73836A_Golden, Pamela L._20190815

CAMA / __i DREDGE & FILL
GENERAL PERMIT
IXNew —Modification ❑Complete Reissue
No. 73836 �y
Previous permit #
V B C D
❑Partial Reissue Date previous permit issued
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 15A NCAC r� I �L' `—
l 0 Rules attached.
Applicant Name
Address jj q 001XV0 c
City '� �n car State Ne ZIP 53
Phone # ('_! , , ,) 7Y-'P_ - 9L''E i E-Mail�� c(' t� ►���G�►►u�j
Authorized Agent T - „ L, ! l
Affected El CW CREW ®PTA RtES LkPTS
AEC(s): ❑ OEA ❑ HHF ❑ IH ❑ UEFA ❑ WA
C PWS:
ORW: yes / no-1 PNA yes no
Project Location: County
Street Address/ State Road/ Lot #(s) Loll y
i �q
rl�.�PSubdivision l-t
City 1_or ZIP �C �`-
Phone # ( ) River Basin ` Q oit
Adj. Wtr. Body j F, ri^o i I P (La7t�yma/n /unkn)
Closest Maj. Wtr. Body r 16 I.,a ?F � �.'
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Agent4 Applicant Printed Name `
i
Signature Please read compliance statement on back of permit'`
Application Fee(s) Check #
O"Cid'A'O koa4l�e4
PermitOfc s Printed Name
,• l
Signatur `
Issuing Date
2/fir
Expiration 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:
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

AGENT /riUT
w.H#iORIZATIQN FOR LAMA PERMIT APPLICATION
■w
I aoldeo
Name of Property Owner Requesting Permit: Leda L.
Mailing Address:
Phone Nunes:
Email Address
I Certify that I have authorized
97V Z
Agent I Contractor
14 ad on my behalf, for the purpose of applying for and obtaining all LAMA permits
necessary for the following proposed development, LJWg.J .^ al- 12�
at my property located at lot Y
in ou.'d--�1 County.
C&k D„ W., 1�6-
32-
1 furthermore certify that I am authorized tb grant, and do in fact grant permission to
Division of Coastal Management staff. the Local Permit Officer ano rneir aaenrs to o .
on the aforementioned lands in Connection with evaluating information related to this
permit application.
Tr�il�P �.. ��lG��✓I
<P'nt or Type Name
This certification is valid through 1

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
1 hereby certify that I own property adjacent to Pam Golden's property located at M
Coun Club Drive on the Albemarle Sound in Edenton. North Carolina.
The applicant has described to me, as shown below, the development proposal at the above
location.
1 hate no objection to this proposal.
j have objections to this proposal.
DESCRIPTION OF PROPOSED DEVELOPMENT
(individual proposing development must fill in description below or attach a site drawing)
Replace a portion of the existing bulkhead damaged by a recent storm. The replacement will include
a portion of the property located of 124 County Club Drive, Edenton, NC.
WAIVER SECTION
I understand that a pier, dock, mooring piling, boat ramp, breakwater, boathouse, lift, or
groin must be set back a minimum distance of 15" from my area or 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 waiv@ the 15" setback requirement.
(Pr a Owner Information)
signature
Pam Golden
Print or Type Name
124 County Club Drive
Mailing Address
Edenton, NC 27932
City/State/Zip
919.308.9984 [e-mail]
Telepho a Number/email Address
*Valid for one calenAaryear after signature*
(Adjacent Property Owner Information)
"Tom & Janet Mullen
Print or Type Name
126 Country Club Drive
Mailing Address
Edenton, NC 27932
City/State/Zip
252.482.1516 [e-mail]
Telephone Number/email Ad
Fate

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that 1 own property adjacent to Pam Golden's property located at UA
CouIlly Club Drive on the Albemarle Sound in Edenton. North Carolina.
The applicant has described to me, as shown below, the development proposal at the above
location.
I have no objection to this proposal.
I have objections to this proposal.
DESCRIPTION OF PROPOSED DEVELOPMENT
(Individual proposing development must fill in description below or attach a site drawing)
Replace a portion of the existing bulkhead damaged by a recent storm. The replacement will include
a portion of the property located at 124 County Club Drive, Edenton, NC.
WAIVER SECTION
I understand that a pier, dock, mooring piling, boat ramp, breakwater, boathouse, lift, or
groin must be set back a minimum distance of 15" from my area or riparian access unless
waived by me. (If you wish to waive the setback, you must initial the appropriate blank
below.)
1 do wish to waive the 15" setback requirement.
I do not wish to waive the 15" setback requirement.
Information)
Pam Golden
Print or Type Name
124 County Club Drive
Mailing Address
Edenton, NC 27932
City/State/Zip
919.308.9984 [e-mail]
Telephone Number/email Address
311al, .201-)
7alidfor
one calendaryear after signature"
Signature'
Allan T. Smith
Print or Type Name
122 Country Club Drive
Mailing Address
Edenton, NC 27932
City/State/Zip
252.482.1516 [e-mail]
Telephone N mber/email Ad
v�l �o
Date
(Adjacent Property Owner Information)

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NC Division of Coastal Mgt. Habitat Impact Computer Sheet
Applicant: �-am0ct &(Ct , yl Permit #:
Date: ca//
Describe below the HABITAT disturbances for the application. All values should match the name, and units of measurement
found in your Habitat code sheet.
Habitat Name
DISTURB TYPE
Choose One
TOTAL Sq. Ft.
(Applied 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
' 4
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Dredge ❑ Fill ® Both ❑ Other ❑
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Dredge ❑ Fill ❑ Both [a Other ❑
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Dredge ❑ Fill ❑ Both Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
252-808-2808 :: 1.888-4RCOAST :: www.nccoastaimanagement.net revised: 02/03/10