59631_LOCK, JAMES_20111201

❑CAMA / ❑ DREDGE & FILL
GENERAL PERMIT
❑New ❑Modification ❑Complete Reissue ❑Partial Reissue
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
I j
Previous permit #
Date previous permit issued
Applicant Name .l, - . ^ Project Location: County
Address �' Street Address/ State Road/ Lot #(s)
City State ZIP
Phone # ( )_ Fax # (_)
Authorized Agent
Affected ❑ CW ❑ EW ❑ PTA ❑ ES ❑ PTS
AEC(s): ❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A
❑ PWS: ❑ FC:
ORW: yes / no PIMA yes / no Crit.Hab. yes / no
❑ Rules attached.
Subdivision
City. !Uer-I ZIP
Phone # ( ) ( &- River Basin
Adj. Wtr. Body fO °j L, r" (nat /man /unkn)
Closest Maj. Wtr. Body
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INUMMEMEME SESSION
EMM MEME
Agent or Applicant'Pririted Name
Signature Please read compliance statement on back of permit
Application Fee(s) Check #
PermitOfficer'S Signature
Issuing Date Expiration Date
Local PlanningJurisdiction 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 [)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 (910-796-7215) for more information on how to comply with these buffer rules.
Division of Coastal Management Offices
Raleigh Office
Mailing Address:
1638 Mail Service Center
Raleigh, NC 27699-1638
Location:
2728 Capital Blvd.
Raleigh, NC 27604
919-733-2293
Fax: [phone]
Morehead City Headquarters
400 Commerce Ave
Morehead City, NC 28557
252-808-2808/ 1-888ARCOAST
Fax: [phone]
(Serves: Carteret, Craven, Onslow -above
New River Inlet- and Pamlico Counties)
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)
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
910-796-7215
Fax: [phone]
(Serves: Brunswick, New Hanover,
Onslow -below New River Inlet- and
Pender Counties)
Revised 08/09/06

JAMES & ROSA LOCK
5573 EVDIANA ST
CAMP LEJELTNE NC 28547
V1
1054
68-7497/2560
DATE
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L L A R S
NAVY
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DIVISION OF COASTAL I+lAj, IAGEMENT
A0JACIENT RIPARIAN PROPE.R7Y OWNER AiC�il�l�-iT1��a'�'is\.l�J�� FORIIV
t lame of Individual applying for Permit:
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e
(Lot or Street #, Street or Road, City & County)
I hereby certify that I own property adjacent to the above referenced property. The individual
applying for this permit has described to me as shown on I:he attached drawing the development
they are proposing. A description or drawing, with dimensions, should be provided with this letter.
I have no objections to this propos-al.
If you have objections to what is being proposed, please write the Division of Coastal
Management, 400 Commerce Avenue, Morehead City, NC, 28557orcall [phone] within
90 days of receipt of this notice. No response is considered the same as no objection if you
have been notified by Certified Mail.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boathouse, boatlift or sandbags 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.
-J L( I do not wish to waive the 15' setback requirement.
(Applicant Information) (Riparian Property Owner Information)
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Mailing Address
� i3rn 4 �6's3g
City/State/Zip
Telephone umbe
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or Type Name
70 -3oo-7Cl(12
Telephone Number
Date / Dale
11-d- --16 //

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CERTIFIED MAIL • RETURN RECEIPT REQUESTED
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Property Owner:
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Address of Property: ZD - L- ; /ilZAW©6 E 02 //6WLyr IVC' 265'12 e9,vJ
(Lot or Street #, Street or Road, City & County)
Applicant phone #: /mil A�-08 t-ffs Mailing Address: 2.U2
T iUC 295e"g
I hereby certify that I own property adjacent to the above referenced property. The individual
applying for this permit has described to me as shown on the attached drawing the development
they are proposing. A description or drawing, with dimensions, must be provided with this letter.
I have no objections to this proposal. I have objections to this proposal.
If you have objections to what is being proposed, you must notify the Division of Coastal Management
(DCM) in writing within 10 days of receipt of this notice. Contact information for DCM offices is
available at www.nccoastaimangementneticontact—dcm.htm or by calling 1-888-4RCOAST. No
response is considered the same as no objection if you have been notified by Certified Mail.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boathouse, or lift 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 nAt wish to waive the 15' setback requirement.
(Property 9'vyiipyInformation)
Signa u V
1'�qA 'C7 ql A;"4
Print or Type Name
Z �r- 1x1Vg1 0 t t: ,a2
Mailing Address
City/State2ip
Telephone Number
Date
(Rip ian Pr perty Owner Informatio n)
g ature
Print or Type Name
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Mailing Address
ity/State/Zip
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Telephone Number
Date

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