56957_GALLOP, MARSHALL_20101029

�❑ CAMA / ❑DREDGE & FILL
GENERAL PERMIT i V Previous permit#
L New ❑Modification ❑Complete Reissue El Partial Reissue A_ 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
Address
City State ZIP'' i
Phone # O Fax # ( )
Authorized Agent
❑ CW ❑ EW -j PTA
Affected
AEC(s):
o OEA ❑ HHF ❑ IH
❑ PWS: ❑FC:
ORW:
yes / no PNA yes / no
E ES ❑ PTS
0 USA ❑ N/A
Crit.Hab. yes / no
Project Location: County
Street Address/ State Road/ Lot #(s)
Subdivision
City ZIP r?'
Phone # ( ) %- 7`� ' River Basin
Adj. Wtr. Body (nat /man /unkn)
Closest Maj. Wtr. Body
SEEN
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Agent or Applicant Printed Name
Signature Please read compliance statement on back of per i
Application Fee(s) Check #
;_—
PermitOfficer's Signature
Issuing Date Expiration Date
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 complywith 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.
(Serves: Carteret, Craven, Onslow -above
Raleigh, NC 27604
New River Inlet- and Pamlico Counties)
919-733-2293
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)
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

NC Division of Coastal Mgt. Habitat Impact Computer Sheet
Applicant: Marshall Gallop
Date: 11/9/10
Permit #: 56957C
Describe below the HABITAT disturbances for the application. All values should match the name, and units of measurement
found in your Habitat code sheet.
Habitat Name
DISTURB TYPE
Choose One
TOTAL Sq. Ft.
(Applied for.
Disturbance total
includes any
anticipated
restoration or
temp impacts)
FINAL Sq. Ft.
(Anticipated final
disturbance.
Excludes any
restoration
and/or temp
impact amount)
TOTAL Feet
(Applied for.
Disturbance
total includes
any anticipated
restoration or
temp impacts
FINAL Feet
(Anticipated final
disturbance.
Excludes any
restoration and/or
temp impact
amount
Open Water
Dredge ❑ Fill ❑ Both ❑ Other O
138
138
Dredge ❑ Fill O Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
252-808-2808 :: 1-888-4RCOAST :: www.nccoastalman Nement.net revised: 02/03/10

RCDENR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
Beverly Eaves Perdue, Governor James H. Gregson, Director Dee Freeman, Secretary
Date ///,3�/0
RECEIVED
Name of Property Owner Applying for Permit: OCT 15 2010
^W6 o jq4 �v . Morehead City DCM
Mailing Address:
P p Box 7/Oa
ockv Nou,%f' /%C Z
I certify that I have authorized (a2ent)9044ie /'Vejb r��M! CO Hit- to act on my
behalf, for the purpose of applying for and obtaining all CAAMA Permits necessary to
install or construct (activity)% D D�% L �. / i o H o ! CX� S�� K 1 Dr/0 Ck�e�f ff
at (my property located at) 0Z p ,G ;et c V & l'j.0Y -
This certification is valid thru (date) Oelb)& v d % Z o/ o
Property Owner Signature
Date
400 Commerce Avenue, Morehead City, North Carolina 28557
Phone: [phone] FAX: [phone] Internet: www.nccoastaimanagement.net
An Equal opportunity 1 Affirmatve Acton Employer — 50% Recycled l 10% Post Consumer Paper

SEP-13-2010 13:04 From:FAX AREA 12529378100 To:19198636622 P.2/3
ADJACENT RIPARIAN PROPERTY OWNER STA,TFMENT
(FOR A aPIT&MOORIIYG PILINGS/BOATLIFTIBOAT,rHOU,SE) ,MC11VED
I beraby certify that I own property adjacent to rt V.S lot 11 i7_� 6,* _ J0P.,,
(Name of Property Owner) T
property located at 2 fOLf V w, Wrehead City DCM
/�j s �% (Lot, Block, Road, etc.) %
on v✓ h b� H Y lil f4t t`✓O► f✓t� .x ! N.C.
(Waterbody) (Town and/or County)
Applicant's phone 4: 967 qnd W Y �a6 Mailing Address: PO AeX Ze)00
,WO_Ck Il AddI- wt -, Al4f Z 70PO
He bas described to me, as shown below, the developramt be is proposing at that location, and,1
have no objections to his proposal. I understand that a pier/mooring pilings / boatlift ! boathouse
must be set back a rninimwn distance of fifteen feet (15) from my area of riparian access unless
waived by me. (if you wish to waive the setback, you most initial the appropriate blank
below.)
I do riot wish to waive
�T C/YrV I do, wish to waive that setback regWroment.
DESCRIPTION AND/Oil, DRAVVU4G OF PROPOSED DEVELOPMENT:
(To be filled in by indtvfdual proposing developnwnt)
�Xi.t �,, 4 d l ac f[ abo
(Information for Property Owner Applying
for Permitl
P013.)e 7/ao
Mailing Address
City/StateMiplT
ZXZ 737 --t ZOo(8) .-7 C�'rlij
T one N b
stp ature Date
(Riparian Property Owner Information)
Sign ature
3'stwYej tr, j+fask•� j J-_ .r DYE+ o
DeIFa 1, Gat k"C
Print or Type Name
r Telephone Number
� /13 ,6
/ / Y
C> C N/rw /-1 0v. Date
Cst,. tra 14f x3�P� JU rr

SEP —13-2010 13:09 From:FRX AREA
12529378100 To:ROC P.3/3
—'s
1 ul�- �-SA
RECEIVED
2010
morep".0cl city Dow
4.,F.,DAIF Vf

1P
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/MOORING PILINGSIB�jOATLIFTBOAATHO USE)
I hereby certify that I own property adjacent to r "/ a 0,$),W 11,4- Ll A mo p J-y-, 's
(Name of Property Owner)
property located at; % O F L' -W c v -c 1 S V V.
(Lot, Block, Road, etc.) ll
on �a � u e .� O K r1 oK in .�i? eV * )A2 �S /� N.C.
(Waterbody) (Town and/or County)
Applicant's phone #: ZS Z ` io3 -{��a6 Mailing Address: P D -9 `X 7,10 p
ADD. ky1-04-,k AI C Z 7eOy
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. (If you wish to waive the setback, you must initial the appropriate blank
below.)
I do not wish to waive
I do wish to waive that setback requirement.
------------------------------------------------------------------
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
/41 O cY % T i . C a k 0 Yl 0 � e is / . -S /1, Yt x 0 C /r-
Gt
bCa -� l T f 4 e v a H-ttkeX .40d`� I vaN" .
RECEIVED
--------- ------------------------------------------- ------0 C T 5 2010
(Information for Property Owner Applying
fox,permit)
Dc0 7/0 0
Mailing Address
ock. /06k�f, �V c z7roy
City/State/Zip
(Riparian Property Owner Information) MOteheadCity DCM
Signature
R abev �- �%eaJ��fS
Print or Type Name
ZSZ-i37-zLOa�t).�y 2-go3���io6�<.� 919-701-6zz6,
TelKie Number / Telephone Number
9113)�
Signature Date 2. ! 0 6 E,"'.� U �� Date
= C1 a « rile N C

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SAMMIE E. TURNER
MARINE CONSTRUCTION ACCT
252-725-3415
P.O. BOX 1885
MOREHEAD CITY, NC 28557
PAY
TO THE
ORDER OF
C)b �l,o
4937
66-112/531
DATE L .,-;t - i " 2O
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BRANCH BANKING AND TRUST COMPANY
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