HomeMy WebLinkAbout77491_William Tipton_20201208 41 ,__CAMA/ ❑DREDGE & FILL N . 77491 A /B, C D
GENERAL PERMIT TP4107T lol Previous permit# •
1rc !I New ❑Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued ; 'a
As authorized by the State of North Carolina,Department of Environmental Quality
and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC ,i1 Z-,: )(_- .
)i ]Rules attached.
Applicant Name (djj I' I rk,,‘ p ,,\ Project Location: County -- ( , �:�
Address (,:-7 (, Ck if Lt)/7/5 C J'(/ Street Address/State Road/Lot#(s) /-70 J
City -,,SA, ti 4-w. State ;;VC ZIP 2 ''.-- i/%iS f La I c /. .-fr
Phone#(;<,-/ 99y4/ $(11/ E-Mail ti--/t)„l (� .a,- /, (c-,. , Subdivision P. 7/.
Authorized Agent T t i r ye__ City AA e . ' /7/�{ ,
ZIP Z
Affected ElCW W ff[ 1PTA rX,ES 'PTS Phone# ( SJ pL// t/ 7/ River Basin /Ve e4 .,•G
❑OEA ❑HHF ❑IH ❑UBA ❑N/A
AEC(s): Adj.Wtr. Body gc,7/ (7, 74_, at man /unkn)
❑ PWS:
ORW: yes /-no PNA es no
Closest Maj.Wtr. Body-_F../ ' - Y•
Type of Project/Activity /2 /%&.,,I f, „)-'0 5P'• o o ,-(., L. ,.. \ P .. r/X/c 1 /", .-u-k-' 43'-.
-c- /O X 30 /���.''/ti o i 1 se D‘(---1 /7 e ) / ,1-- (Scale: N
Pier(dock)length y/
Fixed Platform(s) i y` (
Floating Platform(s) & l` ,)r-k L1 Y�o se,�
Finger pier(s) I i..........._.___._.___�_.._. ' [sue
Groin length �a �,�:�?ri I I
.i
5 I G—
Bulkhead/Ripr p length ' OQ number
! T� V--,-
---y �avg distance offshore i C, - V c..---+- - . .:ar
V/—.� E
max distance offshore ric Ivii N/
Basin,channel C V , ` >'
& l t )/'iT'�0
i n� �' ; I six dL' Pier
cubic yards U
Boat ramp / j
•
is `k -v' -- L _
Boathouse/Boatlift 1 .... .._ �...._.............................._._.......... —.....-.-.....
T..
Li--;
Beach Bulldozing `` j Pt or
- I
1 L . 1 4
Other }
Pra 1
Shoreline Lengt l Cc
h
i
SAV: 'not sure yes no .— IV f ' 1
1^Moratorium: n/a yes ! 1L` riles
Photos: yes �__} _
Waiver Attached: no 1 1.... I 1 1
A building permit may be required by: „-, jl'e,0 i�' �]See note on back regarding River Basin rules.
. g g
(Note Local Planning Jurisdiction)
Notes/Special Conditions 4 511 P} Z tr, 1( I f r"" 1-4 C,r'c-,e � ` l011 }/2- &tot AO't•5e(V0O 41t Z
iI ' (-,,IIc e-r --- /0 'Pie • hear L.)t4-, U/.--.c4
Agent or Ap • t Printed eV - Pe Olfiter s - ) ' .
Signatu Please read compince statement on back of permit" Sign r
CPif (,do -a 29 5.s* / )-€0 . S, ZoZp d (f/ 20zI
Application Fee(s) Check# IssuingVate Expiration 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 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 Resources. Contact the Division of Water Resources at the Washington Regional Office (252-946-648 I) or the
Wilmington Regional Office(910-796-72 1 5)for more information on how to comply with these buffer rules.
