27837_TEAM, ROBERT A JR_20010424

. &S,
CAMA and DREDGE AND FILL
G E N E R A L 27837 �
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
Address
City State zip
Project Location (County, State Road, Water Body, etc.)
Type of Project Activity
PROJECT DESCRIPTION SKETCH
I Pier (dock) Length
Groin Length
number
Bulkhead Length
max. distance offshore
Basin, channel dimensions
cubic yards
Boat ramp dimensions
Other
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.
issuing date
(SCALE:
applicant's signature
permit officer's signature
expiration date
attachments
application fee

2420
BW
MIKE NOE CONSTRUCTION CO, INC. Branch Banking anCompany
PH. 252-728-3828 617 FRONT STREET
P.O. BOX 586 BEAUFORT. NC 28516
BEAUFORT, NC 28516 66-112/531 4/23/2001
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PAY TO THE $ **100.00
F ORDER OF NC DENR
One Hundred and 00/100**************************************************************************************** DOLLARS
NC DENR
151-B HWY 24 s
MOREHEAD CITY NC 28557
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MEMO:
PERMIT TEAM' Z! putt Q . -0a—W
►i'00 24 2011" o:0 S 3 LO 1 L 2 1,1: S 2 L 3806868Ill
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ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
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(FOR A 1b E"OORING PILINGS/BOA TLIFT/80 4 T Hp USL j
1 hereby certify that I own property adjacent to ry I property located at ,
�jJ —AName of Property Owner)
�S ��2 �� i S � .
(Lot, Block, Road, etc.)
OR in
(Waterbod . ,NC.
�) (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 mast be set back a minimum distance of fifteen feet (1595)
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.
—DESCRIPTIOIV AND/OR DRAWING OF PROPOSED DEVELOP
MENTr — —
(To be filled in by individual proposing development)
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Print or Type Name
Telephone dumber
Date: / ` ���-

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ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
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(FOR A PIE"OORIN(; PILING,S/BOATLIFT,'Bi>AIHOr�SE)
I hereby certify that I own property adjacent to
Name of Property Owner)
property located at -r2,P^J
(Lot, Block, Road, etc.)
on L�r9 r /! ����-� ' (�'aterbody)
(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/boatbouse must be set back a minimum distance of fifteen feet (1511)
from my area of riparian access unless waived by me.
(� I dot wish to waive the setback requirement.
I do wish to waive chat setback requirement,
- - - - -DESCRIPTION AND7OI2 DiUA N- lVG OF' PROPOSED DEVELOI'MENT - - - -
(To be filled in by individual proposing development)
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S i g'natwe���/��1->�.�G�
Print or Type Name
Telephone Number
Date: G �� - G%

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PRAZiER,
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