28981_YAMPALA, HENRY_20010926

CAMA and DREDGE AND FILL
G E N E R A L� -�
PERM I T
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 "tv Phone Number ' k1- �, / -S17G'
Address ; f (A,: ; tl►�l 3
City State M Zip -7t
Project Location (County, State Road, Water Body, etc.) �Ya. It ! /, ti—TA f tyl i4
ifeN rvlir,�r ilbtr' _r7 h t -Gr4'i 6UHei,
Type of Project Activity - t 1
PROJECT DESCRIPTION SKETCH AIrl' F0,V`
Pier (dock) Length Al c l 7_ a _ 177
_
Groin Length
number
Bulkhead Length
max. distance offshore
Basin, channel dimensions
cubic yards
Boat ramp dimensions
Other
i
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.
(SCALE: A/cNF
applicant's signature
permit officer's signature
- ,'<
issuing date
expiration date
( frl TCG'v
attachments
application fee

OUTER BANKS MARINE CONSTRUCTION BB&T 5056
P.O. BOX 1988 BRANCH BANKING AND TRUST COMPANY
ATLANTIC BEACH, NC 28512 MOREHEAD CITY, NC 28557
66-112/531
[phone] 9/25/2001
PAY TO THE D E.H.N.R. $ **200.00
ORDER OF
Two Hundred and 00/100**************************************************************** DOLLARS
Security features
included.
Details on back.
D.E.H.N.R.
MEMO Vanpala-------- Dorsey
118005056u' i:053LOLLao:L231,01529511'

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIERIUNCOVERED BOAT LIF1)
I hereby certify that I own property adjacent to ��) �� P's
l \� (Name df Property O ner)
property located at 1)240�
(Lot, Block, Road, etc.)
on pDoo in
CN 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/uncovered boat lift
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.
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DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
TSAI
1 E
C4-1ta"j
Print or Type Name
') I/O) _)S�-7 -,/
Telephone Number
Date: Wzs-1-3)

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIERIUNCOVERED BOAT LIFT)
I hereby certify that I own property adjacent to 's
(Name ol Property Owner)
property located at
'(Lot, Block, Road, etc.) ` I ,
on �O� , in ���� C �� Ti" , 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/uncovered boat lift
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.
v I do wish to waive that setback requirement.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
!L\)D
Signature
Print or Type Name
wok 33 r S-
Telephone Number
Date: y - -2 /—��