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GENERAL PERMIT Previous permit# A B C
New ❑Modification El Complete Reissue ❑Partial 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 .
r,...- ( p Rules attached.
Applicant Name Z' � .1 A >1 j Project Location: County �''jr1'-'r
Address Cf �s .' -�'+�r ��;; r "� Street Address/ State Road/ Lot #/ (s)
City { � Statel�l ZIP �� 0'7 �r,�(� i�"G /�� crlJ^ �r
Phone # E-Mail Subdivision -�
j
Authorized Agent 1� r'n �� � - i �, �► , i'% City 4 AT,-" + ZIP� ! �
Affected ❑ CW/ -p EW a13 PTA ❑ ES ❑ PTS Phone # ( ) River Basin s^ ►!;
it
❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A r
AEC(s): Adj. Wtr. Body * -'* 1 i,<-�((� (Inat /man /unkn)
❑ PWS: { 0
�..� Closest Maj. Wtr. Body
ORW: (yes,Y no PNA yes /rno /
Type of Project/ Activity r �J' i ! 3 �� �� e J r
Pier
Fixes
Floa
Fingi
Groi
Bulk
Bash
Boat
Boat
Bea(
Othi
Shor
SAV
Mor
Phoi
Wai,
(Scale: f )
MEN
ME
MOMME
ME
MEMEM
i length
MEN
immoOMMEN
M
EMP101
M
MEE
MUMUNMEEMM
number
=NEEMMMMMMMEMMM
Emu
MEMIN
avg distance offshore
MEN
max distance offshore -
BOB
cubic yards
Wom
—MEN
MENEM
-1
MEN
NNEMOMMEMEMOMMINIV.
Bulldozing
EUMMANNEEMEMMEM
ME
NONE
0DOEM
MEN
M
MENEM
not sure yes
No
torium: n/a yes
ENOMMEN
No
ONE
fs: yes 60
ENNEMMINE
6
Wom
.&NNEEMMU",
0001111111111
0
MEN
:nrA,r!;.cVed: Vas li,
MEMMEMEMOMIN
EMMAMENMEMMINTO
memn'T'll
A building permit may be required by:
( Note Local Planning Jurisdiction)�j
Not�sj,Special Conditions
�, C '� ('i ^ ❑ See note on back regarding River Basin rules.
Agent or Applicant Printed Name
Signatur. ** Please read compliance statement on back of permit*
Application Fee(s) Check #
PermitOfficer's Printed Name
Signature I
,i.��li 1��'�lt
h
Issuing date Expirab n 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, certifythatthis project is consistentwith the North CarolinaCoastal 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 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/ 1-888-411COAST
252-946-6481
Fax: [phone]
Fax: [phone]
(Serves: Carteret, Craven, Onslow -
(Serves: Beaufort, Bertie, Hertford, Hyde,
North of New River Inlet- and Pamlico
Tyrrell and Washington Counties)
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)
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://www.nccoastaimanagement.net/
Revised 08/27/ 14

Oct 021510:55a
' '
Brooks Dredging
2525044744 p.2
I hereby certify that I own property adjacent to L
property located at GZZ (N
(Address. Lot, Bloct
on .oft ��� , in
(Waterbody) (�
J5 \a. 's
ame of Property Owner)
Road, etc.)
,1� . G-��-r (.�.� r��, N.C.
:ity/Town and/or County)
The applicant has described to me, as shown below, the; development proposed at the above
location
I have no objection to this proposal.
I have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF
Ondividual proposing development must MI in de
WAIVER SECTION
I under � and that a pier, dock, mooring pilings, boat ramF
must be set back a minimum distance of 15' from my are;
me. (If you wish to waive the setback, you must initial the
I do wish to waive the IF setback requiremer
I do not wish to waive the 15' setback
ED DEVELOPMENT
below or attach a site drawing)
i
RECEIVED
OCT 0 2 2015
DCM- MHD CITY
breakwater, boathouse, lift, or groin
of riparian access unless waived by
appropriate blank below.) RECEIVED
ner Information)
(ATc
ent F
Statwre 'yl.
rint or Type N me
S,
194qat
P 'nt or
re*
Type
6 II��I
ftr
W7iFfi a Addre s ' �.S
Civs6te/Zip
Telephone Number/email address
Mai .
City/St
Telep
relZi
ne N
Date
Date*
Owner
OCT 0 9 2015
4-441-I CITY
ation)
me
i c
)er/emai address
'Valid for one calendar year after signature'
(Revised Aug. 2014)

