19659_AMADEO, RONALD_19980915

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CAMA AND DREDGE AND FILL /� 4
GENERAL f.P� ��5� --
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
Applicant Name t
f s � t-'b-- Phone Number
Address A -1 h: Lz I t xCe _.
City
Project Location (County, State Road, Water Body, etc.) _
State Zip
Type of Project Activity s
PROJECT DESCRIPTION
SKETCH .r
(SCALE: )
Pier (dock) length]
Groin length
number
Bulkhead length
�/
+
�k7`p l 1
max. distance offshore
Basin, channel dimensions
_
-71
i
cubic yards
o1rA
Boat ramp dimensions
Other
n
4
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.
applicant's signature
permit officer's signature
issuing date expiration date
attachments r`
In issuing this permit the State of North Carolina certifies that
this project is consistent with the North Carolina Coastal
Management Program.
X'
application fee

ADJACENT RIF RIAN PROPERTY OWNER STATEMENT
I hereby certifylt at I o 'n property adjacei t o
Lo A��1/. s roperty
located at _ � �'_ on
(Lot. Bloc k, -Road, etc.)
in _ rpll�� ��/oLL � _ , N.C.
(Water Body) (Town and/or Cou t�
He has described to me as indicated below t e levelopment
he is proposing at that location and I,have no ot:ections,
to his proposal. I understand that a pier, pi ir.Js and
dredging must be set back a minumum distance o. f.fteen feet
(151) from my area of riparian access unless waived by me.
I do not wish to waive that setback requirement.
xI do wish to waive that setback requirement.
Description and/or drawing of proposed development:
(.To be filled in by individual proposing development.) I
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Date
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signature
Print Name
Phone Number
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ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to
,-�E)/,,f,4Lo A1,m,4rJE�eU is property
located at _ `��'��� T�� `� on
(Lot, Block, Road, etc.)
i n �(li� �,rc/d L L N. C.
f�C'C'ES S �? lrhrl�/t iLc� _ ,
(Water Body) (Town and/or County)
He has described to me as indicated below the development
he is proposing at that location and I have no objections
to his proposal. I understand that a pier, pilings and
dredging must be set back a minumum distance of fifteen feet
(15') from my area of riparian access unless waived by me.
I do not wish to waive that setback requirement.
xI do wish to waive that setback requirement.
Description and/or drawing of proposed development:
(.To be filled in by individual proposing development.)
OP Ade-e1�,,gtil`r
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Signature
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Print Name
Phone Number
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Z 088 399 485
US Postal Service
Receipt for Certified Mail
No Insurance Coverage Provided.
Do not use for International Mail See reverse
Sent to ea>a'e-
Street &umber AC JCL
Pos ce, Sta , & ZIP C ' U
Postage $
Certified Fee 3
Special Delivery Fee
Restricted Delivery Fee
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Whom & Date Deld
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