14725_VENTERS, KIMBERLY_19950607

CAM A FILL
GENER
01995
PE IT
as authoriy-t' fate IVY arolina
Depart met*iuffETviron7n!Lsnf;'Heallg"anT Natural Resources and the G'oa�fal Resources Commission
in an area of environmental concern pursuant to 15A NCAC r `
Applicant Name r Phon'e Ntrimber - _2
Address
r
City State Zip
Project Location (County, State Road, Water Body, etc.)
Type of Project Activity
PROJECT•
Pier (dock) length
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length
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2
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Bulkhead
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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 -
0is consistent with the local land use plan and all local
fiances, 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.
applicant's signature
permit officer's signature
issuing date expiration date
attachments - / r' •`� :�f
k
application fee - -
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kimberly ,4. venters
XClll 5956214 SSM 240 25-3697 1382
213 4 Street 636 5758
p 0 90X 740 566-7538/2531
i3rir1get0sr, �IVG' 285i9 19_�
PAY TO THE " 1
ORDER OF
Point Federal Credit Union
1208 East Main Street
Mavefook, North Carolina 28532-2405
FOR
1:2531753841:
Clwb gnyikm
101G00554 H■ 5307 138 2
$ 5b`iP�
WOTJ

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
Thereby certify that I own property adjacent to
1
►:1 e.�.N n r( / s property located at
(Name of. Pro ty. Owner)
P5
(Lot, Block, Road, etc.)
/ t C.
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••on'• C' S ��� 2�C� in /J ,
N.
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Town
. ,.� (Waterbody) ( 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.
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DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
.(To be filled in by individual proposing development)
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Print or Typd Name
Telephone Number
Date
TnJ U N 9 1 1zjex� I: 1
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