Gallop, Marshall A. Jr.

DAMA / DREDGE &FILL
GENERAL PERMIT
Previous permit#
Z�New ❑Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environment and Natural Resources f
�`�
� � (J �`�
and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC
_
71 .. ,
Applicant.Name
qRuleq
Project Location: CountY
attached.
Address j ' x j
Street Address/ State Road/ Lot #(s)
City a fi 'ii t i` ; State 1 ~ZIP__
_
Phone # (�cl, VtFax # (LL-_) (
Subdivision
_ _ ♦ ..
Authorized Agent t
City . r` r �' t - ZIP _
❑ CW CIEW PTA ES ❑ PTS^
Q
Phone # S��,r
( f River Basin i (C.,��.�_�:r�:.{
Affected
❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A
AEC(s):
Adj. Wtr. Body is Y a (nat /man'/unkn)
0RW: �y s' no PNA yes / �tol Crit.Hab. yes / no
Closest Maj. Wtr. Body
■■■■■■■■�■■■■■■■■■■■■■■■■■■■■
/i■■!�i lei►■■■■■
LII�tlil■■■■■■■■■■■■■■■■■■■■■■®■■■■■■■■■■
�n�■■
its■■�■■■■■■■■■■■■■■■■■■n■■■■■■■■■■
...
■
agent or ApplicantyPrinted Name Pe
1'f4f+ )
Signat re !� Please read compliance statement on back of permit ** Is ui
ApplicationFee(s) Check# 19c�
rmitOfficer's Signature
ng Date
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, certifythat this project is consistentwith the North Carolina Coastal Management Program.
River Basin Rules Applicable To Your Project:
Tar- Pamlico River Basin Buffer Rules 0 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 howto 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/ 1-888-4RCOAST
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

M TAVIslon 01 ComztnR VJ%p'�. Habltvn� lm'-pnvl� co-Inpliz"o—Y Z�Dt a�
Applicant:
Date:
Describe below the HABITAT disturbances for the application. All values should match the name, a ��of measurement
found in your Habitat code sheet.
Habitat Name
DISTURB TYPE
Choose One
TOTAL Sq. Ft.
(Applipd 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)
Dredge E] Fill X Both 0 Other 0
Dredge [I Fill 0 Both El Other El
Dredge E] Fill [] Both El Other [I
Dredge 0 Fill [I Both El Other 0
Dredge [I Fill El Both El Other El
Dredge E] Fill 0 Both [I Other [I
Dredge [I Fill El Both El Other El
Dredge El Fill El Both El Other 0
Dredge [I Fill El Both El Other El
Dredge El Fill El Both 0 Other 0
Dredge E] Fill [] Both [I Other El
Dredge El Fill [I Both [I Other 0
Dredge [I Fill El Both [I Other El
Dredge El Fill [I Both 0 Other 0
Dredge [I Fill El Both El Other El
2-32-808-2303 :: 1-8,38-4RCOAST :: revised: 02103/10

)ep.14. (ulj-, 4:ugrw, w No.46831 P. 71
EVAEHR
North Carolina Departrnent of Envlronmeni and Natural Resources
Division of Coastal Management
Governor Pat rnor Braxton C. Davis John, E. Skvarle, Ili
Director Secretary
ISM, -
Date #/
RECEIVED
Aqv4AA ItA.�-�114ApplicantNgme l� I � � OCT 01 2013
Mailing Address u 69 16 o x 71 DCM A1HD CITY
9
I certify that I have authorized (agent ' to act on my behalf, for the
purpose of applying for and obtaining all C A Permits necessary to install or construct (activity)
iew ZZ weq M 4fp 41 /YC. a (location)
/V C
This
\, Signature
valid
Z S'Z-9,?7"Z.2 OD
OF
400 Commex* Ave., Morehead C 1y, NC 2W
Phone:26Z8082808%FAx-252.247.3330 Wemetwww,nc=ylalmar,egema►u,net
M Epud 0FPNWmlf+lAffimwl f Aeft rm&yof
NOne�tvar'0 � a
at�rr�
9/1 'd SD6 'ON
wVWO1 Elaz '1 '130

ADJACENT RIPARIAN PROPERTY O NER STATEMENT
I hereby certify that I own property adjacent to ' Gii%1!1r�LLa
property s
Property located at S!/ � �p � � (Name of p rty Owner)
W (Address, t_at, Block, Road, etc.)
in
(Waterbody) ' Y`~" , N.C.
(CitylTo and! r County)
The applicant has described to me, as shown below, the development proposed at the above
location.
�lS I have no objection to this proposal.
I have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(Individual proposing development must flll in description below or attach a site drawing)
"AlKIV A4,eilFod,01 - It*au1 kirl`,'�1
RECEIVED
OCT 01 2013
DQU MO CITY
WAIVERSECTION
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 to waive the 16 setback requirement.
/2-1 A I do not wish to waive the 15' setback requirement.
(Property Owner -information) (Adjacent property Owner Information)
1
S gnature Signature
d M1�N��'� Av,d�
Print *vpe Name C. Print or Type Name
M ilin ddress
Mailing Address
City/StatWZfi Clty/StafelZip
-Z s >6 y 0.3 v.�
Telephone Number 9.11 Telephone Number
1 Date - 3v -ice° a ova
Date
(Revised 61IN012)
9/6 'd SW 'ON hM:01 M6 '[ '100

ADJACENT RIPARIAN PR PERTY OWNER STATEMENT
I hereby certify that I own property adjacent to w&rA
's
Property located at (Name of Property Owner)
on Cif (Address, Lot, Block, Road, etc.)
,�, in `� .-- �- , N.C.
(Waterbody) (Cityrro and/ r 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 PROPOSED DEVELOPMENT
(Individual proposing development must rill itr description below or attach a site drawing)
ZN�i�LL iv
RECEIVED
OCT o 1 209
DCM'NMD CITY
I understand that a pier, WAIVER SECTIQN
p 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 to waive the 15' setback requirement.
I do not wish to waive the I & setback requirement.
(Pro Arty/ Owner Information) (Adjacent Property Owner I formation)
a
49nature
Signature
d
tint or Type Name / n
TYPO Ns e��+`,�`f`
M ilin ddress
cc Address
City/State2ip --22ac City o aten;s.,. �i�q
—
Telephone Number "g,
Telephone NUfter
Date D
bate~
(Revised 6/18/2012)
K 'd SD6 'ON NVW01 Eloz '1 '130