16077_WILLIS, FANELLA C_19960415

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CAMA AND DREDGE AND FILL'
GENERAL
1:V 016077- c"
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PERMi T � V
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 O'ly'. Po C, •P ��'
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Applicant Name Phone Number
Address / S 7
City "If4?:le State 'tom zip ASS a
Project Location (County, State Road, Water Body, etc. � �o� � ^ 4-14,r <`� �"'� �=f�`' 1
Type of Project Activity �e:e ' 4W 6' 1i/i.vGr.I _ r1C1�eLJI8 �` 3� 'out-7r• ... or
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PROJECT DESCRIPTION SKETCH c_ �� �� �, E y (SCALE:
Pier (dock) length
Groin length IV
ri ro4 lit' �,t{,� OL'j
number f°P�jX�,�%� �
Bulkhead length
c �o
max. distance offshore �a
Basin, channel dimensions tt
n,
cubic yards fiYq 0
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Boat ramp dimensions f
Other — `rl i•-� �ri _.�--...�— —
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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,
applicant's signature
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.
_J permit otticer's signature
issuing date expiration date
attachments o 2#1
application fee
r i760

OUTER BANKS MARINE CONSTRUCTION
P. O. BOX 1988 PH, 919-240-2525
ATLANTIC BEACH, NC 28512
PAY
TO THE
ORDER OF
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MOREHEAD CITY, NORTH CAROLINA 26557
FOR P-* D166 %7 C
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1110000 2 7 6011' i:0 5 3 10 1 1 2 11: 1 2 3 10 1 5 2
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2760
4_ 1 � 66-112
DATE 531
DOLLARS
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ADJACENT RIPARIAN PROPERTY O'" NER STATEMENT
(FOR A PIERIAWORING PILINGSIBOATLIFT/BOATHOUSE)
I hereby certify that I own property adjacent to bIJ - 's
(Name of Property Owner)
property located at uD
(Lot, Block, Road, etc.)
on , in1��} �C , 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.
`t I do not wish to waive the setback requirement.
I d,Q wish to waive that setback requirement.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
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Pnnt or Type Name
v�la zo 0
\ Telephone Number
Date:

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