57126_COOPER, A B_20110225

OCAMA / ❑ DREDGE & FILL
GENERAL PERMIT
❑New ❑Modification ❑Complete Reissue El 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_
Previous permit #
Date previous permit issued
❑ Rules attached.
A 1' nt N
e oe Pr ct L c tion- Cou
am
pp a
Address
City State ZIP
Phone # () Fax # (_)
Authorized Agent
Affected ❑ CW ❑ EW ❑ PTA ❑ ES ElPTS
AEC(s): ElOEA ElHHF ❑ IH ElUBA ❑ N/A
❑ PWS: ❑ FC:
ORW: yes / no PNA yes / no Crit.Hab. yes / no
my
Street Address/ State Road/ Lot #(s)
Subdivision
City ZIP
Phone # ( ) River Basin
Adj. Wtr. Body (nat /man /unkn)
Closest Maj. Wtr. Body
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Street Address/ State Road/ Lot #(s)
Subdivision
City ZIP
Phone # ( ) River Basin
Adj. Wtr. Body (nat /man /unkn)
Closest Maj. Wtr. Body
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Agent or Applicant Printed Name
Permit Officer's Signature I
Signature ** Please read compliance statement on back of permit **
Issuing Date Expiration Date
ApplicationFee(s) Check# 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
landowners).
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 ❑ 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

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Ap licant: ✓ �/
Date:
J
Describe below the HABITAT disturbances for the application. All values should match the name, and units of measurement
found in your Habitat code sheet.
Habitat Name
DISTURB TYPE
Choose One
TOTAL Sq. Ft.
(Applied for.
Disturbance total
includes any
anticipated
restoration or
temp impacts)
FINAL Sq. Ft.
(Anticipated final
disturbance.
Excludes any
restoration
and/or temp
impact amount)
TOTAL Feet
(Applied for.
Disturbance
total includes
any anticipated
restoration or
ternim acts
FINAL Feet
(Anticipated final
disturbance.
Excludes any
restoration and/or
temp impact
amount
Dredge Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
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ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIERIMOORING PIL17VGSIBOATUFTIBOATHOUSE)
I hereby certify that I own property adjacent to ke P-- is
(Name of Property Owner)
property located at —Z 2!,4 t, � C; � -T
(Lot, Block, Road, etc.)
on �A in N.C.
(Waterbody) (Town and/or County)
Appticaurs phont#'� -7 ZC 6S Mailing Address-. Z-5 0
He has described to me, as shown below, the development he is proposing, at that location, and, I
have, no *ections to his proposal. I understand that a pier/mooring pilings. fboatlift / boathouse
must be set back a minimum distance of fifteen feet (15. from my area of riparian access unless
waived by me. (If you wish to waive the setback, you must initial' the appropriate blank
befow.)
I do not wish to waive
I do wish to waive that setback requiremem.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To, beftffed in by individual proposing dere1qpnwn#
(Information for.Property Owner Applying
for Permit)
ho- "'P D-,c 0
Mailing Address
City/State/Zip
--I z (' z � G-5
Telephone Number
L 1 �
4
to
(Riparian Property Owner Information)
1-2, 1 45 _� -Z 5 '
�0 <-- 4, 1 P5
Signature
Prifft or Type Name
,-,- --3 -1- -1 ti) -1 -Il V
'2--2P- q
Telephone Number
Signature Date Date

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/MOORING PILINGSBOATLIFTBOATHOUSE)
I hereby certify that I own property adjacent to 4 P z� P-- 's
(Name of Property Owner)
property located at 1 '�i Q4 h rz�
(Lot, Block, Road, etc.)
on e� A in &L'a„ 4/L eL 1- k , N.C.
(Waterbody) (Town and/or County)
Applicant's phone #. % Z6 2. SGE Mailing Address: P. O 13oy-2S o
AL, N
He has described to me, as shown below, the development he is proposing at that location, and, I
have no objections to his proposal. I understand that a pier/Mooring pilings / boatlift / boathouse
must be set back a minimum distance of fifteen feet (l 5) from, my area of riparian access runless
waived by me. (If you wish to waive the setback, you must initial the appropriate blank
below.)
I do not wish to waive
I do wish to waive that setback requirement.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
,N5 DZ3Lk
(Information for Property Owner Applying
for Permit)
cD 13 ox 2 So
Mailing Address -
b4-LIQ 41 C' 6gch 1 N-C-zS2Z
City/State/Zip
--� Z (0 2 <?G 5
Telephone Number
L 144
v
v�
(Riparian Property Owner Information)
L's
1-�-, I5',�25W
ZocL -\]DS
Al
—'Print or Type Name
--2 /_ ?6 �r6,
Telephone Number
�- z-I- iJ
Signature Date Date

Y
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
Beverly Eaves Perdue, Governor James H. Gregson, Director Dee Freeman, Secretary
Date 2-2-1— 11
Applicant Name t' K
Mailing Address 1 - U - �Ux 2 5t) Al (/tnv `I -o+c-k
I certify that I have authorized (agent) w ✓ ,--� L C'�- 4 to act on my
behalf, for the purpose of applying for and obtaining all CAMA Permits necessary to
install or construct (activity) 0 f e'-, y� �k,� � S 1, af
at (location)#
This certification is valid thru (date
Signature
400 Commerce Avenue, Morehead City, North Carolina 28557
Phone: [phone] \ FAX: [phone] \ Internet: www.nccoastalmanagement.net
An Equal Opportunity \ Affirmative Action Employer — 50% Recycled \ 10% Post Consumer Paper

ALFRED B COOPER JR
PO BOX 250
ATLANTIC BEACH, NC 28512
PAY TO THE
ORDER OF N
NCDENR
1617 Mail Service Center
Raleigh, NC 27699-1617
MEMO 1 �. -� l lI�
512
North Shore dredging
FIRST CITIZENS BANK
firstcifizens.com
I1500150211' j:053L00300i:001I3L75236991''
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2/25/2011
*" 600.00
1502
66-30 531 I
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AUTHORIZED SIGNATURE I