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Home My WebLink About52187_LANE, BILLY_20080116❑ CAMA / ❑ DREDGE & FILL < t L 18 GEIVERAL 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 r and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC ❑ Rules attached. Applicant Name - Project Location: County Address Street Address/ State Road/ Lot #(s) City State ZIP Phone # O Fax # O Subdivision' l ' Authorized Agent ""�" City ZIP Affected ❑ CW ❑ EW ❑ PTA ❑ ES ❑ PTS Phone # ( ) River Basin AEC(s): ❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ NIA Adj. Wtr. Body (nat /man /unkn) ❑ PWS: ❑FC: ORW: yes / no PNA yes / no Crit.Hab. yes / no Closest Maj. Wtr. Body ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■i■�■■■■■■■■inn■�■■■i®■■��■�i■�i■i■A ■■■■■■■■w=■■r&e�■■■■■■■■■■■■■■■■■■■■■ ■■■� ■■■■■�_■■iiIF■■E.■ ■■�■■��■�� n�r■iiW■■ _ .■■■■■■■■■■■■■■■■�■■■.■■■■■:.:■■■■■■■■ Agent or Applicant Printed Name Signature Please read compliance statement on back of permit Application Fee(s) Check# Permit Officer's Signature Issuing bate Expiration Date i Local PlanningJurisdiction Rover File Name— e 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 [)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: 919-733-1495 Morehead City Headquarters 400 Commerce Ave Morehead City, NC 28557 252-808-2808/ 1-888-4RCOAST Fax: 252-247-3330 (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: 252-264-3723 (Serves: Camden, Chowan, Currituck, Dare, Gates, Pasquotank and Perquimans Counties) Washington District 943 Washington Square Mall Washington, NC 27889 252-946-6481 Fax: 252-948-0478 (Serves: Beaufort, Bertie, Hertford, Hyde, Tyrrell and Washington Counties) Wilmington District 127 Cardinal Drive Ext. Wilmington, NC 28405-3845 910-796-7215 Fax: 910-395-3964 (Serves: Brunswick, New Hanover, Onslow -below New River Inlet- and Pender Counties) Revised 08/09/06 Z. AS i�� I th. Gal"014i'!� Department of Environment and �dattara D3 ;sIcri I Coasts! Manag,s; ssri't (Michael F �Easlr:y, Governor Chades S. Jones, Diractor Morehead City DCM Resources William G. Ross Jr., Secret irf C.ailinticlre3003 4 t Lss $xxay Gil N c TkIet*?- i( ictea01S I certify gnat I have authorized (agent) -pts to act ou Kn7- behalf, for the pnrposP- c,f applying for and obtaining all CANLA, Permits necessary to install or construct (activity) C—F�� 7 1)Q ;E-*15DX at (locatioan) 3 $' C a& +jvleo m i4P OLb c-t-�S0q ._ PFFL,)HTIC- '1-*c This certAfication is valid thru (date) Signature RIVED � i rr { 1> � ,�1_+ 0i 1 l .. ' 1 ll..:.l� (FOR A FIEF/UjY"' 0 YLER.FD B OA T L T r . _Morehead City DCM Q`;"ii V1 ViiCI'-r` CQiaL property lcczted ai � g- � G� �1�, rn�P Black, Roa etc.) OF! in N.C. aterb �dy) (Tom and/o Couaty) He has desc-ibe~i to me, Is Shown belo,, , the developr7enc he is proposing at that Location, and, I have no object ons to his proposal. I understand ljhac a pier/uncovers boat lift must be set back a minimum distance or rirUetin rat (I5') from my;area or riparian acct-ss urdess waived by me. / I do not wish to waive the setback re"ulrement. V I do wish to waive that setback recuLem . ent. DESCRIPTIO i �_N_D/OR DR WTvG OF PROPOSED DEVEr OPN.LE.N'T: (To be jWed in by individucl proposing development) ?runt or 1 yp-- i�+arne Telephone i�iumb;�_r s CD CD cc!c! P L !an 07 ��8 04:05p BILLY LANE 919-644-1028 p.2 IFIX ADJACENT RIPARIAN PROPERTY OWNER S �i, MENT - (FOR, PILINGS/BOATLIFTIBOATHOUSE I y 2008 I hereby certify that I own property adjacent to p> I LLq L ' ` ,, eaa City qCM - ' Kinie of Property Owner) _. property located at 3 �' �S-� .._ T�1� r , liTj' a L-� GA liSC l�-�i� 7 RD (Lot, Block, Road, etc.) IX - on N. C. (Waterbody) (Town andloe Count ) 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 most 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 I iQ wish to waive that setback requirement. ------------------------------------------------------------------------------------------------------------------ DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPNJENT: (To be filled in by indii�irlual proposing det,eloprnent) S ionature Pr(- i C e U/ i LS 6-ri Print or Type Name I-a<-o- ?a 3 y/ TCleohone Number Date LL 0 ND THERMOCHROMIC. ABSENCE OF THESE FEATURES WILL INDICATE A COPY. I AMOUNT BOX A 919 THE FRONT OF THE DOCUMENT HAS MICRO-PRiN ISSUING AGENT • 7G-ram. 011ey orders :cZ1 INTERNATIONAL MONEY ORDER IS AMQ_UXT,_:K--v, cv) L0 (y PAY TO THE ORDER OFJ PAGAR A LA to - ------ ORDEN DE: ASHING im p-RTANT - EEBACKBEFORE N_ co �LIBRADO� co K:t 11E PRAID W DEL PURCHASER, NER FOR DRAWER R ORjHFIRT? YOU AGREE I THE ER CHARGE AND OTHER TERMS ON THE REVERSE SIDE PURCHASER, BY SIGNING YOU AGREE 0 R C R6 AN E . R j:jijjgT-E RECIPIENT MONEY ORDER: ADDRESS �ES jj Payable Throulgh ISSUER/DRAWER: NtIon,I Bank MONEYGRAM PAYMENT SYSTEMS, INC. TO AUTHENTICATE BUS CIRCL E PARA AUTENTICAR RESTFEGAR EL CIRCULO South Centra la,iba.lt. MN 1:09 L900 5 3 31: 5 7 1. SCU,It. 90