18417_HOWELL, TOMMY_19970903

CAMA AND DREDGE AND FILL df I
GENERAL 0-18417
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
Applicant Name
Address
City ,/o - State
Project Location (County, State Road, Water Body, etc.)
Type of Project Activity
Phone Number
Zip
PROJECT DESCRIPTION
SKETCH L li� %�
(SCALE:
1� /- )
Al
Pier (dock) length
�� ! ¢ / % }
Groin length
4^
i
number
Bulkhead length
max. distance offshore!
Basin, channel dimensions%
cubic yards
Boat ramp dimensions
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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,
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.
f! applicant's signature
issuing date
attachments / �- A" � F
permit officer's signature
expiration date
In issuing this permit the State of North Carolina certifies that
this project is consistent with the North Carolina Coastal
Management Program.
application fee

DEREK S. SMITH
NC 7836496 PH 919-247-4426 1069
107 HAWTHORNE DR 66-152/531
PINE KNOLL SHORES, NC 28512 DATE
FAY TOTHE
ORDER OF _c1m t $ 5()`L
DOLLARS
�TACHOVIA
Wacl;ovia Bank of North Carolina, N.A.
Morehead City, N(rY8557
FOR HtwE
-1:0 S 3 10 IS 2 91: SIG I I 13 2 1 LOG 9
0 -ALAND

ADJACENT RIPARIAN PROPERTY OWNER STATEMEENT
(FOR A PIERIMOORING PILINGS/BOATLIFT/BOATHOUSE)
I hereby certify that I own property adjacent to o ,vt /4 's
(Nar6e of Property Owner)
property located at
(Lot, Block, Road, etc.)
on C'�'L� C�ce�� in �4 2 N.C.
(Waterbody) (Town 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)
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Print or Type Name
Telephone Number
Date: 2 — Z-5 — 6 7

OC-7�1-1991 12:5'DPP'1 FI'Oh1 CI_ISTOI`9 MARINE FABRICATION T17 247h- 29 P.C�1
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