56975_COOPER, AB_20101129

❑CAMA / ❑ DREDGE & FILL
GENERAL PERMIT /f Previous permit#
❑New ❑Modification ❑Complete Reissue ❑Partial Reissue ` `_f 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
Address
City
State ZIP
Phone # O
Fax # (� )
Authorized Agent
Affected ❑ CW
❑ EW
❑ PTA ❑ ES ❑ PTS
AEC(s): ❑ OEA
❑ HHF
❑ IH ❑ UBA ❑ N/A
❑ PWS:
❑ FC:
ORW: yes / no
PNA
yes / no Crit.Hab. yes / no
Project Location: County
Street Address/ State Road/ Lot #(s)
w"a
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
Signature ** Please read compliance statement on back of permit **
Application Fee(s) Check #
---
PermitOfFcer's Signature i
Issuing Date �Expiration Dae
f I(A
Local Planningf urisdiction mover File Name — �T

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, certifythat this 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
Morehead City Headquarters
Mailing Address:
400 Commerce Ave
1638 Mail Service Center
Morehead City, NC 28557
Raleigh, NC 27699-1638
252-808-2808/ 1-888-4RCOAST
Location:
Fax: [phone]
2728 Capital Blvd.
(Serves: Carteret, Craven, Onslow -above
Raleigh, NC 27604
New River Inlet- and Pamlico Counties)
919-733-2293
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)
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

Applicant:.
Date'"
o)aq1/o
Describe below the HABITAT disturbances for the application. All values should match the name, and units of measurement
A
ound 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
nt)
TOTAL Feet
(Applied for.
Disturbance
total includes
any anticipated
restoration or
temp impacts)
FINAL Feet
(Anticipated final
disturbance.
Excludes any
restoration and/or
temp impact
amount
Dredge ❑ Fill ❑ Both ❑ Other
f�
�—
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 ❑
v._ .w N'3

RECEIVED
NOV 23 2010
illtieheudCity DCm
''R
North C-*aroiifl-a Department of Environment and ^daturai Resources
Division fu4 Coastal Manags-ment
Michael F. Easley: Governor Chwies S. Jones, Dirvntor William G, Ross Jr., Secrei iry
Date l) 110 - t^
qz M:F, <'� ?a ---
Applicant Naine _ 5
M.aaling Address
fshS� � U3
) - �� to act On M .
J certat'y that I lave auutlnoa-izeel(a�eeni:
behalf, for the purpose era applying for and obtaining all CANIA Permits necessary to
A astall or coaastrn�ct cacti -i i') C.Y� e2s` yT----
at (location)
This certAi'ication is v)iA tlaau (elate)
S i yn, atun re

ADJACENT RIPARIAN PROPERTY O ER STATEMMIX RECEIVED
NOV 2 3 2010
I/
I hereby certify that I own property adjacent to �i l kiwt t-) r-5 's
�iyDC�rt
w—�
�e��
Q (Name of Property Owner) "`"
property located at a' -1 S MiL- -ISM �ftKr-
(Lot, Block, Road, etc.)
on MAQV-: - in 1 l �►�CT1 C- gC-P .O-JA N.C.
(Waterbody) Town and/or C! ui
Applicant's phone #�: Jai � `Z I� ( Mailing Address: 5 ( rnA
He has described to me, as shown below, the development he is proposing at that location, and, I
have no objections to his proposal.
-------------------------------------------------------------------------------------------------------------------
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by property owner proposing development)
r ► i2 � �`
s �
J NN 8 -0)o
--------- `-"-------------"------- ------------
(Informa n for Property Owner Applying g
for Permit)
Mailing Address
City/State/Zip
Telephone Number
-------------------=--- -- ------
(Riparian Property Owner I formation)
Print or Type Name
Telephone Number
Signature Date Date

ADJACENT RIPARIAN PROPER Y OWNER STATEME ; IMBUE)
P � Nov 2 3 2018;
I hereby certify that I own property adjacent to ktrn Pr (5r:�0Pe6 { _ 'sue
(N4 em of Property Owner) m v6he(,dCifyDCM
property located at a "� '� S�N(DQ-15 M 51. + 1 \
(Lot, Block, Road, etc.)
on Vj)o ('NVQE� GA�e"_, in PRILA�ft[G ga► c4i-1z;�� , N.C.
(Waterbody) (Tows nd or QHEty
Applicant's phone. �i Mailing Address:45 7 41flA I-ewnwe
l; I.1-1b0 Pe' 27�� l
He has described to me, as shown below, the development he is proposing at that location, and, I
have no objections to his proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by property owner proposing development)
. r ti-i
L �
T
--------�-----------------------�---------- t--�
(Infor ation for Property Owner Applying
for Permit)
Mailing Address
City/State/Zip
Telephone Number
Signature Date
--------------------- -L--------------------------
(Riparian Prope ty Owner Information)
Signature
Print or Type Name
Telephone Number
Date

ADJACENT RIPARIAN PROPERTY Q,WNNER SST,TEMEN
1I'��v NOV 2 3 2010
I hereby certify that I own property adjacent to42
(Name of Property Owner)
property located at off, G Mib1- 0 N1 P erW
(Lot, Block, Road, etc.)
on c*Wrq-,t, in ETL�►]J�'1C. ��.C'A'T2rTVTZN.C.
(Waterbody) (Town and/or County)
Applicant's phone Mailing Address: YS� ' 1-1 ryliq
He has described to me, as shown below, the development he is proposing at that location, and, I
have no objections to his proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by property owner proposing development)
-b ii �
-Af-Q:b
P0' ,CPT'
L I I-W
--------------------------- -4---- -----
(Informatiot Property Owner Applying
for Permit)
Mailing Address
City/State/Zip
Telephone Number
Signature
Date
IrN
----------------------= - - - - - - - - - ---
(Riparian Property weer Information)
jot
1Signature
Print or Type Name
U-76
Telephone Number
Date

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
..A B G�
I hereby certify that I own property adjacent to I'� Kl�}� s RECEIVED
(Name of Property Owner) NOV 2 9 2010
property located at al� 1`' S ��j'e �(� '�—`%� , 6worelftdCODCM
(Lot, Block, Road, etc.)
on M14DE inee--44
(Waterbody) q (Town and/or C oLbny)
Applicant's phon�; 3bD Mailing Address: 7 SQ rl n%A L) )JDW,�'
DF/� (� Kl PC �2 7--
He has described to me, as shown below, the development he is proposing at that location, and, I
have no objections to his proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by property owner proposing development)
12�
0��.
-6� v1_
(Information for Property Owner Applying
for Permit)
Mailing Address
City/State/Zip
Telephone Number
Signature Date
(Riparian Property Owner Information)
Signature
GL S' N66t 7fip
(.;011� . 1 a
Print or Type Name
Telephone Number
Date

SAMMIE E. TURNER 4934
MARINE CONSTRUCTION ACCT 66-112/531
252-725-3415
P.O. BOX 1885
MOREHEAD CITY, NC 28557 DATE —
TPAY
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