17071_MOORE, GERALD AND RUTH_19970415

CAMA AND DREDGE AND FILL
GENERAL
PERMIT
Fur
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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.)
Type of Project Activity
PROJECT DESCRIPTION SKETCH
Pier (dock) length
Groin length
number
Bulkhead length
max. distance offshore
I Basin, channel dimensions
cubic yards
Boat ramp dimensions
Other
(SCALE: }
This permit is subject to compliance with this application, site
_
drawing and attached general and specific conditions. Any
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violation of these terms may subject the permittee to a fine,
a -•
applicant's signature
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's signature
permit officer when the project is inspected for compliance.
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The applicant certifies by signing this permit that 1) this pro-
ject is consistent with the local land use plan and all local
issuing date expiration date
ordinances, and 2) a written statement has been obtained from
adjacent riparian landowners certifying that they have no
objections to the proposed work.
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.
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ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
. ' (FOR A PIERIMOORING PILINGS/BOAYLIFT/BOATHOUSE)
I hereby certify that I own property adjacent to C,t A tizd -/ 11J- f", Api o ° 's
(Name of Property Owner)
property located at S! I3 s--;,Iel / A-0 -,"/' A QC , "I
(Lot, Block, Road, etc.) �T
on /gep 4 yr Spv, e a , in C-A^114--4- 7` , 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)
4
Print or Type Name
'? p-G- �46a_Q
Telephone Number
c �.r
Date: ' r �'7

. ~ ADJACENT RIPARIAN PROPERTY OWNER STATEXIENT
t (FOR A PIERIMOORING PILINGS/BOATLIFT/BOATHOUSE)
I hereby certify that I own property adjacent to C4 " .* 41/ J /`� 14 114 o �4 /J� 's
(Name of Property Owner)
property located at 5- 11-3 �a •cry �,a,,,•� o,�c ��� d C,'ty� C
(Lot, Block, Road, etc.)
on /3O of S'04.v -� , in C',nfsn� i` , 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/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 DEVELOPM LNT:
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Signature
Print or Type Name
�f 9 z 3 5,--o 1sS—
Telephone Number
Date: