Gooden, Michael

14CAMA 1:1 DREDGE & FILL
L��
GENERAL PERMIT Previous permit #
qi4ew OModification E]Complete Reissue ElPartial Reissue 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 I SA NCAC
[D Rules att�a�hed.
Project Location: County
�Applicant Name
'
1cl
'Address Street lesRoad/ Lot #(s)
s/State
I I , \ : 11,�,/ v j 1 f StateY ZIP
,
City
Phone # Fax # Subdivision
V
ent
I— -- ZIP f, , � City
F-1 CAN Basin /41'
El EW 0 PTA FS 0 PTS Phone P-1 ;el (/ ­1 / 1,
Affected
AEC(s):
ORW:
El OEA
0 PWS:
4
yes / nd_,
0 HHF 0 1H 0 UBA 0 N/A
PNIA yes / no Crit.Hab. yes / no
Type of Project/ Activity _
Pier (dock) length o<?
Platform s
Finger pier(s)
Groin length
number
Bulkhead/ Riprap length
avg distance offshore --
max distance offshore
Basin, channel
cubic yards_
Boat ramp
Boathouse/ Boatlift
'Shoreline Length
ISAV. not sure yes doe
:Sandbags: not sure yes pp`
i Moratorum: n/a yes
I I I Al�
Adj. Wtr. Body di I\
Closest Maj. Wtr. Body
'Scale-
n /unkn)
Photos: es no
VaiverAttached': no
A building permit may be required by: El See note on back regarding River Basin rules.
Notes/ Special Conditions) It
4
Agent or A ermit ffice sAignature
-1 J-
pplicant Printed Name P
iX
4"A
ls;RgbAe I 6piratioln Date,
.,Signature Please read compliance statement on back of permit
Application Fee(s) Check #
Local PlanningJurisdiction' Rover File Name

t
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, certifythat this project is consistentwith the North Carolina Coastal Management Program.
River Basin Rules Applicable To Your Project:
0 Tar- Pamlico River Basin Buffer Rules 0 Other:
0 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/ 1-888ARCOAST
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

N.C. DIVISION OF COASTAL MANAGEMENT
AGENT AUTHORIZATION FORM
Date 3)l ) S
Name of Property Owner Applying for Permit:
Mailing Address:
4z 9 &Dune(
a9Ss-7
Ism ©'fa'e—
I certify that I have authorized (agent) hD3vQ V-- u n" mpy- �( n .c (YD' IS t . to act on my
behalf, for the purpose of applying for /and obtaining all CAMA Permits necessary to
install or construct (activity)
at (my property located at) D U rd -h� C'. ? S S •/
This certification is valid thru (date)
K
Signature
RECEIVED
MAR 19 1015
DCM-MHD CITY
3 lS
Date
RECEIVED
MAR 17 1015
DWO-N?Hp CITY

From: 2522474427 Page: 3/3 Date: 3112/2016 2:16:10 PM
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to 2orc LAn 's
(Narns of Prope�y Owner)
property located at �#Z►g $our+oi br>t k mile
w 7�' NC M5/
(Address, Lot,,Blo k, Ro , etc.)
on in iM , N.C.
(Waterbody) (City/Town ran !or County)
The applicant has described to me. as shown below, the development proposed at the above
10 io
' I have no objection to this proposal.
�►o�k I have objections to this proposal.
(fit _.......� ._
DESCRIPTION ANWOR DRAWING OF PROPOSED DEVELOPMENT
f7'?eJvldu81P>:'0p031n9 developrarent must iN In deserfP1kn betowr er attach a aite dmwfngj
rf-14 11 071 n Ulc�- a awn .
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boathouse, lift, or groin must be set
back a minimum distance or 151 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 Naive the 15' setback requirement. RECEIVED
MAR 19 2015
(P;; woe r an) djacent Property owner i $Ormartlon)
DCk4-MHD CITY
or T31ma Nam�e9 Print or inrr�v N e
nu ►�i_—_ rlp4l " f;res7r RECEIVED
eta' rg Address q s
f 1 arQ (i c. /46 &667 MAR 1 ? 1015
City/sta '
2a 9 t to
Telepho Nu TelephoMUMb7r
Date Date
(Revised 611aW12)
This fax was received by GFI FAXmaker fax server. For more information, visit: http:/Avww.gfi.com

yZ/ 9
fi4o reA cad (�f 14- &/ FS
n
D0L�L"
/ Pro posed
� i5�NAO
We
RECEIVED
MAR .19 2015
DCM-MHO CITY
RECEIVED
MAR 17 2015
DCM-MHD CITY

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to d aej �' 0ccwl-1 's
(Name of Pro a Owner)
property located at �iq �our�o( 1�r� we m nK 9F5 /
(Address, Lot, Blo k Ro d, etc.)
on , in i1/� , N.C.
(Waterbody) (CitylTown an/or County)
The applicant has described to me, as shown below, the development proposed at the above
loc ti
` � 1 have no objection to this proposal.
I have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(individual proposing development must fill in description below or attach a site drawing)
PWM)l 6 � � 7� � do J 1c,05=evi
co-n n-e - --Po
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boathouse, lift, or groin 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 -toy aive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
St at'u�re� "
pPfl�nt or TWe Name
L12cCi 1�0 �.
lCel<
Date
W&M
a'F5s7
RECEIVED
Mat11(Qs--
MAR 17 20b
P or Ty Name
S7 DEtvl-MFlD CITY
cltyi�t te�lp � a y_
TelephonMNber RECEIVED
3SJ Date MAR 19
DCM-MHD CITY
(Revised 6/18/2012)

a���e�0
d C,`-4- ", 6?/�> -SAD
D p
as ec� zo�
0
145rc�'�
PO4-aj,�'N'i vjct
RECEIVED
MAR 19 2015
DCM-MHD CITY
RECEIVED
MAR 17 20,.,
E�?f+9= Nfl 'ITY