34759_LANE, RANDY_20030827

-CAMA / ❑ DREDGE & FALL
GENERAL PERMIT
❑New i 'Modification i-Complete Reissue I-1Partial Reissue
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 I SA NCAC
Applicant Name I. o odr l a nt
Address
City ru State dt ZIP S�
Phone # 31/1 # ( j) Z 15 7/ i 3
Authorized Agent
Affected [- CW ❑ EW LkPTA CI ES ❑ PTS
_i OEA = HHF ElIH ElUBA ❑ N/A
AEC(s):
`I PWS: ❑FC:
ORW: yes / no PNA yes / $So Crit. Hab. yes J no
Previous permit #
Date previous permit issued
❑ Rules attached.
Project Location: County f" f. t 7
Street Address/ State Road/ Lot #(s) t l i 7 /f iP la r » t r/✓!t/
Subdivision
City 11c , IrE ZIP
Phone # ( } River Basin W4 i LX/ V-
Adj. Wtr. Body / ' o r yvie 41- %r.7 r+� / (nat /fir an /unkn)
Closest Mai. Wtr. Body W A / r
Type of Project/ Activity yti.
(State:
Pier (dock) length
Platform(s) `( i
Finger pier(s)
Groin length
number
Bulkhead/ Riprap length
avg distance offshore
max distance offshore_ I
Basin, channel
cubic yards _
Boat ramp-
___ri
Boathouse/ Boatlift f
y
Beach Bulldozing
Other
I
I
I
op
pie
c
!
I
{
I
I
i
(
I
-
-
Shoreline LengthiJ%J
SAM not sure yes Co-ir•
Sandbags: not sure yes
Moratorium: n/a yes 01
Photos: yes
(I
Waiver Attached: +fie) no
A building permit may be required by: 41,4t i
Notes/ Special Conditions
�
River Basin
l � al n,
-
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j / o
r' � 4,,C f?
❑ See note
jn 61 w
on
f
back
' �
regarding
rules.
Witt • n r
Af E. { ✓
to r Jo s_ f r!
A ,vcc
1
Agent Applicant Printed Name
Signature Please road compliance statement on6ckof permit
Application Fee(s) Check #
i
Permit Officer's Signature
f,17 ��S /I �7 r-?
Issuing Date Expiration Date
l"-It .� r.�f�p n} cz7/M
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 (910-395-3900) 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 / 1-888ARCOAST
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

UNITED ST/JTES
POST/JLSERVICES PO C 1tL MONEY
ORDER
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SERIAL NUMBER YEAR. MONTH, DAY \ \
06102706195 COST OF�,,Ea\ \ U 5T iSOLLARS AND CENTS
zoa3-08-27 D 4 it
AMOUNT ONE HUNDRED DO►LLF
PAY TO NEGOTIA
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ADDRESS
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C.O.D. NO. OR
USED FOR����
1:0.0000a00 2100 06 10 2 706 191
D POSSESSIONS
/ CLERK

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11/08/2002 10:06 2527263018 LARRY G ARNOLD PAGE 02
r\j ; ) 5 2003
ADJACENT RIPARIAN PROPERTY OWNER s*rATEMENT
(FOR A PIER/UNCOVERED BOAT LIFT)
I hereby certify that I own property adjacent to
(Name 1proptrty Owner)
property located at JamKe— Of
(Lot, Block, Road, etc,)
on �.. _ in ZrC.
( aterbodr) (Tnwn and/or County)
He bar described to tame, as shown below, the development he Is propoiiws at that location.
and I wave no objectloas to his proposal, I understand that a pierluncovered boat lift must be Oct
back et a atiwimam of fifteen (1 S') fraro my area of riparian access unfelt waived by me.
1 do ag wish to waive the setback requirement.
119 wish to waive that setback requirement.
DESCRIPTION AND/OR DRAWING OF PROPOSED -DEVELOPMENT:
(To be filled in by individual proposing development)
Telephone Number
Print or Type Name
bit

11/08/2002 10:06 2527263018
LARRY G ARNOLD
PAGE 02
i *0 u 2 5 2003
ADJACENT RIPARIAN PROPERTY OWNER s,rATEMENT
(FOR A PIER/UNCOVERED BOAT LIFT)
I hereby tertif+ that I owe property adjacent to
(Warne roptrty Owner)
property bctttwrd at �!�_ �
�Ellack,�xd, etc.) --
in
( stterb°dy) (Yawn eyed/or County)
He has described to me, at rbow» below, the development bt Is proposing at that location.
and I have no Objections to his proposal, ( understand that a pier/ancovered boat lift must be rat
back at a minimum or fifteen (I$,) from my area or riparian access Unless waived by me,
a d9 so wish to waive the setback requirement.
190 wish to waive that setback requirement,
DESCRIPTION AND/OR DRAWING OF PROPO5I=D'DEVELOPMENT:
(To be filled in by individual proposing development)
/
1�
Ttlephone Number
Print or Type: Name
6a►c7 4--