27913_TEUBERT, BERNIE AND NANCY_20010511

CAMA and DREDGE AND FILL
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G E N E R A L F' N• z�si3-�
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 Zg w J_oD
Applicant Name i epic � t-� % Phone Number
Address VlUo D t-� na?-i,3
City IJZx_z State Zip Z�; D
Project Location (County, State Road, Water Body, etc.)
ft1- IC(Q'o Per '�+' • c�FF- Dp 1 t-t9 ��t= i�tD i,� i L�c"i�7J
Type of Project Activity
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.
11 � YoI v i` ,A�o�-c�
issuing date expiration date
071_ 1
attachments
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application fee

tu' e c u r 1t Y en 11 a nc I do u'men t. See 6gak
PRESCOTT BROTHERS INC 1491
141 TARA TRL
ARAPAHOE, NC 28510
PAY DATE / /� 66-30/THE
OR /��
4747
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� ORDER OF (� �''
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DOLLARS N
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A N n FirslLilizens Bank d Trust Company
j}a' Bayboro, N C. 28515
� FOR
11'0014g1n• i:0S31003001:[]011 711025429u' '
PRESCOTT BROTHERS, INC.
Dredging & Marine Construction
Bobby Prescott Terry Prescott
I tome: 252-249-0937 I Come: 252-745-7135
Cell: 252-670-9433 Cell: 252-670-0973
141 Tara 7Tai1, Granisboro, North Carolina 28529

I hereby certify that I own property adjacent to b 9 k tt1,Z �- y T 's
/— K•1Jg4 Q (Name of Property Owner)
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property located at y 06 l fMR M e S i`plt b R A/&A) yj r, ,
(Lot, Block, Road, etc.)
on i s% R s loL in L.
R*V 1-i4vL� 64 � - , N. C.
(Waterbody) (Town and/or County)
He has described to me, as shown below, the development he is proposing at that Iocation,
and, I have no objections to his proposal. I understand that a pier/mooring
pilings/boatlifL'boathouse must be set back a minimum distance of fifteen feet (15') from my area
Of riparian access unless waived by me.
Y I do not wish to waive the setback requirement.
I " wish to waive that setback requirement.
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DESCRIPTION A/OR DRAWING OF PROPOSED DEVELOPVfE`r�I: e
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Print or Type Name
Telephone Number
Date:

ADJACENT RIPARIAN PROPERTY OWNTER STATEMENT
(FOR A PIERIMOORING PILINGSIBOATLIFT/BOATHOUSE)
I hereby certify that I own property adjacent to 13fi1`%A,�y 'FLFu'06kT 's
(Name of Property Owner)
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property located at 1 �I D� �id1J PS tb 2 /ye cu &Q40 IV G 22>S3d ,
(Lot, Block, Road, etc.)
on VX51 Ck , in C/Z,cM/LA) ec)6,v%y , 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/boatlift1boathouse 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
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AND G OF PROPOSED DiVELOPINIENT:
e filled in by individual proposing developm nt)
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Print or Type Name
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Telephone N4mber
Date:
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