Lane, Ralph

E, kCAMA / ❑ DREDGE & FILL : r x 0 2213 C
GENERAL PERM I Previous permit #
New ❑Modification ❑Complete R artial Reissue Date previous permit issued
As authorized by the State of North Carolina, Department no vironment and Natural Resources / / /
and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC f
06)
- ules attached.
Applicant Name .., 7 .. �..`g - F rG'� Project Location: County (�r�c f e 4"
Address y) -,� - Street Address/ State Road/ Lot # s)
City State.0 ZIP ' �% ± U 7 �r��/�0 • ,'
Phone # {J "r`) .� -'� Fax # (_-) Subdivision
Authorized Agent ` G dA 'r6 ArA J� ' City ( '' -/ r� , r u� ^ L ZIP
❑ CW ,aEW ©-FTA ❑ ES ❑ PTS Phone # ( ) ) River Basin
Affected ❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A ( , r <A 1, 0,41c
AEC(s): Adj. Wtr. Body ^ 4 �' nat man unkn
❑ PWS: ❑FC: f
ORW: yes /(no) PNA yes not Crit.Hab. yes / no Closest Maj. Wtr. Body
Type of Project/ Activity Iy e �.
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/I oatli '� y 13
Beach
Other
.Shoreline Length 7S
SAV: not sure yes ;o
Sandbags: not sure o j
Moratorium: n/a yes 5
Photos: yes n
Waiver Attached: yes no j
A building permit may be required by: 11 f l
Notes/ Special Conditions ('! M I k (; J"fOle
(Scale: 3 V )
❑ See note on back regarding River Basin rules.

T
rr
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, 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 (252-946-648 [)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/ 1-8884RCOAST
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 Citv 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

ALA.
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
Beverly Eaves Perdue, Governor James H. Gregson, Director Dee Freeman, Secretary
Date 3-- , 0 3 _
Applicant Name
Mailing Address 111,17 &
I certify that I have authorized (agent) Ito act on my
behalf, for the purpose of applying for and obtai ing all CAMA Permits necessary to
(activity) . tY) _�a Sao
install or construct (
at (location)��u-A�-�
This certification i* alid th te) IS
Signature . /'C�� (I--,' .
���i!viyd
APR 63 20M
DC:M VHD CiTy
400 Commerce Avenue, Morehead City, North Carolina 28557
Phone: [phone] FAX: [phone] Internet: www.nccoastalm'anagement.net
An Equal Opportunity 1 Affirmative Action Employer— 50% Recycled 110% Post Consumer Paper /

-SDJACE.....mpAmI' PROPERTY01�'1i1ER ST�11T£1IE1T
fFOR 1ERri1IQdRING PILIMSl�O�t iLtFT _ Oil Ttl ?tISE)
I hereby oerti thaz:I.o�m property adjacent to 's
�iV'astte o Propest . Q..•nerj
:property located at.
I:Qc; Block, Rood; etr.
_an ; in
{SYsiterbody} o� n.Ani /*r:Coxn ._­ - . : ?! ±, .- �N:C.:
. Ike fins descri to-rte; as shosn.belov►, tl�e dercl
ands oprnent he is proposing at�that-location;
Ihave.aoObjectioi . toNspicposal. Icuiderstand;hPta�pier/moo
:. must be set bacfi a mi i uni dist$nce of fcfttan feet i5. °from � �?!�Pis���'boatiift'boathousd
..u%aived by me. �� 3' area of rip3tisn access unless
i Aim o • 3b cc n aive ihOetback rquirement: -
LdS Wif to itaiye-that.setttack uicerttent:
.. i �1.11M11W1��-wN�MN� -
DESCRIF!'iQ� AADI�R DRAti'IilG 4 PQPOSEB DE��ELOPiE
(To be fllletrLiii L iiiriFlt
.F FduAl proposmg repelopJrienfj -
milli
f3� .APR 3.0 -
DC1K.1t
or
.:.... = -.. � 9= ZED: . - -• .- � � �_ ..
_ - - date: - 3=.3 a - �QI�-- .. •� _

: riDJAC. R AMN PR�P�RT�' t�WNER-STATEMENT
' rFE)R ISA i OJUiYO PMrNGs�aQAM .rr� rf rft ltlsE} .
I hereby cer f.11
that:I.o%m property adlacrnt to ,$
:. (iv'ame of Prapertr ©�►••ner}
:property locatea:at_
Lot; B1gck, Roatl; etr.�
(�Vaterbody) o��-o aA{Ilos County N.C.
..?
He has desert to Ine; .as shos •n below, tho derclap�ent he is proposing artlia�t-location;
and, I have ob,�ectio to his groposal. I understand that a picilm4oringpitir�Qs�boattift'bcachac�e
must beset baci: a zni i uni distance of fifi�xn feet (I5'j� from my aOM of rip3dan a« unless
unived by me.
I dr not ish to Waive iiizsetback rgwc�ment:: RECEIVED
142 svi I to iiaiye-thatsetl�ack airement:
_ APR 0 3 2013 . .
..MN� MMNVItiMNMNM� N - - .
DESCI2IpTip�; AID/OR D AZV'I lG aP P1tQPOSEB DEZ'EI.QP1•
Fla:iiirii-uiddal' ro osiu r epPlo illeiit -
=�, j
= Signature
yt
,.,_ . - Pin:- - . �::V�� .-,�:� •
c 'i aiephone A'imber
Bated
7