13990_BENDER, FRANK_19950403

CAMA AND DREDGE AND FILL /0
GENERAL ��� Ef a ,•, . j; a,;,.. ��
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 ! / % ;r 0 '
Applicant Name
Address �/���`�� r 'iof;-r_r'�
City '' Q_
Project Location (County, State Road, Water Body, etc.)
C_
Eij
Phone Number
State _ Zip'
Type of Project Activity s7tifr { % C:y •' !/r J� (% 6,1 l r.{ / �� by `� 7, s'
PROJECT DESCRIPTION
]C, J
Pier (dock) length
SKETCH
��7�+
�� (SCALE:/ )
-��7
i
'
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I
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FL,-
Groin lengthTf
number
Bulkhead length
P
max. distance offshore
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Basin, channel dimensions
i
cubic yards
Boat ramp dimensions-
-
Other
—
—
i
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, 1
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 Zzr A l // ! �14
In issuing this permit the State of North Carolina certifies that
this project is consistent with the North Carolina Coastal application fee '7
Management Program.

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YEAR, MONTH DAY lr�M�A' r�
SERIAL NUMBER CHECKWRITER
IORINT AREA
PAY TO
�u4DDRESS ADORE
COD NO.OR ., ,. .. ...,
UsFD FOR
Flo 7 5469 ?116
1.f]000O,aDQ 2 1' 6 2499

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER)
I hereby certify that•I own property adjacent to
R4,jK EwaQr=t2 's property,
Name
located at 9 12 ' fiU'6iamy�l vv►cri
on
(Lot, Block, Road, etc.)
2E,J1 J1944 in tvGuy (���2�. clzejC 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.
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)
t1:21(
it o
r
fi
s; x'5
0.' 37°d
612�
Phone Number

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER)
I hereby certify that -I own property adjacent to
F W K fS ►` rj 6QfFte- 's property
Name
located at _ 212 'M4'�Mvokfr.' A4
(Lot, Block, Road, etc.)
on
in Al
w (? ,2�. C1ZA5LJ 9--) 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 (15') 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)
'1CJ 17
i.r � n 37pr
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Signature
C
Name
(0 3 'I - � 1
I���f( Phone Number

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-71
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