19912_CAPITAL AREA YMCA_19980624

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CAMA AND DREDGE AND FILL��o�
GENERAL .���
PERMIT 9
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 Phone Number
Address
City State Zip
Project Location (County, State Road, Water Body, etc.)
Type of Project Activity
PROJECT DESCRIPTION SKETCH (SCALE:
Pier (dock) length
Groin length
number
Bulkhead length
max. distance offshore
Basin, channel dimensions
cubic yards
Boat ramp dimensions
Other
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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,' f
applicant's signature
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's signature a
permit officer when the project is inspected for compliance.
The applicant certifies by signing this permit that 1) this pro- L.
ject is consistent with the local land use plan and all local issuing date expiration date
ordinances, and 2) a written statement has been obtained from
adjacent riparian landowners certifying that they have no
objections to the proposed work. 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.

LIBERTY
LINDA OR WAVERLY D. SHORE
DBA PAMLICO MARINE CONST.
HER NCDL 4789098 HIS 3266479 19 3 2
PH. 919-745-7992 66-7796/2531
P.O. BOX 163, DIXON RD.
VA�N^DE/M7ERE, NC, 28587
PAY TO THE
ORDER OF C,
DOLLARS�64;.Po."a.
Winston-Salem, NC �j�.i[n%'�' J/0/99/7
MEMO .17- J ��r ./Its
1:2S31779681: 001790/3 S a 3 2

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CERTIFIED MAIL 9 RETURN RECEIPT REQUESTED ;A Department2 Etrvirorvnert,
ue=r-Ti-i Heath and N.1-1 Re—ces
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Individual applying for Permit: G�"�P
Address of Property: ' '7 S'" % ��� Cn
or Street #, Street or Road, City & County)
I hereby certify that I own property adjacent to the above referenced property. The individual
applying for this permit has described to me as shown on the attached drawing the development
they are proposing. A description or drawing, with dimensions, should be provided with this
letter.
I have no objections to this proposal.
If you have objections to what is being proposed, please ivrite the Division of Coastal
Management, Hestron Plawa II, 151 B, Hwy. 24, Morehead City, NC, 28557 or call (919) 808-
2808 )vithin 10 days of receipt of this notice. No response is considered the same as no objection
if you have been notified by Certified Mail.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boat house, lift or sandbags must be
set back a minimum distance of 15' from my area of riparian access unless waived by me. (If you
wish to waive the setback, you must initial the appropriate blank below.)
I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
�d. Lez%r-✓�.v� .
Siinature Date
boa. 1'e e
Print Name
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Telephone Number With Area Code
JUN 2 2 1998

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I hereby certify that I own property adjacent to
on in/near Lot#
Community
ier Statement
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11� 1-11 s�.�t .�� en
Name of landowner proposing development
Of
Subdivision, if applicable
Tax Parcel# off SR
Complete description of how to locate this property 3 e, 4( _r Ta gird ^9//0
'f /! , 0 -✓ d" r %C�.? t�/1 AV -iO' 7 ; 4 f o cC c A/ 7'0 4C,0 ,, /J
This proposed project, a ZoA-T Geri and the location has been described to me as
shown in the drawing below and I have no objections to the proposal.
For a Pier, check the Following:
I wish to waive the 15' minimum setback from my riparian access
I do not wish to waive the 15' minimum setback requirement.
Draw the proposed structure in the space provided below. List the size of the structure and
measured distances from the adjacent property lines, other structures on the property, and the
road, water, etc.
ATA
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adjacent
landowners for their consent and signatures. The forms are then returned along with a building plan
and other applicable required information to the Building Insp. Office for building permit application/
processing.
er this form is completed by the landnwner nronosine the nroiect_ a cony is P-iven to the
JUN 2 2 1998