21550_RUMFELT, JAMES_19990318

CAMA AND DREDGE AND FILL -
GENERAL 021550 �
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 ~� c
Applicant Name n S U'%r` / Phone Number
Address '� ✓
City r° State Zip
Project Location (County, State Road, Water Body, etc.) !� '� 1 �� �� (� (2 'J�j
Type of Project Activity
/1U%/ ��� 1a W !- �O-7 /r/
PROJECT DESCRIPTION
SKETCH`S 5 r�G�
P%I� e,14,
(SCALE: )
Pier (dock) length
i
`
Groin lengthLi
j
>�
!fir
Cst►
number
Bulkhead length
' ¢
max. distance offshore
Basin, channel dimensions
cubic yards
Boat ramp dimensions
,Q
Other
LL
7)
r
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
t29 K- i
issuing date expiration date
attachments '�/ r
In issuing this permit the State of North Carolina certifies that
this project is consistent with the North Carolina Coastal
Management Program.
i �~ ri
application fee

Personal Account Information

ADJACENT RIPARIAN PROPERTY OWNER STAITMENT
(FOR A PIERIUNCOVERED BOAT LIFI)
I hereby certify that I own property adjacent to ,�;�-� 's
(Name of Property Owner)
property located at %C C% / Fv'4 c-
(Lot, Block, Road, etc.)
n I ,
on u rs !`1 e , in �c' k %L��?� �� r4Jc 4 N.C.
aterbody) (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 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)
Sittature j
ILt it ) () r', tic
Print or Type Name
2.S z 72-?- 2-iL1/
Telephone Number
Date: — %�

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIERIUNCOVERED BOAT LIFT)
I herebycertify that I own property
fY P perty adjacent to � Ja ��tt I\��-`1 e �J 's
(Name of Property Owner)
property located at 10o l Fc- --S� n
_ (Lot, Block, Road, etc.)
on insn ��c r� o, fit` T N.C.
aterbody) (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 do not wish to waive the setback requirement.
x I do wish to waive that setback requirement.
------------------------------------
DESCRIPTTON AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be,filled in by individual proposing development)
Signature
Print o Type Name
Telephone Number
Date:

FT /601 �'T
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