Oct 021510:55a Brooks Dredging 2525044744 p.3
ADJACENT RIPARIAN PROPERTY O NER STATEMENT
�r at:-
l hereby certify that I own property adjacent to vrt%kc � L 's
( ,ame of Property Owner)
property located at b�D �uh%-r:. Gf�.•��
(Address, Lot, Blocl c, Road etc.)
on Lae / -D�� , in MLA�(.;-r N.C. .
(Waterbody) ( ity/Town and/or Cou ty)
The applicant has described to me, as shown below, the,development proposed at the above
IocaGon.
have no objection to this proposal.
i
have objections to this proposal.
i
DESCRIPTION AND/OR DRAWING OF PRO 30SED DEVELOPMENT
(Individual proposing development must 1711 In descrip Yon below or attach a site drawing)
ECEIVED
zii;
OCT 0 2 2015
1
iD CITY
WAIVER SECTION:
I understand that a pier, dock, mooring pilings, boat ramp, breakwater, boathouse, lift, or groin
must be set back a minimum distance of 15' from my are a of riparian access unless waived by
me. (if you wish to waive the setback, you must initial the appropriate blank below.)
RECEIVED
I do wish to waive the 15' setback requireme t.
11 do not wish to waive the l5' setback rer• OCT o 2015
( Owner Information)
grt toreil 11) - (.1 J-� 79y (5 r
Print or Type Nam _ J
Mai#ng Address
Telephone Number / email address
)I n d at 7R k'(A) *4 V, 1i 1 0 i_I
Date
'IJI-y't. "Ie"
'Valid for one calendar year after signature'
iIt;ment.
t Property Owner Inf
:�.
at jr-e*yji cv4
Print o47�ype Name
.nn_ E. S.
'/ le: 1
amity/ t I tezzip
Teleph ne NunRbqr/
Date' 7 /
fo
2
'Z.46o6c)
ail address
/j
MHD CITY
(Revised Aug. 2014)

Oct 02 15 10:54a
Brooks Dredging
m
2525044744 P.1
Ali! N
le e
RECEIVED
OCT 0 2 2015
DCM- MHD UTY
RECEIVED
OCT 0 9 2015
DCM- MHD CITY

Oct 021510:58a Brooks Dredging 2525044744 p.1
AVG/10/2015v740- 08:44 AM White Oak Commercial FAX No�1 919 632 8043 P. UO2
,vg 061510:40a Brooks Dredging 2525044744 p.1
Name of Property Owner Applying for Permit -
Mailing address:
Telephone Number:
I certify that 1 have authorized
J�a
to act on my behalf, for the purpose of applying and
necessary for the proposed development of
at my property located at
This certification is valid through
(Property owner Information)
Signature
Print or Type Name
Title, co. owner or trustee for property
6 i.5
Date
dig- 3z.� G Pad
Telephone Number
Saito q.
Ema' Address
,J
W. A,/O44 apt.
(agent/contractor),
ktaining all CAMA permits
Q r�G 1JC -
(date).
RECEIVE®
OCT 0 2 2015
®CM- MHU 'Ct : V
RECEIVED
OCT 09E 51
®CM- NIHC
�TF

a>•
earth feet 400
meters 100
RECEIVED
OCT 0 9 2015
DCM- MHD CITY