28821_RHODES, CLIFTON_20010912

CAMA and DREDGE AND FILL /0
G E N E R A L�
PERM I T :.
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
Project Location (County, State Road, Water Body, etc.)
Type of Project Activity
PROJECT DESCRIPTION SKETCH
Pier (dock) Length il'77777
Groin Length
number
Bulkhead Length
max. distance offshore
Basin, channel dimensions
cubic yards
Boat ramp dimensions
Other
Phone Number
State zip
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.
(SCALE:
applicant's signature
permit officer's signature
issuing date expiration date
attachments
application fee

QUEENS CREEK TRAILER PARK & CAMPGROUND 1279
PH 910-326-4564
370 QUEEN CREEK RD.
SWANSBORO, NC 28584
DATE .� 1 66-301531
LFR
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OF
v LLARS B®
CITIZENS BANK & TRUST COMPANY 341
BORO, NC 28584
11100 L 2 7911' I,:0 5 3 L00 3001:00 34 L 2 29 L04011'
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ADJACENT RIPARLAN PROPERTY OWNER STATENLF-IN '
(FOR A PIER/MOORING PILINGSIBOATLIFT/BOATHOUSE)
I hereby certify that I own property adjacent to ()C RN6A1 R �40 L) C 5 's
(Name of Property Owner)
property located at ,37'0 Q UC-Ea/c c REE"K IUD rdA-)cr %a 4uc,.rAvs C h?� a ac
(Lot, Block, Road, etc.)
on p [: GALS C'R EICd� _,in
(Waterbody)
6NS'Ga W
(Town and/or County)
, N.C.
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/boatiift/boathouse must be se: 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 du wish to waive tr.at setback requirement.
DESCRIPTION AND/OR DRAWr4G OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
fl,FrckR Tv 14IrT464E-b fl R04w;Ne
4Lel
Signature
Z/,
Print or Type Name
��/e'�'- 3-p6_ 3(,d I
Telephone Number
Date: ff _ -�o — 61

ADJACENT RIPARLAN PROPERTY OWNER STATEMENT
(FOR A PIER/MOORING PILINGSIBOATLIFT/BOATHOUSE)
I hereby certify that I own property adjacent to Cl- I. p Tom
V. R 4-1 o 1)G S .Sr?,s
(Name of Property Owner)
property located at 3 7 0 f3U bENs C R F t K R D, CA/ EXT T o g&FFN S(V R. g R i DC �
(Lot, Block, Road, etc.)
on OUC-FV S e R Eirk , in D,v S ,to t o , N. C.
(Waterbody) (Town and/or County)
He has described to me, as shown below, the development he is proposing a: 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.
I do not wish to waive the setback requirement.
_ I du wish to waive teat setback requirement.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOP)IENT:
(To be filled in by individual proposing development)
6EFFR T'o qcgGD .0 F?�ct,
Sicrnatur
Print or Type Name
Telep one Number
Date: e/'� 21,2

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