34753_COOPER, RANDOLPH_20030815

C-ICAMA / 7, DREDGE & FILLA GENERL PERMIT
CJNew JModification-lComplete Reissue !JPartial 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
1
34x ' c,
Previous permit #
Date previous permit issued
Rules attached.
Applicant Nam .} I. Project Location: County
Address f ! Street Address/ State Road/ Lot #(s)
City L: /'Al t- �61 Ft State _ ZIP
Phone # Fax # () Subdivision
Authorized Agent U0,x ,-,, ,._,. _ , -, , City__
Affected Ll Cw ❑ Ew ❑ PTA ❑ ES ❑ PTS Phone # (_ )
AEC(s): - OEA :1 HHF - IH ❑ UBA ❑ N/A Adj. Wtr. Body
PWS: 7 FC:
ORW: yes / no PNA yes / no Crit. Hab. yes / no Closest Maj. Wtr. Body
ZIP
River Basin
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Agent or Applicant Printed Name ,
Signature Please read compliance statement on back of permit's
Application Fee(s) Check #
Permit Officer's Signature
Issuing Date ) Expiration Date
Local Planning jurisdiction Rover File Name
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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:
17 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 Il
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

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ADJACENT RIPARIAN PROPERTY OWNER s'TATkIMENT
(FOR A PIER/UNCOVERED BOAT Liff)x -%�
I bereby certify that I swe property adjacent to
04*1116 of 6oplKy0,&tltr)
property locate# at
(L-ot. Mock. Read, etc.)
on
(Watorbody) (Tath "Wor County)
He bat deacribeel to me, as skown below, the development be is proposing at that bcation.
and I have** objections to his proposal. I understand that a pier/aacovercd boat left must be •rt
back as a minimum of fifteen (13') from arty area of riparian access unless waived by rat.
I dam with to waive thr setback "gvira m*et.
I do "Uh is waive that setback mquirewtent.
DESCRIPTION AND/OR DRAWING OF PROPOSEDDEVEL.OPMIE,'YT':
(Tea be f9lkd in by individual proposin �+el�inent) �VP'P5rd
ePX l�r e � •1►� ..
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Telephone Number
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ADJACENT RIPARIAN PROPERTY OWNER. S"iATEIMENT
(FOIL A PIER./UNCOVERED BOAT L�P�- 7-
3i�`x
I btreby certify that I own property adjacent to
(Name rt( Property tier)
property located at -
(La{ , Block, Road, tic.)
!f .� i / in NC
(idVattrbodr) or Covstaty)
He tabs described to sae, as sbown below, the development he is proposing at that location,
and I have no objections to his proposal. I understand thAt a pier/uncovered bolt lilt mint be +et
back as a atiwitaum of Rateeu (tS') from ray area of riparian access unless waived by sae.
I dg go wish to waive the setback requirement.
I iq wish to waive that setback requirement.
DESCRIPTION AND/OR DRAWING OF PROPOSEDDEVELOPMENT:
(To be fiiicd in by individual proposing eyeloRment) f vied
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Signature
Telephone Number
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Print or Type Name
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