79963D - Gold

0.. CAMA / DREDGE & FILL N9 79963 A B C 47
GENERAL PERMIT Previous permit #
��-� New EModification ❑Complete Reissue Partial Reissue Date previous permit issued f
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 5A NCAC 014-k an0 •
/ 6,,Rules attached.
Applicant Name ��� Qne L( � �� °�s�,~� k'�'��S Project Location: County r..As,,_ f r'L_
c v n l -�
Address�5�� � t^ 5 S Street Address/State Road/Lot#(s)
City . i._ 'A1u • State Li(-. ZIP 2.g va 2-
tit
Phone # (lb) Cf 7;`) I E-Mail - Subdivision
Authorized Agent City ZIP
Affected CW [EW A DES ❑PTS Phone # ( ) River Basin `� 1je c
OEA (❑HHF 1❑IH ❑UBA ❑N/A ,
AEC(s): Adj.Wtr. Body SIrt\\4"\ e— Yo'c- CO man /unkn)
❑ PWS: R
ORW: yes /`no �� PNA yes /� Closest Maj.Wtr. Body J`n"��U e l\I'`l
Type of Project/Activity \ 'M/1 {'1.,,,{ f C,..! r ir.r \<--, C 4"G.. .: L"� i �i .v.�.\:' . S\,
9-5
\V\ 5 P�J (Scale: ( S )
Pier(dock)length "' f 00%it L - , ,s
I Fixed Platform(s1)00) l2 s4 V crew
Floating Platform(s) 11 aZ (,- k, 1 --.r j 1 ,� ���_
Finger pier(s) A �-4-
Groin length Jr - { —_
number XT
— _.__.._._..._..
1111.
Bulkhead/Riprap length
avg distance offshore
,
max distance offshore
Basin,channel I j
cubic yards
- i
Boat ramp
IS —t — .._._ _.—..__.
Boathouse%Boatlift — --`_.— ` _
r h
Beach Bulldozing —y
Other �{14"SlC. Fk OdS } ♦ y I '=� .`
L.
It 1 y�rrSL
Shoreline Length AAA*
I
SAV: not sure yes i no ,------- I SS bU
Moratorium: n/a yes 01 I V G� tJ
iii
Photos: yes o ( MMM�yes
l!� t 1- 1 I
Waiver Attached:
A building permit may be required by: ! •dJ`S1/.i iCki-- E U-,—.\- P See note on back regarding River Basin rules.
(Note Local Planning Jurisdiction) I ` a
Notes/Special Conditions . 1 Je c (+ T�(�1.t v s\\ ft o`� P)(C.¢R_� c?S�-..b,SIL•, \ `c i
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Agent or Applicant Printed Name Permit Officer! rinted Name
(I'M 6---7t14/ r-t_ C/.--7 -6.--1_.-
t - - - ' .- '" ----- \-3 -- \ ------
Signature **Please read compliance statement on back of Permit** Signature
> ,
APPlicatill
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Check# Issuing Date Expi Lione
Fee(s)

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 (252-946-648 I) or the
Wilmington Regional Office(910-796-72 1 5)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 252-946-648 I
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.ncdenr.org/web/cm/dcm-home
Revised 7/06/17

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I hereby certify that I own property adjacent to c 1.1,1,4A.as. Cf• 16w44 - 's
Name of Property Owner)
3S6q Yar, te, 't
property located at � � t.+/
� (Address, Lot, Block, Roadtc.)
on S 1,ft ��- . tdQ�. . , in Aed N.C.
(Waterbody) (City/Town and/or County)
The applicant has described to me, as shown below, the development proposed at the above location.
1 V 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)
•
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 wish to waive the 15' setback requirement.
(Property Owner Information) (Adjacent Property Owner Information)
(1 ''''l -%11-- b4(
°11 q-ke .. I 4/ &elk Si nat
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(gn.a�tzfre(� �� g ' + j�
ell K \1 tC..c... C.- ki 0 le ‹ / ' 4 �' :11414 rVI !V f:�"+ (kt
Prim or T,pe N me Print or Type Narn
` 5.(e i 4� ,ifiL� 213 W. to .K.A
ailing A d ess Main aidress
C t / t e r 77
City/Staten
Telenhon a Number Telephone Number
`'9- P\ --Q OP,/ �'zi 7,0ZI
Date Date
(Revised 6/18/2012)

• ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to r 1St)r1.0. t<r )e S 's
(Name of Property Owner)
property located at 3 S Va.r r-ev. . v L/6 aZ -
(Address Lot, Block, load, efc. /
on 5h0.I\e)ft'e= , in Bruos N.C.
(Waterbody) (City/Town and/or County
The applic nt 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)
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.)
f do wish to waive the 15' setback requirement. •
I do not wish to waive the 15' setback requirement.
(Property Owner Information) (Adjacent Property Owner Information)
( 2ds9 1 / IkSi natu re
t�gnattre j
el t�., t� t1 Je eke t tr (,�► cam . C_."
Print or Type Name f Print or Type Name . p
i l L;� ' 'Lek 9,1= I P Ta) in /fit VGA trs V r
Mailing A dress'ess 7. Mailing Address. �;Q
� `rm .
3 City/State/Zip f1:3
Tele 'one Number Telephone Nu ber
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l�
Date Date
(Revised 6/18/2012)

ENTITY INFORMATION
Search Date and Time:5/6/2021 9:04:03 AM
Entity Details
Entity Name: GOLD ONE,L.LC Entity ID: L08098360
Entity type: Domestic LLC Entity Statue: Active
Formation Date: 6/6/1997 Reason for Status: in Good Standing
Approval Date: 6/6/1997 Status Date:
Original incorporation Date: 6/8/1997 Life Period: 12/31/2020
Business Type; UNKNOWN Last Annual Report Filed:
Domicile State: Arizona Annual Report Due Date:
Years Due:
Original Publish Date: 7/22/1997
Statutory Agent Information
Name: ROBERT SOLLIDAY PLC Appointed Status: Active
Attention:
Address: 211 WEST LINGER LANE,PHOENIX.A2 85021,USA
Agent Last Updated: 4/29/2021 E-mall:
Attention: Mailing Address: 211 WEST LINGER LANE,PHOENIX.AZ
85021,USA
County:
Principal information
Title Name Attention Address Date of Taking Office Last Updated
Member KNOLES FAMILY TRUST 2708 N 4TH ST.FLAGSTAFF.AZ,86004.USA 6/6/1997 6/16/1997
Member G ROBERT&CHRISTINA O KNOLES 2708 N 4TH ST,FLAGSTAFF,AZ,88004,USA 6/6/1997 6/16/1997
Page 1 of 1,records 1 to 2 of 2
Address,
Attention: Address:C./0 ROBERT SOLLIDAY PLC 211 WEST UNGER LANE,PHOENIX, County;Maricope Last Updated:
AZ,85021,USA
Entity Principal Office Address
Attention: Address: County: Last Updated:
Bach Return to Search Return to Results Document History Name/Restructuring History Pending Documents Microfilm History

Check
Date Received Date Deposited Check From(Name) Name of Permit Holder Vendor Check number amount Permit Number/Comments Receipt or Re/undReallocaud
Column? Cdumn2 Cniumn2 Column4 Columns Columns Column? Columns Column!)
5/13/2021 .Backwater Marne of NC LLC Sheryl Andrews BBBT 1302 S 200.00 GP#79960D BB rct.13124
5/13/2021 _Backwater Marine of NC LLC _136 Ocean LLC _BBBT 1300_$ 600.00 GP#799610 .BB rct.13125
5/13/2021 David Once Money Order Jeffrey&Laurie Hill Wells Fargo 17-768053784 $ 400.00 GP#799590(overpaid by$200.has$200 credit for next permit) BB rct 14927
5/13/2021 Castle Home Builders Sal Mi lien PNC Bank 4824 $ 400.00 GP#799140 TP rct.10325
5/13/2021 American Marine Construction,Inc _Bean and Teresa Kanzler First Citizens Bank _ 89350 $ 200.00 GP#803070 tmac rot_13008 __
5/13/2021 Once Construction Michael and Loma Greene BBBT 14603 $ 200.00 GP#801960 BB rct.13122 _5/13/2021 Gold Gold One.LLC same Wells Fargo 2696 $ 200.00 GP#799630 BB rct.13118_ _
5/13/2021 Charles V Reed Jr. same First Citizens Bank _ 4338 $ 600 00 GP#802000 BB rot.13119 _ __
5/13/202' Lawrence Zborowski same _BMO Herds Bank 6187 $ 600 00 GP#799580 BB rct.13120__ _
5/13/2021 Ricky McCorkle Rick and Lisa McCorkle SunTrust 2692 $ 200 00 GP#799640 BB rct.13121