Coughlin, Dan

❑LAMA / ❑ DREDGE & FILL
GENERAL PERMIT
❑New ❑Modification ❑Complete Reissue ❑Partial Reissue
As authorized by the State of North Carolina, Department of Environmental Quality
and the Coastal Resources Commission in an area of environmental concern pursuant to I SA NCAC
At
No 70926 A
Previous permit #
Date previous permit issued_
t,
Applicant Name .-G /i U r 0 t Project Location: County
❑RU%s attached.
B C D
Address Street Address/ State Road/ Lot #(s)
City State ZIP
Phone # Mail Subdivision'
Authorized Agent / 4 + ' ' City C.s' { ZIPfJf�'
❑ CW ❑ EW UPM El ES ❑ PTS Phone # ( ) River Basin
Affected ElOEA ❑ HHF ❑ IH ElUBA El N/A AEC(s): Adj. Wtr. Body (nat /man unkn
❑ PWS: ;
Closest Maj. Wtc Body J'' -
ORW: yes / no ' PNA yes / y6" 1
Type of Project/ Activity
(Scale: / )
Pier (dock) length
Fixed Platform(s) d
Floating Platform(s)
Finger pier(s)
Groin length
number
Bulkhead/ Riprap length
avg distance offshore_
max distance offshore
Basin. channel
cubic yards
Boat ramp
Boathouse/ oatlift_
Beach Bulldozing
Other
OWN
• . • � NMI.�No a� a "1;1 _�!
Agent or Applicant Printed Name
Signs% "Please read compliance statement on back f ermit
Application Fee(s) Check#
PermitOfficef's Printed Nqme r
Signature . ff',
S!. / x
Issuing ate 6piration 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, certify that this project is consistent with the North Carolina Coastal Management Program.
River Basin Rules Applicable To Your Project:
_j 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/ 1-888-4RCOAST 252-946-6481
Fax: [phone] Fax: [phone]
(Serves: Carteret, Craven, Onslow -
North of New River Inlet- and Pamlico
Counties)
Elizabeth City District
401 S. Griffin St.
Ste. 300
Elizabeth City, NC 27909
252-264-3901
Fax: [phone]
(Serves: Camden, Chowan, Currituck,
Dare, Gates, Pasquotank and Perquimans
Counties)
(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 - South of New River Inlet -
and Pender Counties)
http://portal.ncdenr.org/web/cm/dcm-home
Revised 7/06/ 17

A4
i!CDEHR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
Pat McCrory Braxton C. Davis
Governor Director
®ate / �-Or�
Applicant Name
Mailing Address
�f N C_O J j f ycJ
s /V C-
01
John E. Skvarla, III
Secretary
I certify that I have authorized (agent) L to act on my behalf, for the
Purpose of applying for and obtaining all CAMA Permits necessary to install or construct (activity)
A 7L / ► at (location)
r F J4 T n +�_ -�- /U
This certification is valid three (date)
Signature��'�
400 Commerce Ave., Morehead City, NC 28557 One
Phone: [phone] FAX: [phone] Internet: www.nccoastalmanagement.net NorthCaroaa
An Equal opportunity 1 Affirmative Action Employer Na&6'v19�"C`

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
�-
I hereby certify that I own property adjacent to Zi ; s
(Name of rotwrty wner)
property located at ---� / ( ,� �E��✓ ` F
on fit);f-rWS f-6-e ot- (Address, Lot, Block, Road, etc.)
in 1"2n'j a., , N.C.
(Waterbody) (City/Town and/or County)
The applicant has described to me, as shown below, the development proposed at the above
location.
-- x— I 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)
v
j�0' 4-A fir'
6 C '0 �
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boathouse, lift, or groin m+t
back a minimum distance of 15' from my area of riparian access unless waived by I{'you
wish to waive the setback, you must initial the appropriate blank below.)
JAN 2 2 2018
I do wish to waive the 15' setback requirement.
UTY
I do not wish to waive the 15' setback requirement.
DCM-
(Property Owner Information)
i
Signatu
Print o Type Name _
0c' 2)z4A alfc- a -
Mai �ng Address � a ---
City/State
Telephone Number
/-/-/s'
Date
(Adjacent Property Owner Information)
S'Anature
lL1ss u-�nr� e,
Print r
.2k
Tye Name,
�Y
�' ilin ddress I
i /State ip S
T e Nu ber ephon
(Revised 611812012)

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
hereby certify that I own property adjacent to `%iy_��/ ct" N,¢ �s ell s
(Name of Property Owner)
property located at
/ (Address, Lot, Block, Road, etc.)
on li" 4 r' .� 4�fr" 5c- k in 4�, N.C.
(Waterbody) (Cit /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.
have objections to this proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(Individual proposing developmen ust fil in description below or attach a site drawing)
�1
t�h,n
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boathouse, lift, or groin
back a minimum distance of 15' from my area of riparian access unless waived 'W
ED
wish to waive the setback, you must initial the appropriate blank below.)
IAN � 2 ?018
I do wish to waive the 15' setback requirement.
L,-' 1 do not wish to waive the 15' setback requirement.
Ctrj- MHD CITY
(Property Owner Information)
Signature
Print or Type Name
Mailing Address
City/StatelZip
Telephone Number
Date
(Adjacent Property Owner Information)
S.;ature
G /ley
P "nt or Type Name
(Revised 611812012)

i •
AMA / ❑ DREDGE & FILL
N2 7092 A B °'
GENERAL PERMIT
Previous permit # C/
QNew ❑Modification ❑Complete Reissue El Partial Reissue
Date previous permit issued
As authorized by the State of North Carolina, Department of Environmental Quality
and the Coastal Resour Commission in an area of environmental concern pursuant to I SA NCAC
.6
Applicant Name UC ``�-
pp ! t�
Project Location:
�fes,attached.
�
County (,,._
Address C 4
Street Address/ State Road/ Lot #(s)
City. {, r State we ZIP l ,i f l _
1 1 4 C `tL, , .r'l e. {
Phone # =: LMail
Subdivision
Authorized Agent ''
City
Affected ❑,Cw 0 E%V ❑,RTA ❑ ES ❑ PTS
Phone #" (
) River Basin
❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A
AEC(s):
Adj. Wtr. Body
� G nat.:' man unkn
❑ PWS:
j'
ORW: yes / no PNA yes / l
Closest Maj. Wtr. Body
Type of Project/ Activity
Pier (dock) length
Fixed Platform(s) 2 .
Floating Platform(s)
Finger pier(s)
Groin length
number
Bulkhead/ Riprap length_
avg distance offshore
max distance offshore
Basin, channel
cubic yards
Boat ramp
Boathouse/ oatlift ,.i j ,
Beach Bulldozing
Other
Shoreline Length-
SAV: not sure yes o`
Moratorium: n/a yes d
Photos: yes
Waiver Attached: yes
A building permit may be required by:
( Note Local Planning jurisdiction)
Notes/ Special Conditions
g -y co k
il
Agent or Applicant Printed Name Permit Off
Sign to Please read compliance statement on back of permit* Signature
IicationFee(s) Check# Issu
(Scale: ''
❑ See note on back regarding River Basin rules.
on Date