21417_ANNIE M PINER, FLP_19990201

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N, 421417— C
PFR&AIT ,4f T/,�'-�, 714f /_1-0z'>r4 I
as authorized by the State of North Carolina
Department of Environment, Health, and Natural Resources and the Coast I Resources Commission
in an area of environmental concern pursuant to 15A NCAC % I % ey
Applicant yN4me /7"' I L �' ''� 7 F4 / Phone Number
Address ` ' t)' " %
City ? !, p I/ ` r State �' C Zip 2 1' si l
Project Locafly (County, State Road, Water Body, etc.) f e
Te of Project Activity ��' A
`
CAMA AND DREDGE AND FILL
GENERAL
PROJECT DESCRIPTION SKETCH, p (SCALE: �/ )
Pier (dock) length
Groin_.length
number
Bulkhead length
fi�
max. distance offshore e tJ /7
Basin, channel dimensions
cubic yards r7 v�yJ
Boat ramp dimensions �t
�a
Other
�y
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.
/ — applicant's signature
permit officer's signature
issuing date expiration date
attachments 14 r / A` /t -) a
In issuing this permit the State of North Carolina certifies that f Pik
this project is consistent with the North Carolina Coastal application fee 7 a C' 4/�, 3
Management Program.

AN IE M. PIN FAMILY LIMITED PARTNERSHIP 0328
HONE [phone]
P O BOX 95 66-301531
MARSHALLBERG, NC 28511 1
19
PAY.TOTHE ► ► \ Q; �/ J ��
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DOLLARS 0 oei:u: e.a
or13AJW Flat-Clll[ens Bank A Lust Company
^/ �(AttIo`nllc Beach, NC 28512
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FOR OU �" ..t,�-✓ '' / / —�`' Np
1: 0 5 3 100 3 0 01: 13 1 2 1 S 9 1 5 r4._-0/3 28

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` ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to N 01 e ✓l . -? z N �,� 's
(Name of Property Owner)
property located at U A U )� h(- -
(Lot, Block,, Road, etc.)
onf�-- :� L , in / I/G4�l'� l�� ACC. , 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. ,
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(To be filled in by individual proposing development)
JAN 2 6 1999
Telephone Number
Date:

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to 0 ��► �/
(Name of Property Owner)
property located at IDS J , -. -E, L J
(Lot, Block, Road, etc.)
on Cl l,— A , in �7 7 L &t T I L J9 , 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.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(To be filled in by individual proposing development)
JAN 2 6 1999
r� o % ti ►, �Ao4 s o tj
Print or Type Name
2�.7_ 0 C V /
Telephone Number
Date: