17023_TAYLOR, BILL_19970529

CAMA AND DREDGE AND FILL C
GENERAL ®�23
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
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Applicant Name -7Phone
Address d f T
Number
_
City ��'''/
State
Zip r�
Project Location (County, State Road, Water Body, etc
y4.
Type of Project Activity rJ
V. 4 ►�
PROJECT DESCRIPTION SKETCH !e_ 1,4,,
Pier (dock) length
G roin,length
number
Bulkhead length
max. distance offshore
Basin, channel dimensions
cubic yards
Boat ramp dimensions
Other
1, !i
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(SCALE
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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.
In issuing this permit the State of North Carolina certifies that
this project is consistent with the North Carolina Coastal
Management Program.
issuing date
attachments
applicant's signature
permit officer's signature
., It / a , � c;
expiration date
;r
a -
application fee

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-ELTON W.-ELLlS JR -
=NC.1855620.PH-919-726-6775
---- - O_ BOX 691— -- -- - ---- -- --_-------
-ATLANTIC-BEACH,=NC 28512
66 152/531 GC
— Pay To The --._ _ - --- - ---
OrderOf
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Dollars
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_—Wachovia Bank of -North Carolinas N A.—
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FOR A PIER
I hereby certify that I own property adjacent to
bill 's property located at
(Name of Property owner)
ors Creek ' /d ' � i�6� '�'-wts7ck—
(Lo B ock, Road, etc.)
on �CYLor��i ��-�- in _ � L Lx,
N.C.
(Waterbody)
(Town and/or County)
He has described to me, as shown below, the development he is
proposing at that location, an4, I have no objections to his
proposal. I understand that a pier must be set back a minimum
distance of fifteen fee-t"Mi') from my area of riparian access
unless waived by -me-4
I do not wish to waive that setback requirement.
I do wish to waive that setback requirement.
._ q
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DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
S gn e
Pr r Type Name
elep one Number
DATE

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Post -it• Fax Note 7671
Dates_ �if
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