16151_GWALTNEY, ANNE_19970108

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CAMA AND DREDGE AND FILL
GENERAL
PERMIT
NO
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 ;/,o % Z 00
Applicant Name `-T ",le ?
� ' ;!
Phone Number
Address ";Do.
City /inr.4,f
State
/IC
Zip 7
Project Location (County, State Road, Water Body, etc.)
i`
Type of Project Activity
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PROJECT DESCRIPTION I SKETCH
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Pier (dock) length ? YE
Groin length
number
Bulkhead length
max. distance offshore
Basin, channel dimensions
cubic yards
Boat ramp dimensions
Other 44- A—Wf;F/.
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This permit is subject to compliance with this application,
drawing and attached general and specific conditions.
violation of these terms may subject the permittee to a
imprisonment or civil action; and may cause the permit t
come null and void.
site
Any
o be- applicant's signature
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.
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/XI'.r,n it
permit officer's signature
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issuing date expiration date
attachments 47,41, /Zoc;
In issuing this permit the State of North Carolina certifies that
this project is consistent with the North Carolina Coastal application fee S-b cy rlirf /! 76 (`
Management Program.

1
DAVID SIMPSON CONSTRUCTION CO. INC.
800 BROAD ST.
P. O. BOX 590
ORIENTAL, NC 28571
11765
66-30/531
S?� _19_2
PAY
TO THE ORDER OF led L 0 �/� O
DOLLARS
FIRST CITIZENS NI
BANKFlrtt�Cltlteni Bank l Trutt Company ^.
Boyboro, NC 25515
FOR 6/6 yCS2� L2 f D/lo le/-C ,
II1000 L L 7 6 s", l:0 5 3 L00 3001:4 7 L l0 07 II'

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NOT
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3

PAMLICO COUNTY BUILDING INSPECTIONS BAYBORO, N.C.
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT EPNO
I hereby certify that I own property adjacent.,to
I I V N L- X• V w r7 I a/ G
Name of landowner propo
-0-A e e s
� body of water
s on
ing development
Aa
near IOR Pl-Al rA�
community
Lot#i3 * of Gd`oa/A% d s
Subdivision, if applicable
)Tax Parcel # = 0 9-1--/9_-3 off SR / 30 8' Complete
S O 91- 19-/Y
description of how to locate this property:
t-o 13. 13 f/- ReTa;KJ; A) GrIR L�
La7 13�- 2ov'"
The proposed project, a 1-07' /4 - 200 ,QoC.K id the
location has been described to me as showli in the drawing
below and I have no objections to the proposal.
S E E fi r7'AC.Ned dRi9WW
FOR A PIER, CHECK ONE OF THE FOLLOWING:
I wish to waive the 15' minimum setback from my
riparian access.
I DONOT 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.
SEE RTTgC
r
Printed Name
Signature
t e IL 1 f'6
13

PAMLICO COUNTY BUILDING INSPECTIONS BAYBORO, N.C.
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT EPN#
I hereby certify that I own property adjacent„to
Name of landowner propo
K
body of water
's on
ing development
#near O R P.n/ ZA1-
community
Lot# /3 *1 of GD'od` UJ; nJ d S
Subdivision, if applicable
Tax Parcel # Z 0 ?X -19-L3 off SR / 30 67 Complete
description of how to locate this property:
La7 13 -
The proposed project, a L. D 7 14 - aO0 A o C K and the
location has been described to me as shown in the drawing
below and I have no objections to the proposal.
SEE AT T4a" dRAW;ty
FOR A PIER, CHECK ONE OF THE FOLLOWING:
I wish to waive the 15' minimum setback from my
riparian sg�
' I DONOTwih to waive the 15' minimum setback
- requirement: ----
********************************************************
Draw the proposed structure in the space provided below.
List the size of the structure and measured die`.ances from
the.adjacent property lines, other structures on the
property, and the road, water, etc.
SEE l9'T7-6C 49 W / It/
Printed Name' ' " `i ` Date 61101 G
Signature\'\ k., 'r �3 �•_,. �� -'cL
cu^e7i( y L-
11
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