Division of Coastal Management Offices
Morehead City Headquarters Washington District
400 Commerce Ave 943 Washington Square Mall
Morehead City, NC 28557 Washington, NC 27889
252-808-2808/ I-888-4RCOAST 252-946-6481
Fax: 252-247-3330 Fax: 252-948-0478
(Serves:Carteret,Craven,Onslow- (Serves: Beaufort, Bertie, Hertford, Hyde,
North of New River Inlet-and Pamlico Tyrrell and Washington Counties)
Counties)
Elizabeth City District Wilmington District
401 S. Griffin St. 127 Cardinal Drive Ext.
Ste. 300 Wilmington, NC 28405-3845
Elizabeth City, NC 27909 910-796-7215
252-264-3901 Fax: 910-395-3964
Fax: 252-264-3723 (Serves: Brunswick, New Hanover,
(Serves:Camden,Chowan,Currituck, Onslow-South of New River Inlet-
Dare,Gates, Pasquotank and Perquimans and Pender Counties)
Counties)
http://portal.ncdenr.org/web/cm/dcm-home
Revised 7/06/17
❑CAMA/ ❑DREDGE & FILL O
-_,��-�,���� N . 77491 A BCD
GENERAL PERMIT Previous permit#
>� ❑New ❑Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued
As authorized by the State of North Carolina,Department of Environmental Quality
and the Coastal Resources Commission in an area of environmental concern pursuant to I 5A NCAC
❑Rules attached.
Applicant Name Project Location: County
Address Street Address/State Road/Lot#(s) /' " '
City State ZIP
Phone#( ) E-Mail Subdivision
Authorized Agent City ZIP
Affected ❑Cw p.EW 'PTA CI ES ❑PTS Phone# ( ) River Basin
AEC(s): ❑OEA ❑HHF ❑IH ❑UBA ❑N/A Adj.Wtr. Body (nat /man /unkn)
❑ PWS:
ORW: yes / no PNA yes / no Closest Maj.Wtr. Body
Type of Project/Activity
a
(Scale: , )
Pier(dock)length 1
I
,� j/ r, 4 1.,.if-
Fixed Platform(s) / `F J ii� -
Floating Platform(s) i 'l _ `~ , { y, f ,� I J
�yy t`
Finger pier(s) _ r / ..... 1 ,.
Groin length I �_ n /4'�' Ili
{-.
number ,-... .. ..-._.__ i t .. ._. ' ...... �_ .... - ._... j ...
•
Bulkhead/Riprap length -* '• -_-
avg distance offshore , , , r µ? l
max distance offshore t
Basin,channel \
cubic yards °' y li M1 i
0i
Boat ramp j
i i
Boathouse/Boatlift _ ,... ... 1.....
- --1.—'1\-IIL'--LI :$it'Is -I1 '(
Beach Bulldozing j I - - t-: t'' 6--
Other i - � • +i { J
r fI rtl(�j? f
Shoreline Length N co r' i
SAV: not sure yes no _ _.__ _ f a `_ _..-
Moratorium: n/a yes rig-71 iy� � i
Photos: yes nb i _
Waiver Attached: yes no � � ' I � , ' --
A building permit may ge required by: i i". . 7 See note on back regarding River Basin rules.
(Note Local Planning Jurisdiction) 1 rr
Notes/Special Conditions F''
Agent or Applicant Printed Name Permit Officer's Printed B
:;c0i) t%1. ' 1 ,11
` .
/�
Signature **Please read compliance statement on back of permit** Signature
g P P
( S , 2020 - ,r e'') S ; 2 02 (
Application Fee(s) Check# Issuing Date Expiration 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 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 Resources. Contact the Division of Water Resources at the Washington Regional Office (252-946-648 I) or the
Wilmington Regional Office(9 I 0-796-72 1 5)for more information on how to comply with these buffer rules.
Division of Coastal Management Offices
Morehead City Headquarters Washington District
400 Commerce Ave 943 Washington Square Mall
Morehead City, NC 28557 Washington, NC 27889
252-808-2808/ I-888-4RCOAST 252-946-6481
Fax: 252-247-3330 Fax: 252-948-0478
(Serves:Carteret,Craven,Onslow- (Serves: Beaufort,Bertie, Hertford,Hyde,
North of New River Inlet-and Pamlico Tyrrell and Washington Counties)
Counties)
Elizabeth City District Wilmington District
401 S. Griffin St. 127 Cardinal Drive Ext.
Ste. 300 Wilmington, NC 28405-3845
Elizabeth City, NC 27909 910-796-7215
252-264-3901 Fax: 910-395-3964
Fax: 252-264-3723 (Serves: Brunswick, New Hanover,
(Serves:Camden,Chowan,Currituck, Onslow-South of New River Inlet-
Dare,Gates, Pasquotank and Perquimans and Pender Counties)
Counties)
http://portal.ncdenr.org/web/cm/dcm-home
Revised 7/06/17
CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DMSION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONANAIVER FORM
Name of Property Owner: W i II,AA4 /46-1-)Ai
Address of Property: it'7n ./M rr�
(Lot or Street#, Street or Road, City&County)
Agent's Name#: 1LINp+5C r°NC _ Mailing Address: 7.3/)3 flit Huh4
Agent's phone#:(16.5-0 '711 - t /) `RA ?rd AJL Z f.S7S` J
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, 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. Contact information for DCM offices is
available athttp://www.:accoastaimanagement.net/web/crIstaff-listing or by calling 1-888-4RCOAST.
No response Is considered the same as no objection if you have been notified by Certified Mail.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, boat ramp, breakwater, boathouse, or lift 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 must initial the appropriate blank below.)
I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(Property Owner Information) (Riparian Property Owner Information)
SIgnature Signature
A)/1/,q4/ L/,/ G(J,'��/� f^r f�lA4IP/
Print or Type Name Print or Type Name
d 7 6 ('/f 70/ /3-,1. tet.L, >Z.
Mailing Address Mailing Address
pity/State Zip City/Stre✓Zip
(t-r- -)9W- ij\/11,(i-/7)70/d _(49/4 /)./4) QZ /95-eb
-Telephone Number/Email Address ' Telephone Number/Email Address
`
Date
CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Property Owner: liJi/1,AA4 //A?A.)
Address of Property: /'70 O kt3;f-il rL A/W- l4/7-rt 7 / 4X7A/c4I)(
(Lot or Street#, Street or Road, City&County)
Agent's Name#: TirAYV rptifl Mailing Address: Z3/)3 NG Hwy 30
Agent's phone#:( z cG) r7t.tc light) 3!964-0 l AIL Z fJi5
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, must be provided with this letter.
I 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. Contact information for DCM offices is
available at http://www.nccoastalmanagement.net/web/cm/staff-listin_q or by calling 1-888-4RCOAST.
No response is considered the same as no objection if you have been notified by Certified Mail.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, boat ramp, breakwater, boathouse, or lift 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 must initial the appropriate blank below.)
I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(Property Owner Information) (Riparian Property Owner Informaattiion)e Q
,44
Signature • ature
14)11f,9/1i 2 ,v I.)pi'rch ,1 c
Print or Type Name Print or Type Name
67 6 t W 6d5c 70! /f1/ 10/11-MM/L 106144 al.
Mailing Address Mailing Address
/,�/tr�i,v �,. J i(l� Z91( 0 /yerr��� , ,Ur. Z frr6
City/State/Zip City/State/Zip
9 1/yrf2// �d�A 60k /)03- Liu jordiaN4 6a,
4elephon Number/Email Address Telephone Number/Email Address
ha lt0 0 111301L)
Date Date
(Revised Aug. 2014)
i r
CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Property Owner: IAA I/i A44 v�
Address of Property: 1,71) ENA iI YC. /NT Alf rrrC7 j AJ( pA/141)(4)
(Lot or Street#, Street or Road, City&County)
Agent's Name#: wtNP J rptit-/ Mailing Address: 7n? NC Sly
Agent's phone#:(ZS-C) ''1Lc yqi)E: -Eg a-0 /1/C Z fiTS` ✓-
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, 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. Contact information for DCM offices is
available at http://www.nccoastalmanaaement.net/web/cm/staff-listinq or by calling 1-888-4RCOAST.
No response is considered the same as no objection if you have been notified by Certified Mail.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, boat ramp, breakwater, boathouse, or lift 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 must initial the appropriate blank below.)
I do wish to waive the 15' setback requirement.
I do not wish to waive the 15'setback requirement.
(Property Owner Information) (Riparian Property Owner Information)
Signature Signature
l vi1M4/ /th///U f C 4//Ait//✓
Print or Type Name Print or Type Name
676 CZY 6ni* 70! cf/G /33-4,l �tfet,t, �,z•
Mailing Address Mailing Address
f/kdi 0,1. /11G Z7fl CATy Z1S7/
City/State/Zip City/Stee/Zip
`TTt )9 ' yif2// m��A//694 (9/0)9z z9s�d
elephone Number/Email Address Telephone Number/Email Address
1 oZ 7C Z 0
Date Date
(Revised Aug. 2014)
AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
Name of Property Owner Requesting Permit: U)11�/AA4 7p-h)�✓
Mailing Address: D 1% (,13H Lod rip
fhous-vii AJC Z '4419
Phone Number: (zczj gift!
Email Address: �t f-�rll� @ 601• cam,
I certify that I have authorized 7);)c4.) Tr,Ap /1i7irAii p,e
Agent/Contrctor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
I
necessary for the following proposed development: 3DAi1 I r ri rode)-
-
Ic (A/Pi I AS ? p rAppl I S)Th,vJSItiL
at my property located at JOY) d PAct rc pOi ,
in -pAA1( I i (,r) County.
I furthermore certify that I 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 Information:
Signa ure
Print or Type Name
Title
Date
This certification is valid through I I
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PIN:7502614600000 OWNER_NAME: li+NW OR_ZIP:23113 SALEDATE:4/17/2018 F 1
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MAPID:K05-7-9 G DEED ACRES:31.8 SALE_AMT:0
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CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Property Owner: U,)i/1,A vi // diti
t� �1 �
Address of Property: � !� � e✓RS�i1J'C. /'nJ�/� A Ir t'n-t-i- � 4,1( ?AMi)t.>
(Lot or Street#, Street or Road, City&County)
Agent's Name#: 170/NPisf (>nif-/- Mailing Address: Z 7/)? but friwy 3Y/
Agent's phone#:(ZS-E) i7L(c qv) 3,-9y,pre) I NC. ZfJj.!`"
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, 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. Contact information for DCM offices is
available at http://www.nccoastaimanagementnet/weblcm/staff-listina or by calling 1-888-4RCOAST.
No response is considered the same as no objection if you have been notified by Certified Mail.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, boat ramp, breakwater, boathouse, or lift 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 must initial the appropriate blank below.)
I do wish to waive the 15' setback requirement.
I do not wish to waive the 15'setback requirement.
(Property Owner Information) (Riparian Property Owner Information)
Signature Signature
LA)//l/All! o/M' Al}44tif ('l/414//1/
Print or Type Name Print or Type Name
676 CW Lad }�i��.� ›,-
Mailing Address Mailing Address
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City/State/Zip City/S te/Zip
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Date Date
(Revised Aug. 2014)
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PIN:7502614600000 OWNER—NAME:Wirffirrii trilitk. OWNER_ l.
ZIP:23113 SALEDATE:4/17/2018 ..--
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CALACRES:32.00840268 OWNER_NAME2:null DEED_YR:20180417,-- • • '
ACRES:31.79 OVVNER_ADDR: 13605 DEEDBOOK:000636 Scale= 1: 1200
_ .... : ACCOUNT:32930 DURHAMSHIRE RD DEEDPAGE:318
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OWNER CITY MIDLOTHIAN
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Pamlico County, NC MAPID: K05-7-9
CALACRES: 32.00840268
This web site is being provided for the benefit of the general public. ACRES: 31.79
The entire risk associated with the use of this site is on the end ACCOUNT: 32930
user.No representation is made that this web site will meet the MAP: 7502
specific requirements of any person or will operate error-free or BLOCK: 61
without interruption.All other conditions or warranties,expressed
or implied are disclaimed.In no event will the County or Atlas LOT: 46
Geographic Data,Inc.be liable for any loss of use,business OWNER_NAME: WHITE MARK G
interruption,loss of profits,loss of data or incidental/consequential OWNER_NAME2:
damages arising from the use of this web site.The County and OWNER_ADDR: 13605 DURHAMSHIRE RD
Atlas Geographic Data,Inc.make no warranties or representations OWNER_CITY: MIDLOTHIAN
as to the accuracy of information on this web site,nor do they
assume any liability or responsibility for any errors or omissions in OWNER_STATE: VA
its content.It is the sole responsibility of the end user to evaluate OWNER_ZIP: 23113
1 of 2 10/2/2020, 10:08 AN
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ROY COOPER
cove►nor
MICHAEL S. REGAN
Secretary
Coastal Management BRAXTON DAVIS
ENVIRONMENTAL QUALITY Director
BUFFER AUTHORIZATION CERTIFICATE FOR SHORELINE STABILIZATION
A riparian buffer authorization is required for shoreline stabilization activities within the Neuse and Tar-Pamlico River
basins per Division of Water Resources(DWR) regulations 15A NCAC 02B.0233 and 0259. The Division of Coastal
Management(DCM)through a Memorandum of Understanding with the Division of Water Resources(DWR) has
reviewed your project proposal and has determined that the project as proposed complies with the aforementioned
regulations.
