13050_WATERS, GLEN_19940419

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CAMA AND DREDGE AND FILL
GENERAL
C t-0
PERMIT
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 � 'y r' `'
Applicant Name �c.''" '�`i ��"' Phone Number � 5
Address 1 67�
City, P n,' : c ,�'r` C State : zip
Project Location (County, State Ro d, Water Body, et .) �- o �r
Type of Project Activity
PROJECT DESCRIPTION
Pier (dock) IengtW(r
SKETCH - 11,; /"'!A , (- k,
PH— 117 T 7— a j _
;%T- i s
.2 4q
It 7
f v� 1
j
(SCALE:
,f
)
/
Groin Ieragth r 1
71
number
Bulkhead length
ax. distance offshore
Basin, channel dimensions_
+
cubic yards
I
f
Boat ramp dimensions
Other
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.
applicant certifies by signing this permit that 1) this pro-
fs consistent with the local land use plan and all local
finances, 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
G
issuing date expiration date
1 )
�y
attachments /LJ e !) /Z
In issuing this permit the State of North Carolina certifies that
this project is consistent with the North Carolina Coastal
Management Program.
application fee. 7

GLENN WATERS-85 2944
LIC. 2946102 PH. 919-735-4022 �i
1554 OLD GRANTHAM RD.
GOLDSBORO, NC 27530
191
OR ER THE /) E /—J- All
O(2DER`OF- / i/'' ��/llh�� t J I $ C'('� OD
DOLLARS
{'liim Centura Bank.
Goldsboro, NC 2753o
MEMO CY PC-1 Q,w
1:0 5 3 1008 501:0 7 5 30 10000,14 2944

-- _--. ri-�,yc.-.�„_,jy ;�;:-----:..iiad�:...,w,a.S�t i.=��r..c •'abls,ds�".•e'T.rcS�X75Y,.".°.m'ujt..�wT''.:�::iiva�:.;:�ak::��tihr _�i_�.A..'r �. ali:.:�XtY _-�,a'�.^sC.Y'i'�__�,
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER)
��I hereby certify thatI own property adjacent to
8n W G 1l'C_r is property
Name
located at
, on
( Lot, Block, Road, (letc.)
C-6nr- CrcY� in Ae-" 16r' 1 C( ►Lr- r�ti� N.C.
(Water Body) (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 must be set back a minimum
distance of fifteen feet (151) from my area of riparian access
unless waived by me.
V- I do not wish to waive that 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)
Signatu
R4JT
Name
72-k--22DD
Phone Number

L
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER)
I hereby certify that -I own property adjacent to
Name
's property
located at YG f pots op,
�- (Lot, Block, Road, etc.)
0 !` C C' (� in
(Water Body) (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
, on
N.C.
proposal. I understand that a pier must be set back a minimum
distance of fifteen feet (151) from my area of riparian access
unless waived by me.
I do not wish to waive that setback requirement.
I do wish to waive that setback requirement.
aL Description and/or drawing
�r
f
FILLED IN BY INDIVIDUAL PROPOSINGDEVELOSept�7'I')velopment: (TKO BE
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Y-2�
Signature
�(J.� e(2T
Name
Phone Number

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