18436_COULTER, JOHN S_19970912

CAMA AND DREDGE AND FILL
GENERAL
PERMIT 401,41,
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
Address
City
Project Location (County, State Road, Water Body, etc.)
Type of Project Activity
PROJECT DESCRIPTION I SKETCH
Pier (dock) length
State
tj� , Iwt r
Phone Number
Zip
(SCALE:
Groin length jfF. /'%7i C"flf J /1T y��!j T,�'� rGFr, J, -7
number srp [ rrrs� .'4ts� 7�c �,rf1 ` r . r . d t
4' �''�t � Cif sf .i�G ' -�, /- h
Bulkhead length j7f�. t�1161 ta f2:-tf° f ♦ F�> c,t, Ste, t rr.JG jft *7 `14, .r'��JGi✓ �?
max. distance offshore
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20
Basin, channel dimensions
A7-1
J
cubic yards F
c�.5�%��c; ��C-. i� -� .�of,l� •a" r•P�►r,u,.�r�i�ff f, ���.c.,,
!7'7i'C.i .�r /yr�,'.�-/ w:jlL %'�r./'�'Y-``- `��!!-E• i�.�%F�"). ''.*r�+:r �I,. ;�'..; .
Boat ramp dimensions •,� �
Ge.. -fit% � 1v� : � � �5..-,!� , ;•f;:{, YFveJ �-.�%��.�sr� [.J"i•*`.
Other ` r
a 1 � + l �d r i Jt N /"r ' � J� j,}�� 1 1 t� r v �C. � `C"� _. IS
f + f
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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
attachments
permit officer's signature
12-12.1-i7
issuing date expiration date
In issuing this permit the State of North Carolina certifies that ,
this project is consistent with the North Carolina Coastal application fee
Management Program.

John S. Coulter Ncdl 7805577T 66-30/5531 1039
Carolien V. Coulter Ncdl3395134 472
256 Morrison Rd Ph# 919-249-1963
Oriental, NC 28571 DATE
PAY TO THE
ORDER OF
DOHARS
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!'OHU.K 776 PAMLICO CUUNTY 111111.DING 1N: FLGTIUNS BAYSUR0, N.C. 2051:•
(9;9) 745-JBG1
(After this form is completed by the landowner proposing the project,
a copy is given to his/her adjacent landowners for their consent and
6ignAtures. The fortis are then returned, along with a building plan
and ether applicable required information, to the Building Inspections'
Office for building permit application/processing.)
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT EPNO
I hereby certify
Natie of landowner proposing development
in/near _ Loth
Community
that
/I own property adjacent to
on
body of water
44-Z em
of
Subdivision, if applicable
1.
Tax Parcel 0 off SR. Complete description of how to
locate this property:.1G1•�iL!� .,�Q L�� �•�i� 'F���
The proposed project, a��.,�IiI�G� . an¢ the location has been
describled tome as shown in the drawing below and I have no objections
to the proposal.
FOR A PIER, CHECK ONE OF THE FOLLOWING:
_Z I wish to waive the 15, minima setback from my riparian access.
I DO NOT wish to waive the 15' minimum setback requirement.
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Draw the proposed structure is the space provided below; list the size
of the structure and measured distances from the adjacent property
_lines, rather structures on the property, and the road, water, etc.
SEE f� 7'7WC#ED
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160BOX 776 PAMLICO CUUNTY IIIj11ZING 1N:iPLCTIONS BAYBOX0, N.C.
[phone]
(After this form is completed by the landowner proposing the project,
a copy is given to his/her adjacent landowners for their consent and
signatures. The forms are then returned, along with a building plat:
and other applicable required information, to the Building Inspections'
office for building permit application/processing.)
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT EPNO
I hereby certify that I own property adjacent to
Name of landowner proposingaievelopment body of water
in/near Lotb__r._ of
community Subdivision, if applicable
Tax Parcel 0 off SR Complete description of how to
locate this property: 71WX' O!t/ Z ZE
,T oXI)
The proposed project, a %i%�D�/�lr� , an¢ the location hot been
describyed to'ae as shown in the drawing below and I have no objections
to the proposal.
FOR A PIER, CHEC1, ONE OF THE FOLLOWING:
✓1, wish to waive the 15, minimum setback from my riparian access.
._.,_ I DO NOT with to waive the 13' minimum setback requirement.
Draw the proposed structure in the space provided below: Gist the size
of the structure and measured distances from the adjacent property
lines, other structures on the orooerty. and the rin.d. water. stc.
SAC /V TT/9 CffrD ZOIAJ 6�__
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Al' 5 1997
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