51833_LOMBARDO, JOSEPH_20090512

0CAMA / ❑ DREDGE & FILL 133
GENERAL PERMIT 1-1— Previous permit #
❑New ❑Modification ElComplete Reissue ❑Partial 4issue 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_ Project Location Coun
Address
City
Phone # () _
Authorized Agent_
Affected Cw
AEC(s): OEA
❑ Pws:
ORW: yes / no
_ State ZIP
Fax # ( )
ElEW ❑ PTA ❑ ES ElPTS
ElHHF [IIH ❑ UBA [IN/A
FI FC:
PNA yes / no Crit.Hab. yes / no
1 tY
Street Address/ State Road/ Lot #(s)
Subdivision
City ZIP
Phone # ( ) River Basin
Adj. Wtr. Body (nat /man /unkn)
Closest Maj. Wtr. Body
Type of Project/ Activity
(Scale: )
Pier (dock) length
Platform(s)
Finger pier(s)
Groin length
number
Bulkhead/ Riprap length
avg distance offshore
j
max distance offshore
Basin, channel
cubic yards
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing
Other
-
I
I
I
j
I
'
I
I
I
I
Shoreline Length -
I i
SAV: not sure yes no —
Sandbags: not sure yes no j
Moratorium: n/a yes no
Photos: yes no ( '
Waiver Attached: yes no
A building permit may be required by: , See note on back regarding River Basin rules.
Notes/ Special Conditions
Agent or Applicant Printed Name
PermitOfficer's Signature
Issuing Date Expiration Date
Signature Please read compliance statement on back of permit
Application Fee(s)
Check #
Local Planning Jurisdiction
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 ❑ 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

k
North Carolina Department of Environment Resources
Division of Coastal Management
Charles S. Jones, Director
William G. Ross Jr., Secretary
Michael F. Easley, Governor
Date �- 3 U— /) °J
Applicant Name,
Mailing
I certify that I have authorized (agent) Folev &Foley Contractors, Inc. to act on my
behalf, for purpose of applying for and obtaining all CAMA Permits necessary to
install of construct (activiI
at (location
This certify inn is valid
400 Commerce Avenue, Morehead City, North Carolina 28557
Phone: [phone]/ FAX: [phone]/ Internet: www.nccoastalinanagement.net
An Equal Opportunity/ Affirmative Action Employer-50%Recycled/10% Post Consumer Paper

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(Bulkhead/rip rap)
roe adjacent to�(Namef
(I�I�,2Gd 's
I hereby certify that I own p p rty rtyOwner)
1 Gated
tc
Property o - -
W � (lot, block, road, etc.)
CL� � MA C ��� N.C.
on a=��in _
(Water body) (Town and/or County)
He has described to me as shown below, the development he is proposing at the
location,_and, I have no objections to his proposal.
DESCRIPTION AND/OR D RA WIN OFo�o OPOSE�D DEVELOPMENT
(to be filled i yindividual
E/U]
(Applicant Information)
a� n — --
Mailing Address
l 1. 99 l P, re -To
City/State/Zip
N d
Teleplioon/�Number
F �1 fLZ� Ct5(D� ----
Date L!` I �6^Oet
Foley & Foley Contractors, Inc
252-636-2515
252-636-3127 Fax
(Riparian Pro erty Owner Information)
Signature
print or Type Name
Telephone Number 12,
Date

■ Complete items 1, 2, and 3. Also complete
item 4 if Restricted Delivery is desired.
■ Print your name and address on the reverse
so that we can return the card to you.
■ Attach this card to the back of the mailpiece,
or on the front if space permits.
1. Article Addressed to:
fib Rom%
s�Ir;�y r�r�d'� UIi da /S i
A Signatur
X`Z ❑ Agent r
Mddressee t
B.eFve C (Pr2p Nagte) C� i �ry
D. Is delivery address different from item 1? ❑ Yes
If YES, enter delivery address below: No
i
I
3. Ice Type
Qk Certified Mail ❑ Express Mali
❑ Registered ❑ Return Receipt for Merchandise i
❑ Insured Mail ❑ C.O.D.
4. Restricted Delivery? (Extra Fee) p Yea
2. Article Number
(Transfer from service labeg %D a i I f 9 0 ocx, 7
PS Form 3811, February 2004 Domestic Return Receipt 102595-02-M•1540
■ Complete items 1, 2, and 3. Also complete
item 4 if Restricted Delivery is desired.
■ Print your name and address on the reverse
so that we can return the card to you.
■ Attach this card to the back of the mailpiece
or on the front if space permits.
1. Article Addressed to:
l Y/3 �•vh ker
Q l lei5k A1c.
A. Signature
x ❑ Addressee
B. Received by (Pnnted C. D to of Deyy'very '
D. Is delive a> Tress different from Item l?' L-7\Y
If YES, nter delivery address below:
APR 2 0 2009
3. Service Type
KCertified Mail
❑ Express Mail
❑ Registered
❑ Return Receipt for Merchandise
❑ Insured Mai
❑ C.O.D.
4. Restricted Delivery? (Extra Fee) ❑ Yes
2. Article Number �/Q /�.,,� n Q Q
(Transfer from service label) 7vo`j I / rd �.WO 7033 70 /5
PS Form 3811, February 2004 Domestic Return Receipt 102595-02-M-1540
0

12.19
FOLEY CONTRACTORS LLC 12-08
257 IRELAND RD
BAYBORO, NC 28515 T Q
„1 � r 66-30/531
DATE
112
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