14586_DOTY, SHAWN_19950516

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C MA AND DREDGE A I A AND FILL
GENERAL
PERMIT J00
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 Jtf / �'�
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Applicant Name ►-'
Address
City
Project Location (County,,State Road, Water Body, etc.)
Type of Project Activity
Phone Number
State
`1 L. ,I
,)vr
zip
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PROJECT DESCRIPTION
Pier (dock) length �'/
�
SKETCH
!A
j � � (SCALE:
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Groin length
3-b,
"
6
number
Bulkhead length—
s
_
max. distance offshore
Basin, channel dimensions
cubic yards
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. F i
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
issuing date expiration date
,/�' '
attachments'/�` � /� / / ;? 4"J
In issuing this permit the State of North Carolina certifies that /t /
this project is consistent with the North Carolina Coastal application Jl;-Ir d
Management Program.

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SHAWN A. DOTY, O.D. 1568
128 Pirates Rd Ph 637-8184
New Bern, NC 28562 66 soisa�
PAY TO THE I� i \' f� /�] C'— ORDER OF
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ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER)
I hereby certify that •I own property adjacent to
's property,
Name
located at 19 w Wa 'j' Rlurh Eg, a on
(Lot, Block, Road, etc.)
�, Kbw 1E"� , 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.
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 DEVELOPIM7T)
.�, 'de ,
i ure
�, Phone Number

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o.--ir ' Jt . , I, , -,
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER)
I hereby certify that•I own property adjacent to
Din, �� 's property.
Name
located at
on
(Lot, blocx, Road, etc.)
in N F-up 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 f if teen 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 DEVELOPIiENT)
SF"F -�:) Rom% 9 , 777,
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Sigg��nature 1
Name
Phone Number

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