27888_SUMMERLIN, HUGH_20010412

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CAMA and DREDGE AND FILL ® 2 7888 _�
,.t G E N E R A L �,, ... (��..'�'
P E R M I T
as authorized by the State of North Carolina I I
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 �' zy� ° , lai►'�
Address
City State Zip `_:f ? Z
Project Location (County, State Road, Water Body, etc.);
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Type of Project Activity
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PROJECT DESCRIPTION SKETCH
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(SCALE:
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Pier (dock) Length41
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Groin Length 2
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Bulkhead Length
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max, distance offshore r
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Basin, channel dimensions
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cubic yards
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Boat ramp dimensions
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Other
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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.
yr
applicant's signature
permit officer's signature
issuing date expiration date
attachments
application fee

ADJACENT RIPARL-, PROPERTY OWNER STATENIE"N'T
(FOR A PIER/MOORING PILINGSIBOATLIFT/BOATHOUSE)
I hereby certify that I own property adjacent to Jqu (h ��Lt fy?1W p1-J d 's
(Name of Property Owner)
property located at 3) 2 T cl s V S tre e 1- ( L-ot 3
(Lot. Block, Road, etc.)
on 60c U C in _ 6aac- ar�-pcp urN.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 se: back a minimum distance of fifteen feet (15') from my area
of riparian access unless waived by me.
47101�I do not wish to waive the setback requirement.
I d-Q wish to waive ti,at setback recuirement.
DESCRIPTION AND/OR DRAWDiG OF PROPOSED DEVELOPMENT:
(To be filled in by individual propo.sin; development)
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--------------
�ij4W,
SiQ. ture
Print or Type Name
'5�i�2r 3$7— 46>0 7
Telephone Number
Date: 3//--
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DIVISION OF COASTAL MANAGE.NVIENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FOR.,"
Dame of Individual applying for Permit: S ' , ni
k ddress of Property:
of 3s'
ayAore �/f iaraz �i7ri-��� �AifPr�t �Q i✓L
(Lot or Street =, Str�.t or Road, City & County)
I hereby ce. airy that I own property adjacent to the above reverenced property. The individual
acelving for this permit has described to me as shown on the attached drawing the deveiopmPnt
^.e,r a'r prposir,a..y description or drawing, with d:,:easions, should be provided with this
le.�er.
I have no obiec6ons to this proposal
If you have objections to what is being proposed, please wr' e the Division of Coastal
Management, Hestron PL,-a 11, 151-B, 'W
2808 within 10 days of receipt o ;
MOreh,.ad C.zv, NC, 28557 or call (252) 808-
of this notice. No response is considered the same as no obiecrion
it you have been notiyTed hy Cert ed Mail.
W An -ER SECTION
I understand that a pier, dock, moorna piiinas, brea�,vate-, bear house. liZ or sandbag; must be
=e: back a minimum distance or I 5' i; om my are a or ,—,rat-.a- ac; ass unless waived by me. (Ir you
wah to waive the setback, you must initial the appr op;;ate blank below.)
I do wish to waive the 1 5' setback re�
<� I do not wish to waive the 15' setback rec :ire.;:ent.
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Date
PI —I'm Name
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Telephone Number With Area Code

DIVISION OF COASTAL MANAGEN ENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORIW
Name of Individual applying for Permit: rn
Address of
S+Y-'p of
14 ' n
S c fL 64 9 lis<rt
(Lot or Strw.t Strom t or Road, City & County)
I hereby certify that I own property adjacent to the above referenced prope,r. The individual
applying for this permit has described to me as shown on the attached dewing the development
th:y are proposing. �, description or drawing, with dimensions, should be provided wit h this
letter.
X I have no obi=6ons to this proposal
If you have objections to what is being proposed, please write the Division of Coastal
Z808 within 10 days of recei
hfanagement, Hestron Plaza II, ISI-B, Hwv. ,Morehead Cuv, �'C 8557 or call (252) 808-
pt of this notice. No response is considered the same as no objection
if you have been notijzed by Certi ed Mail.
WAIV"ER SECTION
1 understand that a pier, dock, mooring pilings, breal rate-, boat house, lift or sandbags must be
se: back a minimum distance of 1�' iiom my area of n,ar;aa acre
W. to waive the setbac r access unless ss waived by me. (I you
k, you must initial the appropr,ate blank below.)
x_ __ti,,,�` I do wish to waive the 15' setback recuir. eme ;t.
I do not wish to waive the 15' setbac&: reCuirement.
Signature
ate
P7,nt Name
-��
I e: phone lumber With Area Code

ADJACENT RIPAR.LkN PROPERTY OWNTR STATEMENT
(FOR A PIER/MOORING PILINGSIBOATLIFT/BOATHOUSE)
I hereby certify that I own property adjacent to j-i 14 0 6 SU m m e r J„�I 's
(Name of Property Owner)
Property located at '' S e P-t--
(Lot. t1ock, Road, etc.)
to /q )
on '1 , in f ° t , N.C.
Waterbody) ( own and/or County)
He has describers 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
pdin gs/'boadift/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 d-Q wish to waive that setback re^uiremient.
DESCRIPTION AND/OR DRAWr G OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposin; development)
�4dd P�°�°�E'd .119itr
I'er
w/ki &af //fir
� o Pose
Signature
Print or Type Name
J , (r % i ,= `> Z
Telephone Number
Date: C1 i