32966_PANE, LORI_20021211

CCAMA / D DREDGE & FILL
GENERAL PERMIT
Previous permit #
❑New ❑Modification ❑Complete Reissue ❑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
❑ Rules attached.
Applicant Name
Address .t.
City If i' J. , 1, ` State ZIP
Phone # ( ) r
(, - 6j ,� Fax #
Authorized Agent L �;..';�)
CW ElEW ❑ PTA El ES ElPTS
Affected AEC(s): _l OEA ElHHF ❑ IH ❑ UBA ❑ N/A
❑ PWS: El FC:
ORW: yes / no PNA yes / no Crit. Hab. yes / no
Project Location: County
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
Signature Please read compliancestatement on back of permit
Application Fee(s) Check #
Permit Officer's Signature
Issuing Date Expiration Date
r I J i
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
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:
❑ 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 Elizabeth City District
Mailing Address: 1367 U.S. 17 South
1638 Mail Service Center Elizabeth City, NC 27909
Raleigh, NC 27699-1638 252-264-3901
Location:
Parker -Lincoln Building
2728 Capital Blvd.
Raleigh, NC 27604
919-733-2293 / I-888-4RCOAST
Fax: [phone]
Fax: [phone]
(Serves: Camden, Chowan, Currituck,
Dare, Gates, Pasquotank and Perquimans
Counties)
Morehead City District
151-B Hwy. 24
Hestron Plaza II
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.nccoastaimanagement.net
Revised 10/05/01

EDWARD C MYERS Z6<t
PH 252-728-1310 NCDL 3578499
P 0 BOX 389 5457
133 MIDDLE LN
BEAUFORT, NC 28516 66-152J531
DATE
VAY T
ORDER
OF /y
4V
_wmo_vu DOLLARS
wachovIa fl.l..' 11(tk.l
FOR M 1'7/< z
:053 LOIS 2911 546 2 1 2 0 S s ?
"W; LAND 2oo I

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIERIMOORING PILINGSIBOATLIFTIBOATHOUSE)
I hereby certify that I own property adjacent to
1.. o 41
property located at 12.).4o
(Lot, Block, Road, etc.)
P.9N L--
(Name of Property Owner)
's
on kM td3 CdetK , in /3&Trft- C.9ATLFtIeT
, N.C.
(Waterbody)
(Town and/or County)
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 (15') from my area
of riparian access unless waived by me.
_ I do not wish to waive the setback requirement.
I do wish to waive that setback requirement.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
v
Signature
41AF DyA" ct4 wZy
Print or Type Name
240 - //S x
Telephone Number
Date: jy

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIERIMOORING PILINGSIBOATLIF (BOATHOUSE)
I hereby certify that I own property adjacent to 4 o )Z / Pt9N L'
(Name of Property Owner)
property located at Alzitl4lera ✓ Zoom
(Lot, Block, Road, etc.)
I
on w0 to s , in Germ--' / Cr9�► �/tc-r— , N.C.
(Waterbody) (Town and/or County)
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 (15') from my area
of riparian access unless waived by me.
A— I do not wish to waive the setback requirement.
I do wish to waive that setback requirement.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
Print or Type Name
24u- 1(g
Telephone Number
Date: 1 t(lo/ 60 L

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TOTAL
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COASTAL WETLAND
ABOVE'
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SET ;RON /
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cee PIPE AT TUNN ,
NOTE: TWO MORE DITCHES CROSS LOTS I. 2,
3. IS 4 DRAINING PROPERTY TO THE %ORTH
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(THEY 3 TO 4 HUNDRED FEET APART AND
APPROXIMATELY PAP.ALELL TO WARD' S CREEK
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51. 34'
10.5 ACRES
�aAGTAL WETLAND / 75.sa',ABOVE
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Ma19' 18'x
COASTAL W<TLA;li A?CVE

December 10, 2002
I hereby authorize Eddy Myers to apply for a permit for a dock in the name of Lori Pane.
The permit will be for Lot 3 Wards Creek Acres, located off Arrington Road in Bettie,
Carteret County.
CGc�� h
Allison Smith