Those activities covered by your Coastal Area Management Act(CAMA) permit have received Buffer Authorization
provided the project is constructed in a manner that continues to meet all of the conditions listed below. Failure to
comply with this Buffer Authorization may subject the property owner and the party (contractor) performing the
construction and/or land clearing to a civil penalty by DWR of up to$25,000 per clay per violation.
i. Impacts: Impacts to woody vegetation from clearing and filling in Zone 1(begins at the most landward of either
normal water line(NWL)or normal high water line(NHWL)and extends 30 feet landward)shall be minimized to
what must be impacted for the sound installation of the shoreline stabilization project. Unnecessary clearing and
• filling in the buffer is a violation of the riparian buffer rules.
2. Clearing& Grading:Clearing and grading of Zone 2(begins at the landward edge of Zone 1 and extends 20 feet •
landward) is allowed provided that it is re-vegetated immediately and Zone l_is not compromised,which includes
maintaining diffused (non-channelized)flow of storm water runoff through the buffer.
3. Construction Corridors:Construction corridors are allowed for shoreline stabilization projects, but they must be
satisfactorily restored as described in condition 5 below.
4. Potential Overwash: For vertical shoreline stabilization projects(bulkheads)only;sites where wave overwash is
expected to be severe,the first ten(10)feet landward(unless specifically authorized otherwise by DCM)from the
structure may be maintained as a stable lawn in order to provide for structural stability.
s. Temporary Stabilization: Immediately post-construction, bare soils must be stabilized as quickly as possible by
providing a temporary ground cover. Newly seeded areas should be protected with mulch and/or erosion matting.
This ground cover is a temporary measure used to address erosion until site restoration can be accomplished.
6. Site Restoration:At minimum,pre-project site conditions must be re-established.A site that was wooded prior to
this shoreline stabilization project must be restored with woody vegetation ata stem density of 260 stems per acre.
Non wooded sites may be re-vegetated with woody vegetation. Restoration must be completed by the first
subsequent planting season (November 1 through March 30)after completion of the bulkhead.
• Pre-project site conditions: / •�e-s ,�rpl/ 1
7. Project Drawing:The drawing on the CAMA General Permit is considered/ the project drawing of your property
indicating the location of the shoreline stabilization structure and anyassociated clearing,
grading,and construction
corridors.This drawing will be used to aid in compliance and monitoring efforts. l
By your signature below you agree to be held responsible for meeting all of the above liste," anditio s a r 4verify that all
in ormation is complete and accurate.
en or A plica Pr' me P Officer's .ture
Age - pl nt Sig ure Issue Date cc
9/CAMA GENERAL PERMIT#: r •
State of North Carolina I Environmental Quality I Coastal Management
Washington Office 1943 Washington Square Mall Washington.NC 27889 1 252-946-6 4 81
Wilmington Office 1127 Cardinal Drive Ext Wilmington NC 28405-3845 1910-796-7215
Morehead City Office 1400 Commerce Avenue Morehead City.NC 28557 1252-808-2808