19813_APPERSON, LUTHER_19980409

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CAMA AND DREDGE AND FILL .K(d/
GENERAL NY 61,9813
PERMIT �qso f
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 Namel Phone Number
Address_+
City 't State Zip
r
Project Location (County, State Road, Water Body, etc.) t-
Type of Project Activity 3 f
PROD ECT DESCRIPTION SKETCH Y..- <{,' �{ "� r,/ �� { .' � f (SCALE: % )
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Pier (dock) length >< e
Groin length
number 4s
Bulkhead length
max. distance offshore
Basin, channel dimensions to
i 4
cubic yards
( i '
Boat ramp dimensions
N 4/ Lk
Other
h"1►'���, d
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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.
applicant's signature
permit officer's signature
issuing date expiration date
,�
attachments C' A
In issuing this permit the State of North Carolina certifies that
this project is consistent with the North Carolina Coastal
Management Program.
J1. , I 1 11 f
application fee

LUTHER V. APPERSON
P, O. BOX 625
LA GRANGE, NC 28551
PAY
TO THE
ORDER OF-
.... .. .................
6257
66-1521531
-1 9A
$
S— featu—
DOLLARSDatalb on ba h.
Vadwww�,Oank
WACHOM
Wachovia Bank of North Carolina, N.A.
LaCmige, NC 28551
FOR
.............. .. . . ..... .........
Ik

" W `ROPERTY OWNER STATEMENT
(FOR A PIERIMOORING PILINGSIBOATLIFT/BOATHOUSE)
I hereby certify that I own property adjacent to Za- eV 's
' (Name A Woperty Owner)
property located at / S I- �� —'�7 e
(Lot, Block, Road, c.)
I i
,� on (i lUY S l Ye , in ✓ 8ti
(Waterbody) ( own and/or Count Y) N.C.
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/boatliftlboathouse 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 the setback requirement.
IC I do wish to waive that setback requirement.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOP'1UNT:
(To be filled in by individual proposing development)
Signature
WA- V. r- a (-boy �
Print or Type Name
yak 3/0--
Telephone Number
Date: A70 y / / 6 / f 9'P

„A:: RIPARIAN PROPIIZTY OWNIIZ STA
• (FOR A PIERIMOORING PILINGSIBOATLIFT/BOATHOUSE)
I hereby certify that I own property adjacent to L-4'ey- H e YSayc. is
(Name of Pi6perty Owner)
Property located at / / 3 FY D-n %`S a, t 7
(Lot, Block, Road, etc.
on ��'P�p , in z �vl �2 v �er C� , N.C.
(Waterbody) (T4wn 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 riparian 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)
Signature
L i /lia-i. lee Ql' s 7Lie r
Print or Type Name
02 3 7 ;7,'
Telephone Number
Date:

Yoe
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