19692_OWENS, LOU_19981006

CAM A AND DREDGE AND FILL
GENERAL (0i9692 C
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 r
PROJECT DESCRIPTION SKETCH u. �) "
Pier (dock) length
Groin length
number
Bulkhead length
max. distance offshore
Basin, channel dimensions
cubic yards
Boat ramp dimensions
Other
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.
"7
i (SCALE: )
f'
t. f
--- l f.Y% ' — -- ---T
attachments
issuing date
applicant's signature
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 application fee
Management Program.

a
JiiL— I-93 FF:I I I :10 AM FLAIIIIIi-I;':;I.I:, F T iI' �A;a, I'l :�i,(4 _
ADJACENT RIPARIAN VROPE.RTY OWNER STATEINUNT
(F'OR A P/ERIUMVPrE,Rl;D BOAT.1,1Fn
t hereby certify that I own property adjacent to
—�
Oil
(Waterbody)
(N811le of Property Owner)
�Sc•� s� N.0
(Town and/or Coonty)
He has described to me, as shown below, tile. development he is proposing at that location, and, I
have no objections to his proposal. I understand that a pier/uncovered boat lift roust be set back a
minimum distance of fifteen feet (15) from my area of riparian access unless waived by me.
i ±31I+at1t wish to waive the setback re�luirenrent.
li". 1! to waive that setback requirement
DES ;Ri '1 -0N AM DRAWINGQF PROZOSED QFUL.Q
MPL L E V`M- EACH L1P(x, - 1 MR
CONS?'RL UON i O-CA1[0N OF WAjFR AND ANXqTUjjLSLRVCjVMS QN
PMPFRT'Yr
'�?3el
s / Signature
�4x,-..� ..rtnt or
type•o�-�� �vf
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JUL-31-98 FRI 11:10 AM PLANNINVAINSPEG 101-IS
FAX NO. 2627286643
P. 1
ADJACENT RIPARIAN PROPERTY OWNER STATENIENT
(FOR A PIERIUNCOVERED BOAT LIF7)
I hereby certify that I own property adjacent to
(Name of Property Owner)
Oil _57
(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/uncovered boat lift must be set back a
minimum distance of fifteen feet (15) from my area of riparian access unless waived by me.
I dg jmt_wish to waive the setback requirement.
t to waive that setback requirement.
ESCRWWON AND D AAWIN(;-QF PMOSED DEYEI.OPAI+ CN(i
MP1 MIJNESa SEA' A K _FROIYI EA L1NE�SI.7.E OF PROPosEn
kHOPERTY,
1
!111
)06 "
Signature
Print or type L4 d:g —
Telephone__—A:V ?5771,1_T
Date