14521_REYNOLDS, WARREN_19950407

CAMA AND DREDGE AND FILL
GENERAL �"
PERMIT'S
as authorized by the State of North Carolina
Department of Environment, Health, and Natural Resources and the Coastal Resources Commission
in an area of environmental concern pursuant to 15A NCAC L 7 H ' if 00
Applicant Name (,AJCkt"_­ '-\. �vtiv,uJci . Phone Number
Address fi!-'i 41",»ls, Pei t
City tf., vir
Project Location (County, State Road, Water Body,
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Type of Project Activity l�.c�E" _ 1-..
State �<-
PROJECT DESCRIPTION
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Basin channel dimensions
cubic yards
Boat ramp dimensions
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 be-
come null and void.
This permit must be on the project site and accessible to the
permit officer when the project is inspected for compliance.
The applicant certifies by signing this permit that 1) this pro-
ject 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.
i applicant's signature
• l �l
permit officer's signature
1,7
issuing date expiration date
attachments D t H. I f c> o
Cat? � y,) r
application fee fajii (f' W( * C7f /1

I
WARREN A. REYNOLDS
ELAINE L. SACHAU
RR 1 BOX 157 PH 249-3996
OLD LUPTON RD
MERRITT, NC 28556
PAY'r0THF
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66-1521531
to
217
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DOLLARS
wachovia Bank of North Carolina, NA 2
nayburo, NC 28515
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FOR 0 2 1 ?
i:053LOI5291: 0785 21OL-30115
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POBOX 776 PAMLICO COUNTY BUILDING INSPECTIONS BAYBORO, N.C. 2851-5
[phone]
(After this form is completed by the landowiier proposing the project,
a copy is given to his/her adjacent landowners for their consent and
signatures. The forms are then returned, along with a building plan
and other applicable required information, to the Building Inspections,
Office for building permit application/processing.)
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT EPN#
1 hereby certify that I own property adjacent to
12-i?F %i i 1 s on C0cr �►� C✓���/
Name of landowner proposing development body of water
in/near Gii�4�� ��/�L Lot# of
community Subdivision, if applicable
fax Parcel #
off SR
Complete
description of how tc,
locate this property:
d�c- ncol t
The proposed project, aand the location has been
described to me as shown in the dr wing below and I have no objections
to the proposal.
FOR A PIER, CHECK ONE OF THE FOLLOWING:
—A� 1 wish to waive the 15' minimum setback from my riparian access.
1 DO NOT wish to waive the 15' minimum setback requirement.
Draw the proposed structure in the space provided below. List the size
of the structure and measured distances from the adjacent property
1.nFc. nthPr structures on the property, and the road, water, etc.
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Printed Name �&- X691 C ��1- Date*C6 Signature

POBOX 776 PAMLIGO COUNTY BUILDING INSPECTIONS BAYBORO, N.G. 28515
[phone]
(After this form is completed by the landowner proposing the project,
a copy is given to his/her adjacent landowners for their consent and
signatures. The forms are then returned, along with a building plan
and other applicable required information, to the Building Inspections'
Office for building permit application/processing.)
ADJAGENT RIPARIAN PROPERTY OWNER STATEMENT EPN4i
1 hereby certify that. I own property adjacent to
5L-0S 's on��--
Name of landowner proposing development body of water
in/ near SJ,,�kQ-611JSkil(.-L Lot# of
community Subdivision, if applicable
Tax Parcel 4k off SR Complete description of how to
locate this property: L-ry�1— 5/C�%i U CJL.D LU Prd N
The proposed project, a �! ,��j�D IGrP/Q, and the location has been
described to me as shown in the drawing below and I have no objections
to the proposal.
FOR A PIER, CHECK ONE OF THE FOLLOWING:
1 wish to waive the 15, minimum setback from my riparian access.
i DO NOT wish to waive the 15' minimum setback requirement.
Draw the proposed structure in the space provided below. List the size
of the structure and measured distances from the adjacent property
line-. other structures on the property, and the road, water, etc.
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Printed Name- y,�� ��', fj �� - Date .4L_/- `Signature