17844_LUTHERAN, J A_19970623

r
CAMA AND DREDGE AND FILL
GENERAL 017si4``
PERMIT
as authorized by the State of North Carolina
Department of Environment, Health, and Natural Resources and the Coastal Resources Commission :k
in an area of environmental concern pursuant to 15A NCAC 0 A/. /2t•'0
Applicant Name Z, I h[r
Address
City
Project Location (County, State Road, Water Body, etc.) —
�, y
Type of Project Activity
PROJECT DESCRIPTION I SKETCH
Pier (dock) length
Groin length
number
Bulkhead length
max. distance offshore
Basin, channel dimensions
cubic yards
Boat ramp dimensions
Other ..�3ols7tocl<< L
Phone Number _2 y L' �' 1 i
State A) C Zip
`x 526, i� 41"11 1 /1,1_/
1C
12
\ rt'�Lir� 'jcx•���7� !\I�
v
k.
4.
l.f
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:
y applicant's signature
r
permit officer's signature
Z 7 9 ?3-1ice
issuing date expiration date
attachments %I� 12c,f.
application fee -/� ^ , 9 / �6

FROM SEA To SHINING SEA
H A. LUTHERAN 182-28-4928 7-81
N J. LUTHERAN 178-30-9870
2834 MILL CK RD
NEWPORT NC 28570 y
PAYTO THE
29VER OF 8 i�!A�bs -
0
.':05310030(f](J:3
L 75739211- SOSG
5056
66-30/531
I

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIERIMOORING PILINGSIBOATLIFT/BOATHOUSE)
I hereby certify that I own property adjacent to
L�ZATA I
(Name of Property Owner)
property located at Z 83fk 1A 1 t_ tr, C ZU'L`c I L t� ,
(Lot, Block, Road, etc.)
on N�-vJcooZ �-2 �� Z , in n\ L.L 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.
J I do wish to waive that setback requirement.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
G"�2.cz k
Signature
y'�:- z n J i t G,- J w
Print or Type Name
Telephone Number

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIERIMOORING PILINGSIBOATLIFT/BOATHOUSE)
I hereby certify that I own property adjacent to
1�v �\-\LaRTA I
(Name of Property Owner)
property located at CZL. xc 2
(Lot, Block, Road, etc.)
on Q-\ ,L a Z , in n\ LL C.Z�t��L- 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.
I do wish to waive that setback requirement.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
kk
c�za k�
i
Print of Type Name
(1'7) 71 � ry13
Telephone Number
Date: �> - J'" /17