26953_PRESCOTT, BOBBY_20001002

0
CAMA and DREDGE AND FILL
G E N E R A L
PERMIT
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
Address
City State
Project Location (County, State Road, Water Body, etc.)
s
Type of Project Activity
Phone Number
zip
PROJECT DESCRIPTION
SKETCH
(SCALE: „F
)
Pier (dock) Length
£
—
Q.001
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1
Groin Length
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number
Bulkhead Length
max, distance offshore
t
Basin, channel dimensions
cubic yards £
I
Boat ramp dimensions
Other-
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and attached general and specific conditions. Any violation of these terms 7 applicant's signature
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- permit officer's signature
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 issuing date expiration 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. attachments
In issuing this permit the State of North Carolina certifies that this project
is consistent with the North Carolina Coastal Management Program. application fee

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PRESCOTT BROTHERS INC
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�' ��.•� f`� �� `i�l _ 141 TARATRL
ARAPAHOE, NC 28510
DATE
�/ 66-30/531
an
PAY . ; /;'.
TO THE `r ,t�,','
�, .
.. r; •�-
ol
ORDER OF
Q� /( �( ��
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DOLLARS 8
f 'T CITIZENS 471
/� Al ' First.Cilizons B k 8 Trusl Company
j�u� Bayboro, N.C. 28515
g
FOR
0 5 3 L00 3001.004
? L LO 2 54 29u■

ADJACENT RIPARIAN PROPERTY OWNER STATEAENT
(FOR A PIER/MOORING PILINGSIBOATLIFT/BOATHOUSE)
I hereby certify that I own property adjacent to _f��Cjl;�:��'//�'�it-1 's
(Name of Property Owner)
property located at e ram. &-r 'L ' (,- - ,
(Lot, BIock, Road, etc.)
on G��+� , in , 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/boatliftiboathouse 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 da wish to waive that setback requirement.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
Signature
Print or Type Name
25
Telephone Number
Date: r '

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ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to��`
(Name of Property Owner)
property located at f :�d
(Lot, Block, Road, etc.)
on k,4a�6t, N.C. �-�
(Waterbody) (Town andlor County)
He has described to me as shown below, the development lie is proposing at that location,
and, I have -no objections to his proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(To be filled in by individual proposing development)
Signat�re�
Print or Type Name
s a� y- OS-fs-
Telephone Number
Date: c2y-u,J
-29-

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