77752D - Gage

0 , CAMA / DREDGE & FILL ND 77752 A q C
GENERAL PERMIT Previous permit# Tell (
)PC '__ New . ❑Modification Complete Reissue Partial Reissue Date previous permit issued L/267/.-0
As authorized by the State of North Carolina, Department of Environmental Quality ( � n
and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC 01- 1 k 1"
f D Rules attached.
A Applicant Name CC AAA (34G.a.-- Project Location: County �n�,,, ,C�J
Address 2 101 6.Y 0 t c i (..)rQ. Street Address/State Road/Lot#(s) I r Z.
City _ ,,jr-ex nSt.0oit) State \-k ZIP 2 O(0 f \( i I l br
Phone # ( ((i) yLjZ CI(o}(I E-Mail JJ` 2Cx�l ��/�tlw0 r, Subdivision
Authorized Agent City ‘--\o i 1JC'6-c (^ ZIP 2 `A(GZ--
Affected ❑Cw 03,EW Et PTA ❑ES ❑PTS Phone # ( ) River Basin L14
AEC(s): ❑OEA ❑HHF ❑IH ❑UBA ❑N/A Adj.Wtr. Body GI'1(. l (na 4,IM /unkn)
0 PWS:
ORW: yes(no; PNA yes C no Closest Maj.Wtr. Body - \W
Type of Project/Activity ,,\ ••\\ kg ..J A,. .. , `�( � i^ ,.., x 1(r, f au fin
` .(_ - 9 y CI. 1.,—A,,, c,\,,;- (Scale: N 'T S )
Pier(dock)length
I I
Fixed Platform(s) " { I
Floating Platform(s) gY 1(C y III, t I Ca
I /'� I
r..•
Finger piers) n'Lt i i
Groin length _ t
number 1—. i
Bulkhead/Riprap length j ' . (clieD I
avg distance offshore
max distance offshore
•
Basin,channel ;, a j
cubic yards i 1 '
e 1 C I
Boat ramp 1 I I
Boathouse/Boatlift i --- -- ; '- j
--- j k ---It---._-- ,
Beach Bulldozing I .l4,.%.‘W 1\VA
Other ` ' i
I v it ,n/i
I
Shoreline Length SUf C `i�``�1 Pt d(� A J y- ? , Fe t' '( 0"I
SAV: not sure yes no
Moratorium: n/a yes no , L
... 1 - ----- -- — I .--._..... ..__._ ._.
Photos: yes I i ... i _ I --r r-
Waiver Attached: yes : -
A building permit may be required by: A(..Sk '^ 6,,,, c.‘ LI See note on back regarding River Basin rules.
Note Local Planning Jurisdiction) _ � 1
Notes/Special Conditions .-, t� (-) C-%"`) c At-,- w& n 04- (04- ►\k f,,,wklntn i1‘ OG.e•`,C.."Sv43c.ce--S J
P-.7S.-C,— M t'M%LA- \ r e n A,G. r 6 c I L
Agent or Applicant Pnnted Name Permit OfficeriPtinted Name ("1\ \<........„,
\ � —
Signature *"Please read Signature compliance statement on back of permit'"'* •
°"-- C-12c402 , 2ip Z OL1 C 12-(oIw11
Application Fee(s) Check# Issuing Date f 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 I)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 (252-946-648I) 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/ I-888-4RCOAST 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 Wilmington District
401 S. Griffin St. 127 Cardinal Drive Ext.
Ste. 300 Wilmington, NC 28405-3845
Elizabeth City, NC 27909 910-796-7215
252-264-3901 Fax: [phone]
Fax: [phone] (Serves: Brunswick, New Hanover,
(Serves:Camden,Chowan,Currituck, Onslow-South of New River Inlet-
Dare, Gates, Pasquotank and Perquimans and Pender Counties)
Counties)
http://portal.ncden r.org/web/cm/dcm-home
Revised 7/06/17

