26966_SWEENY, RUTH_20001023

CAMA and DREDGE AND FILL �
G E N E R A L i a��
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
Project Location (County, State Road, Water Body, etc.)
Type of Project Activity
PROJECT DESCRIPTION SKETCH
Pier (dock) Length
Groin Length
number
Bulkhead Length
max. distance offshore
Basin, channel dimensions
cubic yards
Boat ramp dimensions
Other er
State
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.
Phone Number
zip
issuing date
(SCALE: )
applicant's signature
permit officer's signature
expiration date
attachments
application'

1375
66-1521531
RUTH EVANS SWEENY
NCDL 5595161 PH 919-247-4184
115 DOGWOOD CIR iJ
PINE KNOLL SHORES, NC 28512
PAY TOT11
ORDER
poDOLLARS
W
— A_Wachovia Bank of North Carolina, N.A.
Pine Knoll Shores, NC 28557
FOR
I: !0� s �31 0 Is 2 q I �-- �St. C� �21 q 2 110

FROM COLCiN I RLVMON T;�GUE PHONE NO. : 919 3e7 Be ,' 1 Sep. 28 2000 02: 14PM F'1
3: %32 72,244;j RUTH EVAhS SWFFNY F-AUL IJ.2
ADJACENT REMRIAN PROPERTY owNER STAmuas-T
OVA A PI R/,Mff?OMM PILI'NG&jro l?'Z.IFX'f$OAriO&TS87
Yv e
I hemby amlf1 that T ,>wa property adja=t to zv&e�wEE�V s
(Name of Owner)
psoptrty kxateci at—.-�,.��r� j0 �"� ,
on r L2• use` .�/� �r N.C.
(RWaskibwf; (Town aatdlar Cou z#)
jKv has des-4W to tits, as showtt below, tine dmlxp�* is proWssiag It that
i s&f=, sued, I ltavo AO Ot j=dona to VXWOUL I w4 rst tt that a pierimor=8
pi]inpUadiNboaftm must: be ut h4 a mt$simut dSawce of Moen feet (151) from my a=
of 4arian access vales waived by me.
i wish the waive the setback rOquir*MM ,
_ 192 wish to waive that setback requrczent.
DESCRMION MWOR DRAWNG OF PROPOSED Sal%'EI.OnffN-r:
(To be,jW d is b, tndivfd W pmeske &VCkpr fnt)
yy
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Print or Type Naive
PA,
Telephone Number
00yCIV ""G O's Wt Date:
Ptcsi�iVt', �-Ysiz.

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIERIMOORING PILINGSIBOATLIFT/BOATHOUSE)
�S)N e. e n/
I hereby certify that I own property adjacent to 's
(Name of Pro rty Owner)
property located at / 0 r
(Lot, Block, Road, etc.)
on , �? �+ �, in N.C.
(Waterbody) (Town and/or County)
4111,
He has described to me, as shown below, the development he is proposing at that
location, and, I have no objections to hft proposal. I understand that a pier/mooring
pilings/boatliftlboathouse 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 do wish to waive that setback requirement.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOP.NENT:
(To be filled in by individual proposing development)
7 6 1K/ 171otJ Oij v F
nd c,r'
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Signature
S v�vc.E.�tsjjC
: C r � �Nt) �'o
Print or Type Name
Telephone Number
/Date:C's
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