14829_CONNER, BRIAN_19950926

• CAMA AND DREDGE AND FILL
GENERAL4,9
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 e:'%`/ / ,'%fir✓
Applicant Name ?ri'er:n A/,
Address
4( Al _
City
Project Location (County, State Road, Water Body, etc.)
Type of Project Activity
Phone Number 42,? 1/
_ State Zip ✓ So
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PROJECT DESCRIPTION
Pier (dock) length
SKETCH
{ ILI
(SCALE:bh,
)
i
Groin length
a
' •
zh=
{ Voo
—7
i
'ly
f
—f
number
Bulkhead length�j
i
i
'a
I
max. distance offshore
E
Basin, channel dimensions
14
cubic yards
i
;fit
r
Boat ramp dimensions
12
Other6,0
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.
1 applicant's signature
permit officer's signature
issuing date expiration date
attachments _ 0 2"11' / 7dc,/
In issuing this permit the State of North Carolina certifies that
this project is consistent with the North Carolina Coastal
Management Program.
application fee _!�o +'"r�� i f- c q

BRIAN A. CONNER
NCDL 6417917 66-1f2
1806 N. HERRITAGE ST. PH. 522-5384 631 2095
KlNSTON, NC 28501 S-
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•RANCH BANKING AND TRI-C-M Nv
KINST N. NORTH CAROLI
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2095

ADJACENF RIPARIAN PROYER'I'Y OWNER STATEMENT
(FOR A PIER/MOORING PILINGSIBOATLIFFIBOATHOUSE)
I hereby certify that I own property adjacent to % / - is
(Name of Property Owner)
Property located at � / �" R/;,.,Z�
(Lot, Block, Road, etc.)
on - > in , 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/boattift/boathouse 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 the setback requirement.
I d4 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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SEP261995
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Signature
Print or Type Name
Telephone Number
Date: /'9 — /���

ADJACENT Rip- ARIAN PROPERTY OWNER STATEMENT
• (FOR A PIER/MOORING PILINGSIBOATLIFT/BOATHOUSE)
I hereby certify that I own property adjacent to 11; rc/��J L ti, 's
(Name of Property Owner)
property located at 91 _� k--� �c r &'
(Lot, Block, Road, etc.)
15c,w
I '
on _ �� , in V�
(Waterbody) , N.C.
(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 'parian 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)
o ,4S 7,4L wA
.i 1-I k-Ls ,
Pri or T Name
//) 7,;2 19- - -7//f
Telephone Number
Date: 7 S c 1119 ,r
)95