16963_PERRY, ELY J JR_19961205

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O
CAMA AND DREDGE AND FILL
GENERAL
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
Applicant Name Phone Number
Address
City
Project Location (County, State Road, Water Body, etc.)
Type of Project Activity
State
Zip
PROJECTDESCRIPTION SKETCH (SCALE:
Pier (dock) length
Groin length
number
Bulkhead length
max. distance offshore
Basin, channel dimensions
cubic yards
Boat ramp dimensions
Other
. . . . . . . . . .
This permit is subject to compliance with this application, site
drawing and attached general and specific conditions. Any
Ai,00411
violation of these terms may subject the permittee to a fine,
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 y permit officer's signature
permit officer when the project is inspected for compliance.
The applicant certifies by signing this permit that 1) this pro- SAll A
jest is consistent with the local land use plan and all local issuing ate expirationdate
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.

ELY J. PERRY, JR.
P O DRAWER 1475
518 PLAZA BLVD
KINSTON, NC 28501
10550
66-301531
PAY Sri /x,___19
TO THE
ORDER OF f W AI I $ � r-"' C'
DOLLARS
FDR�IR�ST CITIZENS 164
i �K rim-CBi:am Bonk a Imst company
gntlon. NC 28501
FOR � 1/y�%� . 7j" f—t�� r � � � J � J �+ t�� GI�3'—G'
11'0001055011' i:0531003001:1516929646i

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11-12-1996 10:17AM FROM PERRY.PERRY.PERRY 919 523 8868
P_ 1
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
i (FOR A PIERIMOORING PILINCS/ROATLIT T IMAT OUSE)
I hereby certify that I own property adjacent to Le- I :. ' :n� A. _'s
(Name of Profwrtf Owner)
property located at 2 `f E Vint S C -)L
(Lot, dock, Road', etc.})
on o t.� _ , in �l o�.b�a�' / � , 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
pilingslboatlift/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.
DESCRII''iTON A--TD/OR, DRAWING OF PROPOSED DEVELOPMENT:
(To be ftUed in by individual proposing development)
5 <f -C a 11,� q-� 54-,�-Qf
Post-ir Fax Note
7671
date
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From
Co./Dept.
Co.
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262
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Date: 11 / 12 / 9 6

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11 ud 96 11:05 FAX [phone] PATE: DAWSON CO.
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I hereby =tify aw I Qam wopercy adjrAMt 'v
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$e has 4e3CraW tV me 43 shown bd(m, the devdvpmmt he is
and. I have nc, °bl to his prt�p�
Fig at that
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DESMIp ION A VOX DRAWING OF IPRpp+t��
(TO 3e Jed b� iadiv i prvpoaYag Aim) DETEWPAIDEN';'
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10/28/96 16-57 TX/R( NO-7403 P-003

11/04'98
11*05 FAX
919 778 0604
PATE DAWSON CO.
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