41327_COCKMAN, DAVID_20050427

1CAMA / 'I DREDGE & FILL
GENERAL # PERMIT Previous permi #
❑New 1 1Moufication I-iComplete Reissue ❑Partial Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environment and Natural Resources �/ j /• (/
and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC Y �J
[]•Rules attached.
Applicant Name- Project Location: County
Address ! U Street Address/ State Road/ Lot #(s)
City
`' State ��� ZIP
Phone # ( )
Fax # ()
Authorized Agent
— CW
Affected -
❑ EW �TA El ES ElPTS
AEC(s): I_' OEA
C' HHF ❑ IH ❑ UBA- ❑ N/A
- PWS:
- FC:
ORW: yes / no
PNA yes / no Crit. Hab. yes / no
Type of Project/ Activity
Pier (dock) length
Platform(s)
Finger pier(s)
Groin length
number
Bulkhead/ Riprap length
avg distance offshore
max distance offshore
Basin, channel
cubic yards
Boat ramp
Boathouse/ BoatliR ' ! .�
Beach Bulldozing
Other
Shoreline Length
SAM not sure yes
no
Sandbags: not sure yes
ho
Moratorium: n/a yes
no
Photos: yes
no
Waiver Attached: yes
no'
A building permit may be required by:
Notes/ Special Conditions
Subdivision
City 1, ZIP_
Phone # (_ } River Basin
Adj. Wtr. Body
Closest Maj. Wtr. Body
\i i
Agent or Applicant Printed Name
Signature Please read compliance statement on bac +o ormit
Application Fee(s) Check #
(nat /man /unkn
(Scale: )
See note on back regarding River Basin rules.
Permit Officer's Signature
_7
Issuing Date Expiration Date
m ci(
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 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 / 1-888-4RCOAST
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

(FOR A PIER/UIYC OVERED BOAT LIM)
I hereby certify that I own property adiac nt to '
(tiE14e of Property Owner)
property located at
(Lot, Block, Road, etc.)
on 1� _:.'z J N. C.
to
(Waterbody) T— (Town and/or County)
He has described to me, as shown below; the developent he is proposins at that
m I location, and, I have no objq�ctions to his proposal. I understand ► at a pier/uncovered boat lift
must be set;,back a minimum distance or"riftern fit (15') from my
waived by me. Ali,>��.�; �u` '���,�i6�
�W
I do not wish: to waive the setback requirement. APR 0 5 2005
I do wish to waive that setback requirement. Morehead City DCM
-------- --------------------T --------- -------------------- ---------------I ----
-=-------------------
-\�G � DESCR=0?V A.N-D/OR DRAIWE G OF PROPOSEDIDEVELOP-HYMN-T:
�(To he jWed in by individual proposing deve pment)
SIC-
13
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- - - - - - - - - - - - - - - - - - - - - - -------------------
Sjj tole `-
Print or Type NaFnz
17,AG -.��9 _
Telephone Numb r
Date:

rut
�, i CE-M' fir%}_ 3' LA-' i I? e'; �?E,NY i �' �i i���R S �' `�: ��'?1n=� i�� .
• (FOR A PIENUtYt:OVp--RE•D BOAT LIM)
I hereby certify that I own property adjac, nt to a i , s
("Icime off' Property Owner)
property located at
(Lot, Block, Road, etc.)
on t 00, N.C.
(W'aterbody) (Town and/or) County)
He has desc-ibed to me, as shown below, the developrnent he is proposing at that
location, and, I have no objections to his proposal. I understand chat a pier/uncovered boat lift
must be set back a minimum distance or rirteen rat (I5') from my ;area or rip ari a=ss un.iess
waived by me. "
I do not wish to waive the setback recuirernent.
APR
I do wish to waive that setback r ecui.�ement. M � 5 2405
�Me o
----------------------------------- - -- - ---------------- — ------------------------------------- Mw-
�DESCRIPTIO.N -NOD/OR DRAIVVP G OF PROPOSED, DEVELOP?NLE.-Nfi: try lDC44
mac ` (To be j-We in by iadivrducl posi`n�g deveL. p e:t}���D�
LI
OTb
Signature
Pnnc or Type Na,
jme
72G- Y6/3
Telephone Numb r
Date: 3 - / 7- 6 S—

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