18470_BATT, EARL_19971007

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Applicant Name
A ri ri re cc
CAMA AND DREDGE AND ND FILL Cg-%
GENERAL ^,� 0 8470-�
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
Phone Number
City State Zip
Project Location (County, State Road, Water Body, etc.)-y►�`j� r' ''_
ei
Type of Project Activity Ap%,sf. s e, -
PROJECT DESCRIPTION I SKETCH
Pier (dock) length
Groin length
number
Bulkhead length
max. distance offshore
Basin, channel dimensions
cubic yards
Boat ramp dimensions
Other
(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.
r
applicant's signature
permit officer's signature
A
issuing date expiration date
attachments
In issuing this permit the State of North Carolina certifies that
this project is consistent with the North Carolina Coastal application fee
Management Program.

M/V DELLA JOHN, INC.
507 BAYVIEW DRIVE
HARKERS ISLAND, NC 28531
PAY
TO THE
ORDER OF
Wachovia Bank of North Carolina, N.A.
Harks a lelund. C 285:31
FOR
0000110210 1:0 5 3 10 L 5 291:
1102
66-152/531
19
J50 / 06
Secunry ieaw.es
i Hosea
_ oeia��a a, ear.
NP
5469 0030751

ADJACENT RIPARUN PROPERTY OWNER STATEMENT
(FOR A PIERIMOORING PILINGSIBOATLIFT/BOATHOUSE)
I hereby certify that I own property adjacent toEz\—
(Name of Property Owner)
property located at
on
(Waterbody)
S '
a
(Lot, Block, Road, etc.)
in
(Town and/or County)
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/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)
N
Signature
Phni or Tvpe Name
Telephone Number
Date: ) o — 1 2- %
II

ADJACENT RIPARIAN PROPERT a' OWNER STATEMENT
(FOR A PIERIMOORING PILINGS/BOATLIFT/BOATHOUSE)
I hereby certify that I own property adjacent to�L.��' 's
property located at
on
(Name of Property Owner)
(Lot, Block, Road, etc.)
T
(Waterbody) (Town and/or County)
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/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.
y I do wish to waive that setback requirement.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
(n � -
_!&'
Signature
Print or Type Name
Telephone Number
Date: / 0 — / -- � `7

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