32906_COOKE, RON AND JEANNIE_20021104

C CAMA / u DREDGE & FILL (401
GE
NERAL PERMIT �/V
Previous permit #
17
New 1Modification -Complete ReissueIPartial 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 n -LN 4* i �-V Met (G,L W- C
Address 121, We'L tv P(I
City lit" f" [ State ZIP A1- j?20
Phone # ( �"Y)bb31120 Fax # ( )
Authorized Agent • l ,44
Affected ❑ CW ❑ EW K PTA ❑ ES ❑ PTS
AEC(s): ❑ OEA ❑ HHF ❑ IH ❑ USA ❑ N/A
❑ PWS: ❑FC:
ORW: yes /, na PNA yes / to? Crit. Hab. yes / no
Project Location: County (� . I,,
Street Address/ State Road/ Lot #(s)
Subdivision 164-t•Mu4r V111014
City ot, fv, j ZIP 1 E 576"
Phone # (_ -) River Basin �¢d14
Adj. Wtr. Body ':'c v 4 K n o t-f" '(nat' /man /unkn)
Closest Maj. Wtr. Body—A�v)4 k, ` 4°
:..
.�
as:
I
piers)
�
length
umber
I
ad/ Riprap length
vg distance offshore
ax distance offshore
_I
._..-.._,1�_-...
F-
channel
ubic yards
amp
ouse/ Boatlift
j
I
I
i
i
Bulldozing
I
0
line Length !("[i
not sure yes o
ags: not sure yes ;�o
orium: n/a yes ono
yes no
'
�N. 37Uj�{•f
h
v1I/}E
----�--
Ne 1-.. ,
Signature Please read compliance statement on back of permit
Application Fee(s) Check #
Agent or Applicant Print�d
Permit Officer's Signature
Issuing Date Expiration Date
Local Planningf urisdiction 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, 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
Neuse River Basin Buffer Rules
E1 Other:
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 Elizabeth City District
Mailing Address: 1367 U.S. 17 South
1638 Mail Service Center Elizabeth City, NC 27909
Raleigh, NC 27699-1638 252-264-3901
Location: Fax: [phone]
Parker -Lincoln Building
2728 Capital Blvd.
Raleigh, NC 27604
919-733-2293 / 1-888ARCOAST
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

RONALD H. COOKE, JR. 10-97
JEANNETTE L. COOKE
127 Washam Rd
Mooresville, NC 28117
PAY TO THE
ORDER OF 0— AMA
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First Union National Bank
FN flrstunion.com
R/r 053107963
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66-796/531
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DIVISION OF COASTAL MANAGENIENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM
Name of Individual applying for Permit:
�•
".ddress of Prope. �v:
ago a;e- ' :y The individual
.= Ce,-d=�, that I own p-operry adjacent to the ve r-* e1ct" p:op...
I hereb, .
aoolyinQ for this pe^nit has described to me as shown on the arach:ti d:Gwina the de'�e:opme;,t
.-�y a e proposing. A description or drawing, with d::«ensions, s-ould be provided with this
I have no obiections to this proposal.
If you have objections to what is being proposed, please wrace the Division of Coasal
�ifanagement, Hes<ron Plaza Jl, 151-B, Hwy. 24, Morehead City, NC, 285 or call (2�?) 808-
2808 within 10 days of receipt of this notice. No response is considered the scree as no objection
it you have been notified by Certified Mail.
WAI'Y-ER SECTIOti
'�'-� se, or saadoaas mus oe
I '_ndersta-�,-cj-K, moor,ns pUings, br. �� G.'-- - ��drlra�:z., ac:.esswared by ne.L you
vacA "a of 1�• �OiTi
y ust initial the approunale gunk below.)
�.ah to waive the se.back, OL:LFi
I o wish to waive the 15' se:ba�
co
I do not wish to waive the 1 3' secbac� rec-,ire. ;eat.
�Dat F�
P,;nt Name
Teieonone Numcer With Area Code

I I E E D >, -*-. IL 0 I�F_T , N; 7 � r
DMSION OF COASTkL NI.A.tiAGE:'.IENT
,kDJ:ACZ_ti7' RIFaRIAN PROPERTY OWN-EF NOTITFICATION,`�Al��R FQR�i
/ Na.-le it L"diVfdt..� app'Yin-2 fOr Pe-mit: .
oi
t_ot • 5tr�.x: ;'. S:a... or fat: r:c: 3.::ct,"-;';
_' ." ee:�
u"'_��C
the a ''l'JICL'F
o;, p'ope. ,y adia..y r 7 , r F
h2_- OeSct fccd to m_ as Siown cn L�a z:t: � C �'� 1^ � Gale dS°:e• _ = ''e�<
I✓ ar n cr dtc'.irs .,•-,,;... __. �rcttc w t`.
..
,r ,e r0 OZ� Uon5 to t.,:S 1�ra.csw.
w F r o nor OS2 !. "�Z+I r µ' �" :` 2 .:iiG,I JJ.
have cbJe-= P!tS tc hrlX ;S � =t � r � r" 7:
,. 1 pp �., F-. "i 8?&-
�yn le, `-U; _ =•A
:8t'1 '±l::l 1'�' C:::•"S v"l !EC2' Of thL- !1:.�E..�'. "ESJ7 �S: lb :unS 2• l:.2 5�:"iL' _ :Or
t: lou have be .z
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OLD /(ENT

1V, moo- cvuG uo: 6-1 t-AA eoZ 404 Z063 BBWC Z03
ADJACE'V'i' RIPARIAN PROPERTY OWNER STATEMENT
hereby certify that I own property adjacent b:
(Name of Progwy Owner)
property located at
(Lot, Block, Road, etc.) '
On _ '�_ , in _
(Waterbody) (Town andior County)
He has described to me as shown below, the ro developmenthe is
proposing at that location,
and, I have no objections to his proposal.
DESCRIPTION AND/OR DRAWrL;r, OF PROPOSED DEVELOPMF—N-T
(To 6e filled in by individual proposing development)
u4-t- fv'o e mpTY
Ede
Signature
glzk'*�-k
AJ _ML R 1 AL D
Print or Type Name
Telephone Number
Date: ) 0 - "'� 3 -- Z'

IU1401zuu[ u5: az kAA Z3Z 4b4 15UJ B3WC it03
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent bo, !V�PropeO�wner)"�L
� ame of
Frey located at ' A
d (Lot, Block, Road etc.) '
on R r/ -
(Waterbod�r) , N.C.
{Town and/or County)
He has described to me as shown below, the development he is proposing at that location,
and, 1 have no objections to his proposal.
DESCRIPTION ANDIOR DRA Wr G OF PROPOSED DEVELOPM N- T
(To be,/tdled in by individual proposing development)
C�'P' a- F —( P E a'j-y
Y
Signature
Print or Type Name
Telephone Number
Date.

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