21573_JACKSON, ROBERT AND NITA_19990507

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CAMA AND DREDGE AND FILL (`''
GENERAL li ® 021,573
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 Phone Number
Address
City State Zip
Project Location (County, State Road, Water Body, etc.)
Type of Project Activity
PROJECT DESCRIPTION
Pier (dock) length - C
Groin length
SKETCH "';�,_Ur� T-i IC_. ri
r �
�
number
Bulkhead length
max. distance offshore
Basin, channel dimensions
cubic yards
Y
Boat ramp dimensions
Other \ t ' ✓- v V
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.
In issuing this permit the State of North Carolina certifies that
this project is consistent with the North Carolina Coastal
Management Program.
(SCALE:
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applicant's signature
1.' V permit otticer's signature
i
issuing date expiration date
-� attachments t )� i 1
application fee

POSTAL POSTAL MONEY ORDER 15.800
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SERIAL NUMBER YEAR MONTH. DAY POST OFFICE " U.S. DOLLARS AND CENT:
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04/12/1999 20:45 252726301.8 LARRY G ARNOLD PAGE 02
ADJACENT RUPAWA1N ]PROPERTY OWNER STAMMWM
(MR A FIEWUNCOVEM BOAT Lr j
I hl by C121* 14t I awn property adja=f to
Game of
P� Owner}
property located at� ,
cis --�— --------
,.�A , Book, hoard,, etc.}
tj
own stud/or C j►) 7&4�P
He has desffibtrA to me as
location, aYrd, I have: � ob,��ians to his shown below, the drvciaptru�,:t he is proposing at that
must be W bark a " 'Ir uln &Umce of fl 1S.)find s a pier/w�cavered boat lift
waived by me, �} '•' a.. unless
-- 144..ag wiah ry waive the setback requirement.
I dQ to waive that setback
mgtiiremestt.
F MSCB.IP�t° ON A"/OR DRAWING OF PROPOSM DrMA)pM24T.. M bt, UI*d in by individual prapariag develop5tj�*j
1.�r�_
21
Sri"
3 5a F 1. r(U E
1114
Signature
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Print or Type I�Iame

04/12/1999 20:45 252726301e LARRY G ARNOLD PAGE 02
AD.JACMqT RUPAJUAN FROPMTY OWMM STATEMFM
MOR A PIMUNCOVUM BOAT IjM
I herthy certify W I own propmty adjacent -to
` {Natter of & 0 Owner)
S
Property located at— ±Izg'z�"r
r (Lot, fu0* It"do, etc.)
44 AL- J&
N.C.
(Wittf Inedy) (Town or 4
He 1w dftvfi&,A to me, as shown below, the deMopnw.�, Jig
location, and, I have. T�o As * pnvosing at that
_ WJCWons to his PTOPOW- I understand ftl a pirx/unwvered boat liftsetmust be bark a "w-wn dj&Wc4r
3r-zu . of fiftem feet (15,) from my arm rfr 7jpa� ac= unless
waived by me.
AQ..oU w6h to waive the setback requirement.
AQ wig tO waive that setback requu-cmem.
DESCTUM -------- I ------
. ON AND/OR DRAWING OF PR
OPOSM JDXV)#A.)?MMT,-
be JUkd in by individual proposing d#V11jQP30j0)
jr rf- F- u -A, . 3=) 0 'd
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Print CW Type Name