20221424 Ver 1_Encl 3 - DCM MP 3 Upland Development - Lane, Revised 01-24-2023_20230124

Form DCM MP-3
UPLAND DEVELOPMENT
(Construction and/or land disturbing activities)
Attach this form to Joint Application for CAMA Major Permit, Form DCM MP-1. Be sure to complete all other sections of the Joint
Application that relate to this proposed project. Please include all supplemental information.
GENERAL UPLAND DEVELOPMENT
a. Type and number of buildings, facilities, units or structures b. Number of lots or parcels.
proposed. I
No buildings proposed at present with this Permit; a single
residential structure is anticipated in the future.
c. Density (give the number of residential units and the units per
acre).
1 per 8 acres
e. If the proposed project will disturb more than one acre of land, the
Division of Land Resources must receive an erosion and
sedimentation control plan at least 30 days before land -disturbing
activity begins.
(i) If applicable, has a sedimentation and erosion control plan been
submitted to the Division of Land Resources?
❑Yes ❑No ®NA
(ii) If yes, list the date submitted:
g. Give the percentage of the tract within the coastal shoreline AEC to
be covered by impervious and/or built -upon surfaces, such as
pavement, building, rooftops, or to be used for vehicular driveways
or parking.
Imp. Sfc: Boatramp Access Road 868 sq ft = 3.0%;
Bulkhead with return walls 768 sq ft = 2.7%; Total Imp.
Sfc: 1636 sq ft = 5.7%; Built -upon: Walkway 645 sq ft =
2.3%; Total Imp. Sfc. & Built -upon: 2281 sq ft = 8.0%;
Total including existing Boatramp: 2595 sq ft = 9.1%
i. Give the percentage of the entire tract to be covered by impervious
and/or built -upon surfaces, such as pavement, building, rooftops,
or to be used for vehicular driveways or parking.
Proposed : 1.4%; Proposed plus Existing: 2.1%
j. Describe proposed method of sewage disposal.
On site septic tank and leach field
I. Describe location and type of proposed discharges to waters of the
state (e.g., surface runoff, sanitary wastewater, industrial/
commercial effluent, "wash down" and residential discharges).
None
d. Size of area to be graded, filled, or disturbed including roads,
ditches, etc.
31,023 sq ft
f. List the materials (such as marl, paver stone, asphalt, or concrete)
to be used for impervious surfaces.
Access road to boatramp to utilize gravel, shell, concrete or
asphalt.
h. Projects that require a CAMA Major Development Permit may also
require a Stormwater Certification.
(i) Has a site development plan been submitted to the Division of
Water Quality for review?
®Yes ❑No ❑NA
(ii) If yes, list the date submitted: 1 1/22/2022
k. Have the facilities described in Item (i) received state or local
approval?
❑Yes ®No ❑NA
If yes, attach appropriate documentation.
m. Does the proposed project include an innovative stormwater
design?
❑Yes ❑No ®NA
If yes, attach appropriate documentation.
252-808-28082 :: 1-888-4RCOAST :: www.nccoastaimanagement.net revised: 12/26/06

Form DCM MP-3 (Upland Development, Page 2 of 2)
m. Describe proposed drinking water supply source (e.g., well,
community, public system, etc.)
County water
o. When was the lot(s) platted and recorded?
25 February 1987
12 September 2022; Amended 24 January 2023
Date
Lane Shoreline Development Project
Project Name
Sharon R. Lane
Applicant Name
Theodore Sampson (Agent)
Applicant Signature
n. (i) Will water be impounded? ❑Yes ®No ❑NA
(ii) If yes, how many acres?
p. If proposed development is a subdivision, will additional utilities be
installed for this upland development?
❑Yes ❑No ®NA
252-808-2808 :: 1-888-4RCOAST :: www.nccoastaimanagement.net revised: 12/26/06