38014_COOPER, BUDDY_20040323

r1 CAMA / ] DREDGE & FILL /"
J:�� GENERAL PERMIT
Previous permit #
CNew ]Modification CComplete Reissue DIPartial Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environment and Natural Resources
and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC
Rules attached.
Applicant Name
8VJJT
Address
bac �0
City 1 /aV 4
3"a(L State Nt ZIP
Phone # (=S' ) 376- 78t r Fax # ( )
Authorized Agent
: Jr h4
Affected ElCW
❑ EW El PTA Z ES ❑ PTS
AEC( ): ElOEA
❑ HHF ElIH ElUBA El N/A
❑ PWS:
❑ FC:
ORW: yes / no
PNA yes / no Crit. Hab. yes / no
Project Location: County ' /:. I
Street Address/ State Road/ Lot #(s)
Subdivision
ZIP
Phone # ( ) River Basin
Adj. Wtr. Body P1 Mad,' 1-17 00 I (nat /6aa/unkn)
Closest Maj. Wtr. Body VS `"I k
■■ONE
No
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Agent or Applicant Printed Name
Signature Please read compliance statement on back of permit*
Permit Officer's Signature
Issuing Date
Expiration Date
Application Fee(s) Check # Local Planninglurisdiction
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, certifythatthis project is consistentwith 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 Quality. Contact the Division of Water Quality at the Washington Regional Office (252-946-6481) or the Wilmington
Regional Office (910-395-3900) for more information on how to comply with thesebuffer rules.
Division of Coastal Management Offices
Central Office
Mailing Address:
1638 Mail Service Center
Raleigh, NC 27699-1638
Location:
Parker -Lincoln Building
2728 Capital Blvd.
Raleigh, NC 27604
919-733-2293 / 1-888ARCOAST
Fax:[phone]
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)
Morehead City District
151-B Hwy. 24
Hestron Plaza II
Morehead City, NC 28557
202-808-2808
Fax: [phone]
(Serves: Carteret, Craven, Onslow -above
New River Inlet- and Pamlico 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
910-395-3900
Fax:[phone]
(Serves: Brunswick, New Hanover,
Onslow -below New River Inlet- and
Pender Counties)
www.nccoastalmanagement.net
Revised 10/05/01

THIS MULTI -TONE AREA OF THE DOCUMENT CHANGES COLOR GRADUALLY AND EVENLY FROM DARK TO LIGHT WITH DARKER AREAS BOTH TOP AND BOTTOM
PAY TO THE
ORDER OF �Y -
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ISSUING BRANCH*'-'
DATE
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DOLLARS BY SIGNING YOU AGREE THE SERVICE CHARGE
AND OTHER TERMS ON
THE REVERSE SIDE I
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'LDJACENX' Rf_t�A%L AN;' :'!s' 'I' C)WN':I? S',r'_A
(FOR A PIFFJUNCOVFR-EED B0AT 1; 0'
I hereby certify that I own property adjacent to �-�Py U e-rib 's
_-. - - _---
(�i;Irate of Property Owlier)
property located at___ �56^Li t4 j---zel()E ---
-------- -------------
(Lot, Block, Road, etc.)
(Waterbody) }- -�
( I'owu andlori County)
�-
He has described to me, as shown beto�, the deveiopf writ he is propcsinc- at that
location, and, I have no objections to his proposal. I undersund i,hat a pier/uncovered boat lift
must be set back a minimum distance of rifter:r fit (15') from my area of riparian access unless
waived by me.
I do not wish to waive the seEback requirement.
I do wish to waive that setback requirement.
--------
DESCRIPTION A-ND/OR DRAWENG OF PROPOSED DEyELOP'NLE.NT:
(To be l ed in by ng de ment)
5 - fe 1 (6 c' 0 r-
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Date:

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Mar 22 04
66
12:03p Linda Clements 919-643-4070 p.l
+.�thtj
- nn, a • 'Y.'1'X l7VVZ`7 :1. S'�A."ix?�ii.P�
I�D3 AC 'Nl' kt�. ' Za, u I JL
(FOR A P ER,1E'NCOVEP-V--D"
f_
C,aoPc
I hereby celtify that I awn prop<rsy adsae�nt to -t`:,r„e of property Q,wer)
prpperry located a, -
(Lot, Block, Road, etc.)
Gn L L
(W�tCerbr>dy) (ToNvu anc:'r�ri! ounty)
He has desc ibed to me, as shov.-n below, the devc;ut��;tu rt ht: is prox'sul; �.t t1 ar
I under5[.ilii Gh rapteriuneo(ere. baat ixr
loc-'kuan, and. I have no obj u0ns to hrs proDOS�I. ,;�3 0[ t"Pana'n ac '. S unless
must be set back a mininurl distance Qi tiit�z fit ( �5') fro my j.
waived by me.
I do not wish to waive the le'b ck renuire rent.
I dr1 wis5 to wai%,e that setbacic :eauvement.
-- -- .. - - - - - P
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DESCx'ZI17N a_'�D?OR DR�1
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