26986_ROMO, FRANK_20001023

CAMA and DREDGE AND FILL
G E N E R A L 26986-�
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 : ,1 : c 11 State
Project Location (County, State Road, Water Body, etc.)
Phone Number : :7-
Zio
Type of Project Activity
� 2
�. ' "
` 'Arc
PROJECT DESCRIPTION
Pier (dock) Length
Groin Length
number
Bulkhead Length
max, distance offshore
Basin, channel dimensions
cubic yards
Boat ramp dimensions
Other I,' t Fr r
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.
�n
issuing date
applicant's signature
permit officer's signature
expiration date
attachments
application fee

Ann Rotch brd 66-30/531
Frank P R01M 080 1340
330 Shoreside Dr Ph 252-393-1234 �G j_ 2
Swansboro, NC 28584 DATE Z4506
PAY TO THE F %V9
ff�
OR ER OF — / lN� 7
DOLLARS
u
Look for: Micro Print signature line. gray type and Ilncwork. First Citizens Bank logo on hack. If not present. do not cash.
FIRST CITIZENS 080 BANK
First-Citizens Bank 3 Trust Company
"'" Jacksonville, N.C. 28540
FOR —6� �X—9%0
AP
40 S 3 100 3004000 7 6 7 24 7 3 S Gul 013110 Y

+�� V i a V Li • a 1 �a..L a �� �.ar �i ♦ a 1� VJ l 1J1\ 1 1 V I/ L 3 aJ % I.1 1 L 1 1 LL I l A ,L \ j
(FOR A PIER/MOORING PILINGSIBOA TLIFFIBOA THOUSE)
I hereby certify that I own property adjacent to _74" ,s
(Name of Property Owner)
property located at Sb4. 3 3 n 5 wlux- —5 C�t*� V -- 2-5 5 ES
(Lot, Block, Road, etc.)
on L�.t c �� , 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/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.
I da wish to waive that setback requirement.
DESCRIPTION AND/OR DRAWr4G OF PROPOSED DEVELOPMENT;
(To be filled in by individualV� osin development)
Qoml � Lo I
� PIkj f,7 �� -V CAO,
Print or Type Name
Telephone Number
Date: , I oDo

A,JACEN"T RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/MOORING PILINGS/BOATLIFT/BOATHOUSE)
I hereby certify that I own property adjacent to &22ti IS
Name of Property Owner)
property located at Ly \ (v 5 e \r 33u 5KOre q)'dVe O n J, , 2�t7c
(Lot, Block, Road, etc.)
on d �%� , in ��7J 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/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.
I d4 wish to waive that setback requirement.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOP. TENT:
(To be filled in by individual proposing development)
Sr
El
Signature /
Print or Type Name
oZ.-a - 3 ij3 - ///-.?
Telephone Number
Date: /O-- /9 - o?C00
•