Gooden, Stephen

I CAMA/ ❑DREDGE & FILL
QENERAL PERMIT Previous permit #
Npw ❑Modification ❑Complete Reissue El Partial Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environment and Natural Resources 1-(� { .1
and the Coastal Resources Con)mission in an area of environmental concern pursuant to I SA NCAC t +-i-! 1 ,~7�± %i
s j _! _ --�jtu es attached.
plicant_Name, �'� + �^� (�t( (� Project Location: County
Address _" j _t �' Street Address/ State Road/ Lot #(s)
City ( t + 'i, f' `_., .-State Z P "vi i �� N. 4
Phone #) i ,i- ►
#
uthorized Agent
4qW
�W `fr,pTA
❑ ES ❑ PTS
Affected ❑ OEA
AEC(s):
❑ HHF ❑ IH
❑ UBA ❑ WA
❑ PW ❑ FC:
ORW: yes /
PNA yes /
r60n Crit.Hab. yes / no
Type of Project/ Activity
Pier (dock) length
Finger pier(s) --) VI
Groin length
number
Bulkhead/ Riprap length "
avg distance offshore
max distance offshore —
Basin, channel---f
cubic yards" "
Boat ramp
Boathouse/ Boatlift1�
Beach Bulldozing
f�
Other
itrX 1
`Shoreline length _ `,mil
�SAV: not sure yesno j
Sandbags: not sure yes no
Moratorium: n/a yes no
iPhotos: es no
�Waivei Attached: yes n5
A building perMl
Notes/ Special
Subdivision
, "City � j-,1_:k. L,. ZIP , � �
Phone # ('r):': 'lM River Basin
Adj. Wtr. Body,HY", i-1 t �:. f�' (nat /man /unkn)
6 r,
Closest Maj. Wtr. Body-
(� * }1 �'
!
(Scale: j (—� r )
EMMMMINENNIVE ■■■®■U■■■■■■■■
k( 4 C" i f i ❑! See) dote on back regarding River Basi rules.
t yl�;
j _ ;
-�f1�t k'J �!'r� (�, r:�?it`' F ri ram'mr

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, certifythatthis project is consistentwith the North Carolina Coastal Management Program.
River Basin Rules Applicable To Your Project:
❑ Tar - Pamlico River Basin Buffer Rules
❑ Neuse River Basin Buffer Rules
Other:
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/ 1-8884RCOAST
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

Q
N.C. DIVISION OF COASTAL MANAGEMENT
AGENT AUTHORIZATION FORM
RECEIVED
APR 14 2015
Date DCM-I 1hD CITY
Name of Property Owner Applying for Permit:
54pk:eA G�en
Mailing Address:
I certify that I have authorized (agent) r'l 4 Ccqko act on my
behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to
install or construct (activity) CF- f
at (my property located at) 510
I
This certification is valid thru (date) RECEIVED
APR 14106
Property Owner Signature
Date
DGM-MHD CITY

Apr 1315 05,23p Lea Couch 919-477-6616 p.2
Bogue Banks Marine Const 2522474427 p.2
ADJACEKIRIEARIM pRoMn7ly fl1i1 H R STAT EUENe
e
i hereb, cerft that t ovin prop rtY ad'1acen� 30`Na opp�cGK,1 Ownn� -�
props located.fit 'Jti [I ��
(Ad rasa, Lot, $loch, Road, sic.
in _ �iE. Mc- � 5 "7 , N.C_
on tiltralrsrbadv} lCItIll I ass -tdlor Cou>my)
The aF plic ant has dasccibed to me, as shown below, the d°velopment proposed at the above
tarp'
05 � I have no objection to this proposai.
I l;2Ve objeC'ions to this proposal.
!3FSCl?jnIar4 AND rOP. DRAWING OF PROPOSED UEVF-LUPFJr-W i
pro'Posfrra,�. ' cA9L�lopmerr€ must fold In oe, ctiptice hdovr car aMc;� a sira drawing)
j6,
1 understand that a pier, docic, mooring piimgs, breakwater, boathouse, rift, or groin rnL t be sat
back a minimum distance of 15, from my area of riparian access unless waived by rne. (If you
Wish to t-irahje the setback, you muSTE inir�i the appropriate blank below.)
i do wish to waive the 15' setback recluiremerIL
I do riot• wish to waive the 15'setback, requirement.
tiro -m; f-Awrar informat+-on)
Tber
-15—
(Adjacant imroparty ;Owner ii;fononaatl0n)
Sia-pa-urre ^L. 6Le-e-'4;<' 0.
P; rni or Type Man
`SIC ? o Zif y RECEIVED
�Leamon F. Couch, Jr-
APR 141m5
c/o Stoneybrook Farm
7311 Johnson Mill Road DCItA-MHD CITY
T Saharna, NC 27503
Data / - - 4G
41 -13 /,T! i'Revised WI &2012j

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I ovum property adjacent to S han 6ccde4l 's
- 4 (Name of Property Owner)
property located at J l O {-�-o�� LAA • M Elf
;� � a 2 5 $'7
on 1 ,SOUn (Address, ot,, l ck�adgK,,
''11--�� ��SS � N.C.
(Waterbody) (City/Town and/or County)
The appf' t has described to me, as shown below, the development proposed at the above
I have no objection to this proposal.
I have objections to this proposal.
DESCRIPTION ANDIOR DRAWING OF PROPOSED DEVELOPMENT
(Individual proposing development must fill in description below or attach a site drawing)
I
I r
et xiL
I understand that a pier, dock, mooring pilings, breakwater, boathouse, lift, or groin must be set
back a minimum distance of I & 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.
Owner Information)
i afore
� �oeao(�•V1
Print o Type Name
2-122 J=Jn114 Ln
Mailing Address
t,,A Hrt OJ C SS i
Cr /State0p
7 0[o - :3 as - 51 U G
TIT-9-
hone Number
T- 9 - 1-
Date
(Adjacent Property Owner Information)
RECEIVED
Si a APR 141015
�M
Pn� m r � peon -MHO een
-at7i g Ar)c(res�
Clty/Sta,(e ip _ scot
Telephone NumberNumber
4-1--15^
Date
(Revised 6/1 &2©12)