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�16CAMA / ❑ DREDGE & FILL ' 09C No. 76305
GENERAL PERMIT V Previous permit# A B D
.Nf,Jew ❑Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environmental Quality / a� �y,
and the Coastal Resources Commission in an area of environmental concern pursuant to I SA NCAC 07.14 a ( c�C,��CJ
Rules attached.
Applicant Name ( Project Location: County OnS ?1 w
Add lJ Street Address/ State Road/ Lot #(s)�-Ing
City ' [ rn State /V CZIP
Phone # ) 3 `r,0 E-Mail � -� Subdivision �
-
Authorized Agent L �yi 5A,,t Cal ©�1 City �'7 ZIP
Affected ❑ Cw ❑ EW ❑ PTA ❑ ES ❑ PTS Phone # (_ ) River Basin
AEC(s): ❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A Adj. Wtr. Body Step g m °6n (haY/tnan /unkn)
❑ Pws - . Al�.. i .Ups
g t or Applicant Printed Name
Sig cure ** Please read compliance statement on back of permit
R�x ' X — i 76 ?
Application Fee(s) Check #
VC®n n e //
Permit Officer's Printed N me
Signa ure .
0
I ing ate E pir ion Date

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 Resources. Contact the Division of Water Resources at the Washington Regional Office (252-946-6481) or the
Wilmington Regional Office (910-796-7215) for more information on howto comply with these buffer rules.
Division of Coastal Management Offices
Morehead City Headquarters
400 Commerce Ave
Morehead City, NC 28557
252-808-2808/ I-888-4RCOAST
Fax: [phone]
(Serves: Carteret, Craven, Onslow -
North of New River Inlet- and Pamlico
Counties)
Elizabeth City District
401 S. Griffin St.
Ste. 300
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 - South of New River Inlet -
and Pender Counties)
http://portal.ncdenr.org/web/cm/dcm-home
Revised 7/06/ 17

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U.S. Postal Service"'
CERTIFIED MAIL° RECEIPT
Domestic Mail Only
For delivery information, visit our website at wimmusps.com®.
;: � v- a s s
Certified Mail Pee
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$ ry ^n
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Extra Services &Fees (check box, add fee V, rp—
❑ Return Receipt (hardcopy) $p �P, �y
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❑ Return Receipt (electronic) $ i ! , !_I! !
RA,yrnark
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❑Certified Mail Restricted Delivery $ j;j;l ft<�I
Signature
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Required $
❑Adult Signature Restricted Delivery $
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Postage c r.
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$
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Total Postage and Fees
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Sent To
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treat enrlApt. No., o PC7 Boz IVo.
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■ Complete items 1, 2, and 3.
■ 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.
1. Article Addressed to:
Joe Rain, dampar+
ue
ZZ5I N . 61M
0--5gy
Las Vegas NV 691200
A. Signature 0
tB.Recefived
❑ Agent
��� ❑ Addressee
by (Printed Name�Date--
eryD. Is delivery address different from itees
If YES, }mot s below: ❑ No
APR 0 3 2020
III'III'I I'll IIII IIII (IIII ll IIIIII IIII IIII III 0 Adult ❑ AdultS Signature
a Restricted Delivery ❑ Registered Mail-
9590 9403 0208 5146 1546 76 ❑ Certified Mafi® ry ❑ Registered Mail Restricted
❑ Certified Mail Restricted Delivery Delivery
❑ Collect on Delive ❑Return Receipt for
2. 'F a:_r_ nc. -- T _s .s. Delivery Merchandise
7 019 n rr ua ,t — nauvep, Restricted Delivery ❑ Signature ConfirmationTm
a 7 0 0 0 0 0 2 3 4 6 7 0666 ❑ Signature Confirmation
-- - ------ --- __ tstricted Delivery Restricted Delivery
PS Form 3811, April 2015 PSN 7530-02-000-9053
Domestic Return Receipt

AGENT AUTHORIZATION FOR LAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: Christopher Miller
Mailing Address: 1016 Wolf Island Rd
Reidsville, NC 27320
Phone Number: 336-613-1524
Email Address: [e-mail]
I certify that I have authorized Joshua Barber/PFL Construction ,
Agent / Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development:
Pier and Boat Lift
at my property located at 208 Mason Court, N. Topsail ,
in Onslow County.
1 furthermore certify that 1 am authorized to grant, and do in fact grant permission to
Division of Coastal Management staff, the Local Permit Officer and their agents to enter
on the aforementioned lands in connection with evaluating information related to this
permit application.
Property Owner I formation:
Signature
Christopher Miller
Print or Type Name
Owner
Title
11 108 /2019
Date
This certification is valid through 1 I i�PR 202Q

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�'3iiY� i q AMA S Its gniniistdo bns idf gniylqqs To osogvq -grii ilcil 11ried �m no las of
fi .i Ifo hris 19iqJnomgoI,! +v b bsaoqoiq gniwoilol srtt i0
lro � 3� of Fq yff 4 Is
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Cl' !RO0 s?lkm' fA 'i(1k'�1, bm� m ob bmi ,tnr*-AV M 'betAicidl e, me 1 ISM V)i;ter) �3�C3Ctt14�(�31t1 i ; .
R r c3'1 ..3 1'—A fi i`g3it bill, -we :)i� o f#1i`M;194R 1 ,)03 �)e`j %n A?, ima �v�(��?e�ry�ye i•�y�f�af�stoo AO i:M ���� �ry:�'!
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CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM
Name of Property Owner:�c'►��Tnc�
Address of Property: L.o- t; ems,
(Lot or Street #, Street or Road, City & County)
Agent's Name #: L')�h RCA (heIR F L Mailing Address:
Agent's phone #: 10 3"�R 4J �'sc; N CG
Y,F'Y ► LL % `hLLd
I hereby certify that I own property adjacent to the above refeien���d orngprty Thy indisti(�1a+
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 must be provided with this letter.
I have no objections to this proposal. I have objections to this proposal.
If you have objections to what is being proposed, you must notify the Division of Coastal Management (DCM) in
writing within 10 days of receipt of this notice. Correspondence should be mailed to 127 Cardinal Drive Ext.,
Wilmington, NC, 28405-3845. DCM representatives can also be contacted at [phone]. No response is
considered the same as no o� ection if you have been notified by Certified Mail:
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boathouse, lift, or groin must be set
back a minimum distance of 15' f a of riparian access unless waived by me. (If you
wish to waive the setback y . must initi I. th appropriate blank below.)
I do wish to waive a setback requirement.
f do not wish to waive the 15' setback requirement.
(Property Owner Information)
�igna�ture
Print or Type Name
Mailing Address
ktd- x /'./fie N 2
City/StatelZip
C .33(e) to! 3 L52 �L/
Telephone Number
Date
7(Adjnt Pr Ow ar nformation)
lftnature /
R+C,( A," W
Print or Type Name
7 3 9 M tl.& (C,� b,(. .
Mailing Address
Cityl tate2ip
\3o1) q.f--?-. '777
Telephone Number APR 7.0"zQ
Ui
Date
Revised 611612012

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