13995_BEAM, JOHN_19950404

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CAMA AND DREDGE AND FILL 9
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PERMIT � : r-4
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
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Applicant Name �_� r' �- Phone Number
Address'{ s
City 4 t State Zip
Project Location (County, State Road, Water Body, etc.)
Type of Project Activity
PROJECT DESCRIPTION
Pier (dock) length'
SKETCH
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Groin length
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number
Bulkhead length
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max. distance offshore
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Basin, channel dimensions
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cubic yards
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Boat ramp dimensions
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Other
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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-
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.
issuing date
attachments
applicant's signature
permit officer's signature
expiration date
In issuing this permit the State of North Carolina certifies that
this project is consistent with the North Carolina Coastal application fee
Management Program.

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WARREN MARINE 1471
WARREN SPRINGSTON, OWNER
LIC. 3800599 SSN234-96-9836
325 BOGUE PINES
P.O. BOX 926
NEWPORT. NC 28570
PAY TO T 1-1 E
ORDER Q17
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$
66—' 1141
2S31
DOLLARS
RALEIGH FEDERAL
AVINGS BANK
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, NC /
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FOR ` L� !c �9
POOL 14 7 Lum 1:253L711421:L5500007321►, n■

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(For a Pier)
I hereby certify that I own property adjacent to
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(Name of Property Owner)
property located at L 4 [-7- Qq I S7 - 30 5n q Sen - v Y
(Lot, Block, Road, etc)
on -C—\V Cf ') ; P CY-U� in NC.
(Waterbody) (room and/or Country)
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 (16) from my area of riparian access unless waived by me.
I do not wish to waive that setback requirement.
_X_ I do wish to waive that setback requirement.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
Telephone Nurnber

I hereby oertify that I own property adjeoent to
(Name of Property Owner)
property located at 1 ; �� l- - r„�-1 , E �!� �y r 66P
(Lot, Block, Road, etc)
(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 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 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)
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Signature
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Pnnt or Type Name
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Telephone Number

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