59708_CLEVELAND, WILLIAM_20120307

CAMA / DREDGE & FILL �J
GENERAL PERMIT Previous permit#
New [-]Modification ❑Complete Reissue El Partial Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environment and Natural Resources ii tt i
and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC '7 i`�t, 1 1 6o
Rules attached.
Applicant Name lG
Address
City_ i VV io r , ��E State t ZIP
Phone # (_ _ ) Fax # ( }
Authorized Agent,
Affected U CW ❑ EW 9 PTA ❑ ES ❑ PTS
❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A
AEC(s):
❑ PWS: C FC:
ORW: yes / no PNA yes / no Crit.Hab, yes / no
Project Location: County
Street Address/ State Road/ Lot #(s)
Subdivision
City --1dyaa, ZIP Phone # (' ') t �' River Basin �'l k
Adj. Wtr. Body z Cre _ � _ nat man unkn
Closest Maj. Wtr. Body Cr,.e gym,;,
------------------
-in length
number
head/ Riprap length
avg distance offshore
max distance offshore
cubic yards
ramp
:..
h Bulldozing
._
OWN
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0
NOME
Ems
U
No
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MEN
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NOW-1
2fidIll
eline Length Z'Ocil
notsure yes
bags: not sure yes
•.
tos: yes no
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Agent or Applicant Printed Name
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Signature Please read compliance statement on back of permit
PermitOfficer's Signature
f 3c'
Issuing Date Ex irati n Date
Application Fee(s) Check #
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 (910-796-7215) 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/ 1-888-4RCOAST
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

BROOKS DREDGING & MARINE CONSTRUCTION INC 4791
507 BAYVIEW DR PH. 252-728-6886
HARKERS ISLAND, NC 28631 —
66-1246/531
DATE
PAY fV� $ 400 ,OU
TO THE
ORDER OF
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ct 0 �A "-i Ara--� l D O L L A R S n ..,.,.
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Beaufort, NC 28516 C
FOR �' 1 �—� I�V`Q�a1� �v J L,-c-i�-
11000479 L11' i:053 11 24661: 000 13 79 211'

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FEB-19-2012 10:11 THE ELCO CORP
FE6-20-Z012 10:09 From-.XM MKXTY
2167497462 P.001/001
To:95044744 Paee:1
Datc
Sarre of Pro
M.4iling Add
07 s
M&iroo(
N.C. DIVISION OF COASTAL MANAGEMENT
AGENT AUTHORIZATION FORM
zo . ,20/2—
Owner Appl;yiug for Permit
i CLr- Vrz L. 14ND
1 certify that] Dave authorized (agent)
-a.
behalf, fur the urpose of applying for and o
iustail or corv+uct (activity)
ac (my propert locutcd zt)
This ecrtificat4l is valid thra (date)
Property ownif Signature
4IJ4a6C)
t: uOOHS to act on my
gall LAMA Permits necessary to
0oe(t L.jqevSM YRJ\114-
;Z
Date
TOTAL P.001

Mar 07 12 02:42p Brooks Dredging 2525044744 p.1
03/07/2012 (313:53 9195e39790 BEST COW DEV HAUL duel
ADJACENT RIPARIAN PROPERTY OWNM WATER
NT
(FOR A PLERIMOORING PILINGSIBDA�TtlF7YBD�iTIfDiISE)
I hereby certify that I own property adjacent to�rS
(Name of P1ropefty Owner)
P�r rty located at
(lot, Block, Road, etc.)
on ��tw
,� P .,.N.C.
terbady) (T`o n andlor 1~ounfy}
He bas described to me, as shown below, the developrneat he is pr6posing at that location,
and, I have no objections to his proposal. I understand#. that a piWmooring
pilingslboatlift/boathouse must beset back a minimum distance of fiftsen.f _t.(15') from my area
of riparian access unless waived by me.
I do not wish to waive the setback requirement. 3.
I do wish to waive that setback requirement.
DRscRIPT[ON AND/OR DRAWING OF PROPOSED I?EVELOPMEN-T:
(To be filled in by individual p ropositig development)
pox
Print or Type Name
Telephone Numbbe�
Date:

0
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/MOORING PILINGSIBOATLIFT/BOATHOUSE)
I hereby certify that I own property adjacent toy,'` `` t 's
(Name of Property Owner)
property located at % '�,SJt =� �- d %7 e r C!
(Lot, Block, Road, etc.)
On G �r P 7- S� in N.C.
(Waterbody) (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
I do not wish to waive the setback requirement.
I ISM wish to waive that setback requirement.
------------------------------------------------------------------------------------------------------------------
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
>vkS ih d�;vnx,s ham:, �a
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Signature
13
Print or Type Name
Telephone Number
Date: './'z /'�'