23172_PALMER, TOM_19990726

CAMA AND DREDGE AND FILL
GENERAL . 0a 231 E72
PERMIT C12i\ 0 c
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.) `v` �• r'• �-5 '`.
Z
Type of Project Activity
PROJECT DESCRIPTION
Pier (dock) length
SKETCH�A-i-A1) L,Tt CT[ k-
Groin length
number
Bulkhead length C
max. distance offshore
01 0
Basin, channel dimensions
cubic yards
C
Boat ramp dimensions
Other �C�F i x >i.
tAi7
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.
(SCALE: )
- -
i
'%j�� , r
L
J. is ✓ :� ����
LJ'
1 7, V:-C IN NVt-tifit:Z
applicant's signature
permit officer's signature
issuing date expiration date
attachments
In issuing this permit the State of North Carolina certifies that
this project is consistent with the North Carolina Coastal application fee
Management Program.

i
-
i
77t ,lcl S�� 00 AtJ71,J& IT`S -
IF, A--`16pj
� 4s pu,�� i3 wT we

ADJAUEN'1' RWARIAN PROPERTY OWNER STATENMNT
(FOR A PIERIMOORING PILINGSIBOATLIFT/BOATHOUSE)
I hereby certify that I own property adjacent to DN fg l2 �1 f14 Ffil-Hi-Mlis
(Name of Property Owner)
property located at 3 a 4 14U&t,& ikj Ca>02 ohs / 9 4� ZD �r j
9
�, (Lot, Block,, Road, etc.)
on CU13 Fba— c , in �(, ��? yL—�i) l n U , 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.
N I Co wish to waive that setback requirement.
--------------------
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPIViEVT:
(To be filled in by individual proposing development) c o
O v
n
r
o �
va
=1
�a
(304 i u Fr 10 �?
Z
4l=--�-
Signature
Print or Type Name
If-/Y- S a 9
Telephone Number
Date:
�_ j
JVeR&W

• ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIERIMOORING PILINGSIBOATLIFTIBOATHOUSE)
I hereby certify that I own property adjacent to ion 0!lfilyn F'41,goe's
(Name of Property Owner)
property located at 3 4 1QU&c.f y-4 C,>t>!2 j ,, I, y ZD f �1g�V !'�? �c�
(Lot, Block, Road, etc.) �
on CU/3 C`� �Cr� , in ��14'yL� l n fJkq 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.
N I do wish to waive that setback requirement.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development) O a
O
11111e4ok
n
ILr
o c�
va
=1
1057ALL tG, 4ry L{3 n
� pi L.)FT 10 z
VUSt ►NL� SLI t' —> LO
Si
gnature
fe 'io4 r
P ' t or Type �e�o�
��'SI.�(�t
LGr 19 q(t7 VV-S-�
Telephone Number
Date:

LID" _lp
CED41R, R,EE
E-AT -'S"T'ING --'c,NoRE1.,,TNE