28847_O'MALLEY, JOHN W_20010829

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CAMA and DREDGE AND FILL
G E N E R AL 2 9 7�
,
PER
MIT
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'” 'r '
Address �� i, , t
City State
Project Location (County, State Road, Water Body, etc.)
7 Pv
Type of Project Activity
PROJECT DESCRIPTION SKETCH �1FU , 'r
Pier (dock) Length �� � r l!i '+ � i �j ,'
.. ._
Groin Length
number
Bulkhead Length
max. distance offshore
Basin, channel dimensions
cubic yards
Boat ramp dimensions
Other
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, 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.
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permit officer's signature
issuing date expiration date
attachments
application fee

JOHN W. O'MALLEY 3031
ANN O'MALLEY
802 SEA GATE DR 728-7628 66-30/531
NEWPORT, NC 28570 Date � 006
Pay A %e I $ /".-w- �
®raer of
Do .,,;
FYARST CITIZENS 006 u�t
�I FiratLlti s Ba k 8 Trusl Company
/ i� Boaulorl, N.C. 28516 � �/
1:0 S 3 100 3001:0000 S 7 68 70 21311" 0 30 3 L

ADJACENT R-EPARLkN PROPERTY OWNER STATEN E N—r
(FOR A PIER/MOORING PILINGS/ROATLIFTIBOATHOUSE)
I hereby certify that I own property adjacent to
came of Property Omer) if
property located at
dock Road, etc.)
on , in
(Waterbody) (To n and/or County)
He has described to me, as shown below, the development he is proposing az, that location,
and, I have no objections to his proposal. I understand that a pier/mooring
pilings/boatliftibo thouse must be se: back a minimum distance of fifteen feet (15) frarn my area
of riparian access unless waived by me.
I mot wish to waive the setback requirement.
I da wish to waive t;.at setback requirement.
�W821,/VC—
R DRAWr G OF PROPOSED DEVELOMEN-7;
in by individual proposing develnpment)
Signature
Print or Type Name
Telephone Number
Date:

ADJACENT RIPARL—VS PROPERT1 OWNER STATEMEN-T
(FOR A PI R/MOGRING PILLVGS/BOATI.tFT/BOATHOI.SE)
I hereby certify that I cwri property ad. acent to `� ;'
am oof Property
property located at
Etock, Road, etc.)
on in _ _ _ �.. N.C.
(Waterbody) (T wn and!or County)
He has described to me, as shown bellow, &.e development he is proposing G: tl�at locatior,
and, I have no objections to his proposal. I understand that a pie-`mco,;ng
pidnas/�atiiftlboathouse must be se: back a mirir um distance of fifteen feet (l5*) fr��m my a:
of ripahan access urt.ess waived by me.
I do not wish to wa::e the setback reQuirement.
I wish to waive ::.at setback re uirement_
^� DESCRIPTION AN"D!OR DRAWrG OF PROPOSED DEVELOPNIM),T:
(To be filled in by individual proposing development)
wit S 7 9"7 /;/; W,* r /4L-
1
Print or Type Nre
.�- 5 a-^ 7,/7- 9aY(/ - 7 z�r- --
Te?ephone Nurnber
Date: