14879_BLANKEN, DONALD & ELEANOR_19951025

At
CAMA AND DREDGE AND FILL
GENERAL 1'�=
PERMIT
as authorized by the State of North Carolina
Department of Environment, Health, and Natural Resources and the Coastal esources Commission
in an area of environmental concern pursuant to 15A NCAC G, AT . /Zbc
Applicant Name
Address
City,_ pi0
Project Location (County, State Road, Water Body, etc.))
Phone Number 9/ S ? Vic- /16 K
State Zip
- , ,,. �•.:,-::� __ ,�.�� v'� J't. � -+�/tom
Type of Pro jerct Act' � ,r. _0 'Y
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PROJECTDESCRIPTION
Pier r •length
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NONE■
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on
Elm
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ON mom
ONO no
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Basin channel dimensions
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.
applicant's signature
permit officer's signature
issuing date expiration date
attachments () 911 /ZOO
i/
In issuing this permit the State of North Carolina certifies that
this project is consistent with the North Carolina Coastal
Management Program.
application fee � � � � �' �
*�,1156

DONALD BLANKEN
ELEANOR BLANKEN
5997 SPINNAKER POINT ROAD
ORIENTAL, NC 28571
PAY TO THE D
ORDER OF L-
4!90.
10 Meridian
Bank
MEMO_Sl_�_/v 9- c
1: 0 3 10000 9 5 l: III 1�� •
4140 979711 0456
456
19 C34
$ ,5-0. 06
00 DOLLARS

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/MOORING PILINGS/BOAYLIFT/BOATHOUSE)
I hereby certify that I own property adjacent to 2 4� ,Qa* 8C,"CIR AA-�J,&EAl 's
(Name of Property Owner)
property located at D #/O s N�✓AKE M ,
`' f 1� t, Block,PAM
Road, etc.)
on M 117i1 �R E c/� in Ll G D �/GA17 , 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/boatlift/boathouse 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.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
I
I 1
I � I •�e� � �Ghl�Vc
r
k'q/matiC�d I I
g
VI
iKa ✓C
S a e
Print or Type Name
fib - - % -'30'c�
Telephone Number
Date: ✓

ADJACENT RIEPARIAN PROPERTY ONN NER STATEMENT
(FOR A PIER/A100RING PILINGS/BOATLIFT/BOATHOUSE)
I hereby certify that I own property adjacent to Qd��9r-�L6-AAIVP &4k-/V
(Name of Property Owner)
(117-1
property located at cq t # 0 /t/�
(Lot, Block, Road, etc.)
on ��M �,eGC 71 in T,4,0 l 6 0 � IZAI IV , 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/boatlift/boathouse 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.
DESCRIPTION Ari'D/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be f Ued in by individual proposing development)
,signature
.iv _ ;, ,�o►
Print or Type Name
Telephone Number
Date: I f