Allik CAMA/D DREDGE&FILL N9 7775') A 4 C
.1
ENERAL PERMIT Previous permit# I I
,` New DModification DComplete Reissue DPartial Reissue Date previous permit issued Le
Ertl 2-0
As authorized the State of North Carolina.Department of Environmental Quality , 1 t �
and the Coastal Resources Commission in an area of environmental concern pursuant to I5ANCAC 01-1'1,
°Rules attached.
Applicant Name E `'TC PA;k� (7 Project Location: County kSftis _1 -
Address �V6 rU I Ut C Pr. Street Address/State Road/Lot#(s) r I Z
' City LN•t¢4S(D o n1 State VC- _ZIP 2"i OW MGr t t"^ ( i.
Phone#(f3(p) 942�t(P.3 E-Maii..854x0(a'+t P/41100_co Subdivision
2Ss 2_r?G.c k ZIP `t Ev
Authorized Agent City �-`v� �. �"
Affected O CW MEW I PTA DES OPTS Phone# (_) River.Basin L i..tt4ve.�
❑OEA . ❑HHF ❑IH ❑UBA ❑N/A u
AEC(s): Adj.Wtr.Body C+�4 - , fna IGr '1--)nkn
O PWS: :. A.--�W
ORW: yes( PNA yes no Closest Ma).Wtt Body
Type ofProject/Activity .". a .... c(..t^S Etta( t.,, O k X.( fiec I t j
CtuLL_. c. 9 .y(-I' L.c,., ►, c'oezt- . . - • • . (Scale: N -I
,S )
Pier(dock)length
Fixed Platform(s) 1 "I 11� l 11 ! j I ! ! 1 ! l ! I
FloatingPlatform(s)} Vito(-J:K — — ' i. i._ 11_ —�' ! !T.
——7, i
Finger pier(s) ( ,.— 11 l i�! — �-"" i jj^�_ tI _� -t i
Groin length - . -i--� f !_1 'S ! ! r !—E1— f i i 1 ' I i —['. .� i
number r _ `l is 1 __ j••;_ I , _•1—i J i� I I I I
Bulkhead!Riprap length _ ! i 1 I l i I
avg distance offshore 1 _ld!!___�,,� t(, ( ! 1 1 ! . i I ,
max dance offshore I I i 1 ! i 11 1 1 I i I i I
Basin dented —--- j i i _1 I__ _i ii
Sa
cubic yards I ! l 't j I t I
Boat ramp ! I -I � I l r i ! 4� l J E I ! I i I •!. ' ! 11 ,
Boathouse/Boadift '——_ — II_—^_1 i—i. —^ 1��� I f III �I I 1
_ 1
Beach Bulldozing I i J 1 ^ —r-- (4 1 V`/ ,j7 i lt-iHw _ i
Other i 'I I i 1 1 I I. ....I. I I i I I
.. —1 I L ! 1 l 1. .
Shoreline Length �Ut 1 roJLL
. 1 Ws bie‘j
spy: not sure yes I I I._ �— — ��t-i -�!-i— —' ---j----i-- �—4—
i_}_ _ _��lY i .n�f;-—.___.`,\"i -ram n\_l r 1 _ , 1`w�4r1�t?
Moratorium: n/a yes $p :: :±
i I I _ I t I !.._ �— I I I yi
yes ——r —— 1:--�-—1 Z_ _photos: I j— , . _�_WaiverAttached yes 4 -- OS
� ` _ ! _.I—~ 1 i ! -
A building permit may be required by: r 1(St Le\ ( C C k - - 0 See note on back regarding River Basin rules,,
(Note Local Planning Jurisdiction ( y�
Notes/Special Conditions ` 7c'citA-•. .C.auk t�-� w k\� n.54 IQ.: 3,,..1 f.,, .�. iri_()t�r',�n -
.
I - .. , +tenon 1 roc L
Agent or red Nam PermitO ice' nted Name
(.>\
Signature Pleas ' d compliances mencon back of permit" Signature
2 L Z \ Zip i 2-0Zt_ s ZIr
Check ck# • Issuing Date ZOZ
i, ApplicatlonFee(s).
Expiration Da e``
i I
Scanned with CamScanner

NC Division of Coastal Management r„ o �3 A B CCD)
Cashier's Official Receipt
• Date: 20 z"
Received From: J
Permit No.: -7-1�' Check No.: 1��'ice
Applicant's-Name: % C �`' County: �� `^S.-�c I
1t +�
Project Address:
Please reta r ipt for your co s as proof of payment for permit issued.
Signature of Agent or Applicant: Date:
r-1 1
Signature of Field Representative: ' ' • I---- `_ " Date: i` 2-U/Z-I
Scanned with CamScanner

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. AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION
•
Name of Property Owner Requesting Permit: Greg and Alita Gage
• Mailing Address: • 2909 Charolais Dr
Greensboro NC 27406
Phone Number: 336/442-9676 or 912/655-7749
Email Address: ggage2001 @yahoo.com or [e-mail]
I certify that I have authorized N/A
Agent!Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits •
necessary for the following proposed development:
•
at my property located at
{
in County.
I furthermore certify that I am authorized to grant, and do in fact grant permission to •
Division of Coastal Management staff, the Local Permit Officer, and their agents to enter
on the aforementioned land 's connection with.evaluating information related to this
permit application.
Property 0 ormation: r •
. gnature --
Pri or Type N me
•
OC,111-fe —
Title
I e
Date
This certification is valid through / •
/
. i
� f

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
LE NARD FERGUSON
I hereby certify that I own property adjacent to 's
property located at _ 110 MARLIN DR (Name of Property Owner)
. CANAL (Address, Lot Block Road etc.
, in HOLDEN BEACH
, N.C.
(Waterbody) (City/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 PROPOSED DEVELOPMENT
(Individual proposing development moist fill in description below or attach a site drawing)
1- - •
t
161
se-Y18' y' co r\ c)(+)rf41-)
01
AS I
pry
WAIVER SECTION
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 15'setback requirement.
I
do not wis • ive the 15'setback requirement.
(Pro Owner I for/ • (Adjacent Property Owner Information)
rt
Sign re Signature
GREG GAGE LEONARD FERGUSON
Print or Type nn�ame Print or Type Name
2909 CHAROLAIS DR 9415 FERGUSON RD
Mailing Address Mailing Address_
GREENSBORO NC CHARLOTTE NC
City/State/Zip 336/442-9676 City/State/Zip 704-578-5310
Telephone Number Telephone.Number
\aLl/2o t8-ao
Date Date
(Revised 6/18/2012)

, - ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
,
I hereby certify that I own property adjacent to LYERLY AL LYNWOOD JR 's
property located at - 114 MARLIN DR (Name of Property Owner)
CANAL (Address, Lot Block Road etc.)
on
in HOLDEN BEACH , N.C.
(Waterbody) (CitylTown 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 PROPOSED DEVELOPMENT
(Individual proposing development must fill in description below or attach a site drawing)
P '
gor Dock &Jere-
J
as'
c�'
Ovl f P.r
4-77
'1.)‘ -k- (t) 0, Lt'
am.
t C WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boathouse, lift, or groin must be set back a I'
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
I do wish to waive the 15'setback requirement.
i
I do not wis • ',,-ive the 15'setback requirement.
(Prop; 0 ner Infor •tion (Adj ent Pr erty Owner In ormation)
t' 11.'!!�e r---
GREG GAGE Signature LYERLY LYNWOOD JR
Print or TypeNalneCHAROLAIS DR Print or Type Name
2909 5312 GOLDMINE RD
Mailing Address Mailing Address_
GREENSBORO NC moNROE NC
City/State/Zip 336/442-9676 City/state/Zip 704-589-2728
Telephone Number Telephone Number
a'2/7/9 11511
Date Date
{Revised 6/18/2012)

•
•
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