y
Address
Sotµ F40-11bg
R-o .
Mw'4�e� # << ZBSS,7
Phone
ZSZ- 714 - R327—
Name
Address
Phone
• A list of previous state or federal permits issued for
work on the proje= tract. Include pe.—mit numbers,
permittee, and issuing dates.
• A check, for $250 made payable to the Department of
Environment, Health, and Natural Resources
(DEHNR) to cover the costs of processing the
application.
• A signed AEC hazard notice for projez-s in
oceanfront and inlet areas.
• A statement of compliance with the N.C.
Environmental Policy Act (N.C.G.S. 113A - 1 to
10) If the project involves the expenditure of public
funds or use of public lands, attach a statement
documenting compliance with the North Carolina
Environmental Policy Act.
A r R 2 9 2002
6. CERTIFICATION A.N-D PERINUSSIO:ti
TO ENTER ON LA_TID
I understand that any permit issued in response to this
application will allow only the development described in
the application. The project will be subject to conditi=
and restrictions contained ;,i the permit.
I certify that to the best of my knowledge, the proposer
activity complies with the State of Noah Ca+oIira's
approved Coastal Management Program and will be
conducted its a manner con-Sistent with such progam.
I certify that I am authorized to grant, and do in fa ,
grant permission to representatives of state and feder aI
review agencies to enter on the aforementioned lands in
connection with evaluating information related to this
permit application and follow-up monitoring of the
project.
I further certify that the information provided in this
application -is truthful to the best of my knowledge.
This is the day of
Print Name
Signature
L= dow er or Author` -a Ag'
Please indicate attachments per,inin; to your proposes
project.
DCM MP-2 Excavation and Fill Information
DCM MP-3 Upland Development
✓ DCM M9_4 Structures Information
DCM M2-5 Bridges and Culver -Ls
DCM MP-6 Marina Development
NOTE. Please sign and dare each arracnment in tr.
space provided ar the borrom of each form.
400 copies of this public document were printed at a total cost of S52.48 or S .13 per copy.

Form DCM-MP4
STRUCTURES
(Construction within Public Trust Areas)
Attach this form to Joint Application for CAMA Major e. Mooring buoys N/4
APR 2) 9 2002
Permit, Form DCM-MP-1. Be sure to complete all
(1)
, Commercial _Community _
Private
other sections of the Joint Application which relate to
(2)
Number
this proposed project.
(3)
Description of buoy
(Color, inscription, size, anchor, etc.)
a. Dock(s) and/or Pier(s)
(1) _ Commercial _Community _ Private
(2) Number l
() Length 200'
(4)
Width of water body
(-) Width &`
✓
(5)
Distance buoy(s) to be placed
beyond
(�) Finger Piers Yes No
shoreline
(i) Number
(ii) Length
f. Mooring stricture (boatlift, mooring pilings,
etc.) N/A
(iii) Width
(1)
Commercial
Private
(6) Platform(s) ✓ Yes No
(2)
_ ^Community _
Number
(i) Number
(3)
Length
(ii) Length 10
(4)
Width
(iii) Width 1 (10
(") Number of slips proposed Nat4e
g. Other (Give corrTlete description)
(8) Proximity of stricture to adjacent riparian
properry lines fte-15' - PcaTFMAA - t o '
(9) Width of water bodv Sono' k-
(10) Water depth at ,vara ward end of pier at
MLW or NWL 1.0 , t
b. Boathouse (including covered lifts) H/A
(i) Commerc:al Private
() Length
(3) Width
c
Groin (e.g. wood, sheetpile, etc.)
(1) Number
(2) Length(s)
r! /A
d. Breakwater (e.g. wood, she pile, etc.)N(R
(1) Length
(=) Average distance from MHW, NWL or
wetlands
(=) Maximum distance beyond MHW, NWL or
wetlands
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Applicant jest N
Signature
�-
Date

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DIVISION OF COASTAL MANAGEMENT
ADJACENT. RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FO IM
Name of Individual applying, for Permit: Z. A2o4,•/ Fv. Co . - L . A.
Address of Property: _BO iCWA 'Aiz e nFr Co,
APR o J
(Lot or Strut #, Street or Road, City & County)
I hereby certify that I own property adjacent to the above referenced property, The individual
applying for this pexmit has described to me as shown on the attached drawing the development
they are proposing. A description or drawing, with dimensions, should be. provided with this
letter.
____._ I have no objections to this proposal.
V y0a fluve ob,'ections to what is being proposed, please write the Division of Coastal
Man_agernent, Hesrron Plaza Jr, 15I-B, Hwy. 4 Morehead City, NC, 28557 or call (2.52) 808-
2808 wit3iir 10 days of receipt Qf this notice. No response is considers the sarr�e as no nbaectiort
if'you have been no4fled by Certified Afail.
WAMER SEcrION
I understand that a pier, dock mooring pilings, breakwater, boat house, lift or sandbags must be
set back a minimum distance of�15' from my area of riparian access unless waived by me. (If you
wish to waive the setback, you ;rust initial the appropriate blank below)
I -do wish to waive the 15' setback requirement_
I ido not wish to waive the 15' setback requirement_
S i, nature Date
Print Kane
Telephone NumbeIr Witl1 Area Code

5j.rT
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY O'WN'ER NOTIFICATIONIWAWER FOB 1
Name of Individual applying for Permit: Co . - L
Address of Property: --84�E__Allq 44-574 02l0t: o`/— i /, G. Z V-
(Lot or Strait #, Street or Road, City &. county)
I hereby ceruzy that I awn property adjacent to the above referenced property. The individual
applying for this ;permit has described to me as shown on the attached drawing the development
they are proposing. A description or drawing, with dimensions, should be provided with this
letter.
n�
APR
I have no objections to this proposal_
1 Yu& i4a e objections tv what is being proposed3 please write the DiyLion of C"oastttl
Management, ernen% ea'tron Flaw II, I5I-B, Hwy, 24, Morehead Ci),, NC, 28.557 or call (252) 808-
2308 within 10 days of receipt of this notice. No response is considered the same as no objection
if you have been, notified by Certified Uail.
W MITER SECTION
I understand that 4 pier, dock, mooring pilings, breakwater, boat house, lift or sandbags must be
set back a minimum distance of 15' from my area of riparian access unless waived by me. (If you
wish to waive the setback, you roust initial the appropriate blank below,)
I -do wish to waive the 1 S' setback requirement -
I ido not wish to waive the 1 5' setback requirement_
niture Date
Pxim Nami7
Telephone Number With Area Code^

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or on the front if space permits.
1. Article Addressed to:
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A. Received by (Please Print Clearly) 113. Date of Delivery
C. Signature
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D. Is delivery address different from item 1?
❑ Yes
If YES, enter delivery address below:
❑ No
3. SS Type
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❑ Registered ❑ Return Receipt for Merchandise
❑ Insured Mail ❑ C.O.D.
4. Restricted Delivery? (Extra Fee)
❑ Yes
2. Article Number (Copy from service label)
7oy4? *Oo-1 lel.sd 9557
PS Form 3811, July 1999 Domestic Return Receipt 102s9s-99-M-1789
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: LAND SURVEYING, P.A.
MCLEAN BLVD.
tTERET,NC 28584
7099 3400
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If YES, enter delivery address below: ❑ No
3. SServiicc Type
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❑ Registered ❑ Return Receipt for Merchandise
❑ Insured Mail ❑ C.O.D.
4. Restricted Delivery? (Extra Fee) ❑ Yes
2. Article Number (Copy from service label)
7049 3V 0,/) o0oy `WSJ 9 SS 7
PS Form 3811, July 1999 Domestic Return Receipt 102595-99-M-17e9

PRESTIGE LAND SURVEYING, P.A.
501 W. B. MCLEAN BLVD.
CAPE CARTERET, NC 28584
OFFICIAL BUSINESS
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■ Print your name and address on the reverse
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❑ Registered ❑ Return Receipt for Merchandise
❑ Insured Mail ❑ C.O.D.
4. Restricted Delivery? (Extra Fee) ❑ Yes
2. Article Number (Copy from service label)
70y-? 3'10o 000q ly D (7s96
PS Form 3811, July 1999 Domestic Return Receipt 102595-99•M-1789
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PRESTIGE LAND SURVEYING, P.A.
501 W. B. MCLEAN BLVD.
CAPE CARTERET, NC 28584
OFFICIAL BUSINESS
7099 3400
0004 150 9588
7099 3400
0004 1450 9588
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If YES, enter delivery address below: ❑ No
3. SServi�c Type
LN'Certified Mail ❑ Express Mail
❑ Registered ❑ Return Receipt for Merchandise
❑ Insured Mail ❑ C.O.D.
4. Restricted Delivery? (Extra Fee) ❑ Yes
2. Article Number (Copy from service label)
-�oyg 3�f�� Door /yso 9s�,�
PS Form 3811, July 1999 Domestic Return Receipt 102595-99-M-1789

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