26974_POLOWY, KLAIR_20001018

CAMA and DREDGE AND FILL�q
,.� G E N E R A L
tAPERM I I
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
Address
City State
Project Location (County, State Road, Water Body, etc.)
Type of Project Activity
zip
PROJECT DESCRIPTION SKETCH - (SCALE: )
Pier (dock) Length 71
Groin Length
number
Bulkhead Length
max. distance offshore'
Basin, channel dimensions
cubic yards
Boat ramp dimensions I�
Other
l• iF
:7r-
inns permit IS SUU)eU W UU111pl Id11l.0 WIUI U11D a[Ji J1ll.alKJ11, aiic uiavrnir
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- j
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 — I issuing date
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.
applicant's signature
permit officer's signature
expiration date
attachments
I
application fee

CARL HEVERLY
NCDL 6078185 PH 252-354-7154
7306 CANAL DR
EMERALD ISLE, NC 28594
Pay to the
Order ofey ')
I —;--
902
66-30/53I
Date
/ f 135
(/
Dollars
F(RS I GITI7I;NS
, 1
rust Company
13'�—7V� k &5T5Salter PathN C28^p1
�u/cao,l ��ry r
For
1; 0 5 3 L 0 0 3 0 0: 0 0 3 4 L 7 7 7 3 5 L 6 il' 00902
GUARDIAN�SAFE y BLUE WDBL

(FOR A PIER/MOORING PILINGSIBOATLIFT/BOATHOUSE)
Typ.
I hereby certify that I own property adjacent to &, r lPo� 0 w I I
(Name of Property caner)
Property located at y Ccc- T a (-a , c- ,
(Lot, Block, Road, etc.)
on cao-e ! oa ,,,A , in E,.kee -IA I'S1Q , N.C.
(Waterbodv) (Town and/or Countv)
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/boatliftlboathouse 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 dQ wish to waive that setback requirement.
DESCRIPTION AND/OR DRAWUVG OF PROPOSED DEVELOP'v[E.,,-T:
(To be filled in by individual proposing development)
--9. S a�L�L)
C`T'`5'
ARK -
Ae I L, o o
Print or Type Name
gIg-,-7-4 gJ-6ss-3
Telephone Number
Date: 9 r'6 , a, DOD

ADJACENT RIPARIAN PROPERTY OWNT-R STATEMENT
(FOR A PIER/MOORING PILINGSIBOATLIFT/BOATHOUSE)
I hereby certify that I own property adjacent to S , Pc� c ci � 's
(Name of PropertyOwner)
property located at Ccc e Tj e
(Lot, Block, Road, etc.)
on 3A�c� s� �-,� , in E ,N.C.
(Waterbodv) (Town and/or County)
He has described to me, as shown below, the development he is proposing at that location,
and, I have no Obj:CtlCnS t0 his proposal, i understand that a pie. �70011ng
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.
v I d-Q wish to waive that setback requirement.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be
Tp,
in by individual proposing development)
1-_ •
150
1 J
Ei,4, •~5
'Z. i w Y; oL�
,e6�a
Y)iv _ e-tv 0 )6 O/V
Print or Type Name
0,29
Telephone Number
Date: �1� �7-. 2 2 2__ d_