27984_TINGEN, BILL_20010515

CAMA and DREDGE AND FILL c27984 _�
G E N E K A L
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 N
Project Location (County, State Road, Water Body, etc.)
Type of Project Activity
State
Phone Number
Zip
PROJECT DESCRIPTION SKETCH
Pier (dock) Length ! t X
;'-{
! .}t
r F r-
li
I
tr
t
(SCALE:
e
)
_T11
•
Groin Length
number
Bulkhead Length t.
max. distance offshore
p
f
i
-_ p/i
,4
t
6
"I �.•
Za
1/ t
Basin, channel dimensions
Sr /
CO d
I.
;
•
II
cubic yards
Boat ramp dimensions
other
8
'_44�
-.
4
�cV 04
1•
�'r t
►t
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
applicant's signature
permit officer's signature
expiration date
attachments
application fee

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SHORELINE MARINE CONST
ASHLEY BROOKS 6 6N3CDL-7666496
PH 212
PO BOX 5173
EMERALD ISLE, NC 28594
PAYTO r
N
THE
ORDER OF T) �i , \ 2
O
WACHOVU
Wachovia Bank. N.A.
I'iur mull 5 NC 488.i,
FOR IP6P4 tT .1 106'C
1" 2801053G"' :05310 15 291:
5467 00 25 7i�'
28010536
f 66-152/531
DATE 5 I t S!II a
NP

ADJACENT RIEPARUN PROPERTY OWNER STATEIVEN'T
(FOR A PIER/MOORING PILINGS/BOATLIFT/BOATHOUSE)
I hereby certify that I own property adjacent to r) 9 's
(Name of Pro erty Owner)
r
property located at ��� ��'c+rS �l C►
!� (Lot, Block, Roa
d, etc.) -
on �6'0���1 ��rt' , in C-�C- ! 7 N.C.
(Waterbody) (Town 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
pdings/boatlift/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_2 wish to waive that setback requirement.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOP.ME`T:
(To be filled in by individual proposing development)
Signature v
r
Print or Type Name
--:�Viz- 7z8
Telephone Number
Date: —�s LO

i
ADJACEIN-F RF-PARLAN PROPERTY OWNER STATEMENT
l
(FOR A PIER/MOORING PILINGS/BOATLIFT/BOATHOUSE)
I hereby certify that I own property adjacent to ' �1�� �/` is
(Name of Property O ,ner)
Property located at 3 / 1�
(Lot, Block, Road, etc.)
on ����c�%_ , in ���,c , 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/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 ih wish to waive that setback requirement.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOP.'vIE�-T:
(To be filled in by individual proposing development)
o k o
L� 1,��ti 12 X zo
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0
s
----------------------------------------------------------------------------------------------------------------
Signature
Print or Type Name
2 z �/
Telephone Number
Date:
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