27037_TINGLE, WILLIAM_20001219

CAMA and DREDGE AND FILL Your project is subject to the NC Division oi�
Wat,;r Quality Neuse River Buffer Rules due c .
its location Nvithin the
G E N E R L to NeuseRiverBasin.
PERMIT Plcasc contact DEBORAH SAWYER at
252-946-6481
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
Project Location (County, State Road, Water Body, etc.)
Type of Project Activity
State
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.
zip
issuing date
applicant's signature
permit officer's signature
expiration date
attachments
application fee

4443
WILLIAM F. TINGLE
P. O. BOX 397
66-152/531
BAYBORO, NC 28515 i
DATE
Ov
TO THE �\ ado v
ORDER OF
~t DOLLARS p 5, o„Y .. ,.,
.i".°ih �aa.
�TACHOVIA �
Wachovia Bank, N.A.
Ilaybo MCA j28515
FOR
11500004443ii' l:0S3 L0 LS 291:
nr
D?a9 030 L490

PAMLICO COUNTY BUILDING INSPECTIONS
P.O. BOX 776
BAYBORO, NC 28515
(252) 745 - 3861
ADJACENT RIPARIAN PROPERTY OWNERS STATEMENT EPN#
I HEREBY CERTIFY THAT I OWN PROPERTY ADJACENT TO MR.
NAME OF LANDOWNER PROPOSING
DEVELOPMENT
ON OL-Wb&
Body of Water
IN ©Z t ON -- LOT # W "4
COMMUNITY SUBDIVISION, IF APPLICABLE
TAX PARCEL #
COMPLETE DESCRIPTION OF HOW TO LOCATE THIS PROPERTY
THIS PROPOSED PROJECT:
FOR A PIER, CHECK ONE OF THE FOLLOWING:
I WISH TO WAIVE THE 15' MINIMUM SETBACK FROM MY RIPARIAN ACCESS.
I DO NOT WISH TO WAIVE THE 15' MINIMUM SETBACK REQUIREMENT
SEE DRAWING
After this form is completed by the landowner_ proposing the project, a copy is given to the adjacent landowners for their
consent and signature. The forms are then returned, along with a building plan and other applicable required information,
to the building inspection office for building permit application/processing.
SIGNATURE
PRINTED NAP
DATE IZ-) ' d-�' - <�n6

PAMLICO COUNTY BUILDING INSPECTIONS
P.O. BOX 776
BAYBORO, NC 28515
(252) 745 - 3861
ADJACENT RIPARIAN PROPERTY OWNERS STATEMENT EPN#
I HEREBY CERTIFY THAT I OWN PROPERTY ADJACENT TO MR. 'jlLL- TF11f�(oL�
NAME OF LANDOWNER PROPOSING
DEVELOPMENT
I`- ON EaDtE
Body of Water
IN 0i2-� LOT #
COMMUNITY
TAX PARCEL #
SUBDIVISION, IF APPLICABLE
COMPLETE DESCRIPTION OF HOW TO LOCATE THIS PROPERTY
THIS PROPOSED PROJECT:
FOR A PIER, CHECK ONE OF THE FOLLOWING:
I WISH TO WAIVE THE 15' MINIMUM SETBACK FROM MY RIPARIAN ACCESS.
I DO NOT WISH TO WAIVE THE 15' MINIMUM SETBACK REQUIREMENT
...........................................................................
SEE DRAWING
After this form is completed by the landowner proposing the project, a copy is given to the adjacent landowners for their
consent and signature. The forms are then returned, along with a building plan and other applicable required information,
to the building inspection office for building permit application/processing.
SIGNATURE
PRINTED NAP
DATE l V` .20 J- C 0 L