17060_PIKUTIS, JUNE_19970425

CAMA AND DREDGE AND FILL
GENERAL C- 01750
PERMITas authorized by the State of North Carolina
!Y✓��/ Department of Environment, Health, and Natural Resources and the Coastal Resources Commission
in an area of environmental concern pursuant to 15A NCAC ` ''
A licant Name C7, Ll �` �Jr r— C/ t r Phone Number
pp
Address
City t"
Project Location (County, State Road, Water
Type of Project Activity 4 c,
r PROJECT DESCRIPTION
Pier (dock) length
Groin length
number
Bulkhead length
max. distance offshore
Basin, channel dimensions
I
cubic yards
Boat ramp dimensions
Other
State _
etc.)
Al .
Zip
SKETCH �' 1A ' /"�?� Q (SCALE: )
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A �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.
In issuing this permit the State of North Carolina certifies that
this project is consistent with the North Carolina Coastal
Management Program.
N
a, r}
.lot,
applicant's signature
permit officer's signature
LY
issuing date expiration date
attachments
application fee

__m �� __� —_-- 66-30342 1924
LEE C. OR MARJORIE B. JONES 531
[phone] 19-
257 LIVE OAK RD RFD 5
NEWPORT, NC 28570
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Pay To /��/�
_—� $
The Order OF m , ,
'---y i/ / e�` _ __ __—Dollars
o M FIRST CITIZENS BANK 342
& TRUST COMPANY
SWANSBORO, NC 28584
NP
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is053L003001:341763L657u'3,92+�_�

ADJACENT RIpARLAN PROPERTY OWNER STATEMW
(FOR A PIERIMOORING P.IL,I'NGSIBOA7UFT/BOATHOUSE)
I hereby certify that I own property adjacent to T_ 6 N 1_ P, n 5 Is
(Name of Property Owner)
property located at S v I t 1 4-1) & ,,� )I N r= , r= l r� C
t, Block, Road, etc.)
on l 1� -Tn Y7 t=
, 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/boattift/boathouse must be set back a minimum distance of fifteen feet (15') from my area
of riparian access unless waived by me.
I do 1got wish to waive the setback requirement.
X I �o wish to waive that setback requirement.
-------------------------------
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be JWed in by individual pmpasing development)
a
/- ! G L,1 L k is
4,14"A -Y 4na-�-'
Signature
/P� I c.i-+0 r?li 1'l G , a
Print or Type Name
`724-`-F"';�"i
Telephone Number
Date: C)y -z j,-61 r7

• ADJACENT RIPARIAN PROPERTY OWNER STATEIVE'
(FOR A PIER/MOORING PILINGSIBOATLXFT/BOATHOUSE)
I hereby certify that I own property adjacent to :To ;J�► 1<v,7,s 1s
(Name of Property Owner)~
property located at G )4V l . �- a C'
t, BloeIt, oad, etc.)
'Yin , 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
pilingslboattiftlboathouse 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� I do wish to waive that setback requirement.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be Jilted in by individual proposing development)
Print or Type Name
Telephone Number
Date: H/ 2, a/ 17

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