16978_MOORE, ALLEN_19970206

O
CAMA AND DREDGE AND FILL
GENERAL Q�`$
PERMIT "Alc ;JA
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 f 1
Applicant Name
A Phone Number % % '% . a i/ 7 7�
Address 9 �� � A h
City C f
Project Location (County, State Road, W ter Body, etc.)
Type of Project Activity —7 h - ! ICA 1'
PROJECT DESCRIPTION
Pier (dock) length _
Groin length
number
Bulkhead length
7
max. distance offshore
Basin, channel dimensions
cubic yards
Boat ramp dimensions
Other
SKETCH
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.
_ State
Zip 5 7
(SCALE:
W
applicant's signature
permit officer's signature
issuing date apiration date
attachments rd r /,/ e �1 i! r
i
application'

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CHARLES R INE Colq
P.0, aox . WESS S'rjj (J Crj 0
MOREM41)15 PH. 919 �11 OW
IVEnIVC/7-y, NC-228j
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ADJACENT RIPARIAN PROPERTY OWNER STATEMENT WOR"2�R)
I hereby certify that I own property adjacent to
property located at 3 C2 utP',T— -T-rL -4--f-
(lot, block, road, etc.)
on M O�2 03JADE CAL�4L in CA70--U , N.C.
(water body) (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 must be set back a
minimum distance of 15 feet from my area of riparian access unless waived by me.
IFcle
do not wish to waive that setback requirement.
on
e)
Description and/or drawing of proposed development: (to be filled in by individual
proposing development)
v "C-
PUS e
Name
-? �)-6 ._ l Ll
Phone Number
R

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT (FOR A-FtEk)
5"FA w F} c
I hereby certify that I own property adjacent to cLc/' Mob is
property located at 3 [Jr--6b L-Djl� ��� N 7 Ss��
(lot, block, road, etc.)
on f�o C u A-L in � �"� , N.C.
(water body) (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 must be set back a
minimum distance of 15 feet from my area of riparian access unless waived by me.
I do do not wish to waive that setback requirement.
(circle one)
Description and/or drawing of proposed development: (to be filled in by individual
proposing development)
tc�1STlIJ6
ect po sip
Signatule
� f- 141
Name
Phone Number