27849_MINTZ, JACK F_20010319

CAMA and DREDGE AND FILL lc849
G E N E R A L r.-.
PERM I T r
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 15 NCAC
Applicant Name Phone Number
i
Addrt-
City State zip
Project Location (County, State Road, Water Body, etc.)
Tyne of Project Activity
PROJECT DESCRIPTION SKETCH ; _
Pier (dock) Length °4 (1
Groin Length
number
Bulkhead Length
max. distance offshore
Basin, channel dimensions
cubic yards
Boat ramp dimensions
Other
This nnrmit is ctihiart to emmnliance with this aonlication, site drawing
and attached general and specific conditions. Any violation of these terms
may subject the permittee to a fine, imprisonment 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 of-
ficer when the project is inspected for compliance. The applicant certi-
fies by signing this permit that 1) this project is consistent with the local
land use plan and all local ordinances, and 2) a written statement has
been obtained from adjacent riparian landowners certifying that they
have no objections to the proposed work.
In issuing this permit the State of North Carolina certifies that this project
is consistent with the North Carolina Coastal Management Program.
(SCALE: n i`
applicant's signature
permit officer's signature
issuing date expiration date
attachments
application fee

J• F. MINTZ
FAYE P. MINTZ
NCDL 707627 903292
478 LOBLOLLY DR. PH. 910-245-7007 sEnlor�s�nesr'
VASS, NC 28394 ELIIE
PAYTOTHL" [ 1 r
ORDER OP J f
V S. CAROUNA 2
Inr.
�:0 53 104568�: 2330 2189 2112
66-456/531 2307
233021892
DATE
2 `
- ----- "'

IIAR 15 2091

U_. vf
(1.1p
fT
Iil
f0 12APIL", I ?r,
oF:'
— — rx. 11"MA I i'('r
REFERENCE :I_of'j 17,LA'. C.
IT
0,
t
vt
2..
A 4'ui
I To
E
11 ­11 '-'- cu , r--
e I
" vlCjdy(..
1, Pate D. Phillips hereby certify that
this map Is correct Allf'7 ..ri IT-
't
�FESS/p2,�'y
Z-
SEAL
L-264
t). P VA\%—"o
/A)rvl�"ll wrl;
'�'ur Ifoo M)E- 1­vF_f_
re it, i 2c,
Lo-r AV_Lt\
lf"61(1(1 51:v FT
( 6-( Goa f V.)
AV (-A I f fix, rf
mo. l(rj f'� r,,3
u
_fj\LP I UAF_ - (,.A
40
PATE PHILLIPS and ASSOCIATES, P. A.
swonsboro, n. c. 28584
M
Projecl No.'

ADJACENT' RIPARIAN PROPERTY OWNER STATE- NLE, NT
(FOR A PIERIMOORING PILINGSIBOAILIFT/BOATHOUSE)
I hereby certify that I own property adjacent to 7-- � N �'/U f2_ 's
(Naive of Property Owner)
property located at 26,17 ZbT `-N e r S ' 0-reek b j•,' ►/ (?,
(Lot, Block, Road, etc.)
on ! I fe,6 C r5 C4 F e �, in &,� P/t&I C1 -'7—S /N , 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 cess 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)
3'
fax�lo
y x � 6 r�"--'—� �� Ire Q�� � ► n.G t) o Ck
`K
f
----------- 7 EL,-i-- --------------a----------------------------------------
g ature
Print or Type Name
Telephone Number
Date: J-/J- ��

ADJACLNl' RIPARIAN PROPERTY OWNIM STATL+ME, NT
(FOR A PIERIMOORING PILINGSIBOAILIFFIBOATHOUSE)
I hereby certify that I own property adjacent to �� 4 Q2 e_ /V(; lU z 's
(Name o Property Owner)
property located at 20,17 zg rM e rs' DW k 1) r, ` V 2 ,
(Lot, Block, Road, etc.)
on f) rM e r S C r 6 E L , ui &-ne v-0 /d T-S �� , 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)
f- I; S+" N d Oct.
MI^ii� 15 zoos
"fer /iNC
Signature
6tl / &-7
Print or Type Name
9/g- - zyZs
Telephone Number
Date: -3/ 0 /0/

1 r'�
�YII , i _