53017_COOPER, AB_20081217

EICAMA / F] DREDGE & FILL
GENERAL PERMIT Wevious permit #
ONew ElModification EComplete Reissue D Partial 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
El Rules attached.
Applicant Name il Project Location: County_
Address Street Address/ State Road/ Lot #(s)
2
City
State zip-,
Phone # 4 Fax # Subdivision
7�
Authorized Agent City ZIP---
Affected —
El CW [-JEW EJFT-A 0ES El PTS Phone# River Basin
I,-- —,
AEC(s): El OEA El HHF El 1H [I UBA El N/A Adj. Wtr. Body (nat /man /unkn)
El PWS: L1 FC:
ORW: yes / no PNA yes / no Crit.Hab. yes no Closest Maj. Wtr. Body
Type of Project/ Activity
(Scale:
11-T
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/ Boatlift
Beach Bulldozing
Other
—7
\-J
T..
V--
—
—
—
—
I
I
I'A
IJ
I
Shoreline Length
SAV: not sure yes no
Sandbags: not sure yes no
Moratorium: n/a yes no
Photos: yes no
Waiver Attached: yes no
A building permit may be required by:
Notes/ Special Conditions
El See note on back regarding River Basin rules.
Agent or Applicant Printed Name
Signature Pfeasjread 'compliance statement on back of permit
Application Fee(s) Check #
Permit Officer's Signature
Issuing bate Expiraion"DitV_
771/
Local PlanningJurisdiction Rover-�File Namle

0
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 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 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.
Raleigh, NC 27604
919-733-2293
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

NCDENR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
Michael F. Easley, Governor James H. Gregson, Director William G. Ross Jr., Secretary
Date i 2. 10. o `S
Name of Property Owner Applying for Permit:
Mailing Address:
T'p, Z,3
I certify that I have authorized (agent)
Tv
t,
C 1 ?008
Morehead City DCM
to act on my
behalf, for the purpose of applying for and obtaining all CAMA Permits nece`sssaaryy o
0install or construct (activity) �— �6 fi
at (my property located at)
Z O S Norz4-1, `5 %, ole- &�7"
This certification is valid thru (date)
) 2 • 1 -0' a'K
Property Owner Signature ' v Date
400 Commerce Avenue, Morehead City, North Carolina 28557
Phone: [phone] FAX: [phone] Internet: www.nccoastalmanagement.net
An Equal Opportunity1 Affirmative Action Employer— 50% Recycled 110% Post Consumer Paper

ADJACENT RIPARIAN PROPERTY OWNER STATEMENTL�
FOR A PIER/MOORING PILINGSBOATLIFTBOATHO USE)
I hereby certify i thatproperty a ,I own adjacent to BrPA � 's C ?QQ
._,,. ,, .. J
(Name of Property Owner p�I.
tY DCA4
property located at t orbs M 9- ,
QQ (Lot, Block, Road, etc.)
on ►Jo LE '501 ►,rl �y-� t C. 13E; 14 e., N.C.
(Waterbody) (Town and/or County)
He has described to -ire as shown below, the development he is proposing at that location,
and, I have no objections toffs roposal. I understand that a pier/mooring pilings/boatlift/boathouse
must be set back a minimum stance of fifteen feet (15') from my area of riparian access unless
waived by me.
I do not wish to -waive the setback requirement.
I do wish to waiNW iat setback requirement.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
,(To be filled in by individual proposing development) A
411
41NS
ID 7
(Information for Property Owner Applying
for Permit)
Mailing Address
Ci /State/Zi
2 �zz �2-<�I'
Telephone Number
%P
-_A--
(Riparian Propprty QjXner Information)
Signature
C[06�— cti4C�'
Print or Type Name
-5 "2-- 241- q 5 q ! -
Telephone Number
Date
z-11-012
`Zoo + 2? z Lf4
c4-\i65
Signature
Date

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIERIMOOR"G PILINGSBOATLIFTBOATIIOUSE)
`�� Ji)y
I hereby certif; 00
that I own property adjacent to I& A � �. 's 6
14
- '44
(Name of Property Owner)
property located at 0 5 N a ► + o M
(Lot, Block, Road, etc.)
on 60i�r l04SS Aj'ig—in I`i'T L i N.C.
(Waterbody) `' (Town and/or County)
He has described to as shown below, the development he is proposing at that location,
and, I have no objections to 2s:goposal. I understand that a pier/mooring pilings/boatlift/boathouse
must be set back a minimum distance of fifteen feet (15') from my area of riparian access unless
waived by me.'`
I do not wish to waive the setback requirement_
I do wish to wai�that setback requirement.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
,(To be filled in by individual proposing development) A
13Sn So �
%A• j2av+2-?z L'4
L � -�T p •in5
K— Zl�f
(Information for Property Owner Applying
for Permit)
P 0, '3o,C -5':%z3
Mailing Address
KIN`541ti .�- --z
Ci /State/Zi
Telephone Number
D/
- - - - - _ /i- --------------------
--
(Riparian Property Owner Information)
Signature 1
Print or Type Name
Telephone Number
/-7— //—e)9
Date
Signature
Date

MR. ALFRED B. COOPER, JR. WACHOVIA BANK, NA 5469
BUSINESS ACCOUNT
P.O. BOX 250
ATLANTIC BEACH, NC 28512 66-21/530 1/5/2009
PAY TO THE $ **1,200.00
ORDER OF IV_CDENR _
One Thousand Two Hundred and 00/100********************************************************************************* DOLLARS
Security features
tincluded
Deleils on beck.
NCDENR
Ivr
NIFMO __ dredging _permits -_ North Shore )$6AUTH�1ZE*S1G3NR
II'00546911' 1:053000 2 19I: 105460 18 26 133Ill