28832_RANDLEMAN, THOMAS_20010808

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 Phone Number f
Address
City > , State r,i Zip
Project Location (County, State Road, Water Body, etc.)
i I, •r / lee
Type of Project Activity 1 a'i[ Inf`k!br,
PROJECT DESCRIPTION c'rcTr'-'
Pier (dock) Length
Groin Length
number
Bulkhead Length
max. distance offshore
Basin, channel dimensions
cubic yards
Boat ramp dimensions
Other
t icier c. A1i w/F i
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,
applicant's signature
permit officer's signature
issuing date expiration date
attachments
91(c,00 ` f fl Yi /f �
application fee

ADJACENT R.IPARL-�N PROPERTY OWNER STATEMENT
(FOR A PIER/MOORING PILINGS/BOATLIFT/BOATHOUSE)
I hereby certify that I own property adjacent to '
(Name of Property 0 er)
property located at
;,
(Lot, Blgck, Road, etc.)
on / , in , N. C.
(Waterbody) (To4n and/or County)
7'?Z)
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 se: back a minimum distance of fifteen feet (15') from my area
of riparian access unless waived by me.
1Z I do not wish to wai%-e the setback requirement.
I dR wish to waive that setback recuirement.
DESCRIPTION AND/OR DRAWLNG OF PRO POSED'DEVELOPMENT:
(To be filled in by i ividual prop
o�.rzg development)
ed
7
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MAI
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Signature
Print or Type Name
Telephone Number
Date:

' FROM :
T.R. TRYLOR & SONS SFD., INC. PHONE NO. : 1 919 225 2011
Rug.03 01
Q
t20P Julian Dickens 553-8051
P.I
�JxCIENT RLFAYLLA.N PROPERTY OWNER STATENEEIN7
(FOR A PIER/MOORING PILINGSIBOATUFTIBOATHOUSE)
I
reyby certify that I ow,' property adjacent to
(Name of Property 0 er)
property I
at 7-?
I (Lot, 111 r-k, Road, etc -)on
H.C.
erbody) (T n find/or County)
and,
H
I
hasjdacribed W me, as shown below, the deve?opmeat he is proposir.- at that location,
Iva no objections to his proposal. I understand that a pier/mooring
pilings
Mxiuhouse must be se, back a minimum distance of fifteen fcc'.t (15,) frum, my-W.Ca_
of ripari
accxss unless waived by me.
,VJ
` I do no wish to waivc the setback requirement.
If d4 wish to waive &..at setback requirement.
-------------------------------------------------------- C IPTION AN-D/OR DRAW1N- G OF PROPOSED DFVELOPNENZ-:
(To be filled in by
i iridual pry o 'ag derelo meet)
x�
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lY
-
-
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S:gnat.:re
t
Print or Type Name
Tcl=phone
Numb,, --
Dam:
P81