16959_RITCHIE, TOM AND JENNIFER_19961115

69
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 , f/ r"� �'1'fr `�` %; f �� r Phone Number "Fr � `�''"31� %" "r�L
Address
City �:a >r/>44-.f ,r!,r State 1�'.� Zip:'
Project Location (County, State Road, Water Body, etc.) f r�:.� // rf� �?J--' f�'""" '
fir:' .% /!f �/a^ d l� .� ,•, ��a ,1.•,,:.y i' �'• � :EL O.�
Type of Project Activity
i
f.
x
PROJECT DESCRIPTION SKETCH (SCALE:
Pier (dock) length
Groin length
number
Bulkhead length
max. distance offshore
Basin, channel dimensions
cubic yards
Boat ramp dimensions
Other
Fill
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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.
applicant's si
permit officer's signature
issuing date expiration date
attachments
application fee 3 79

J. MICHAEL SANDERS
MARY E. SANDERS -
58-61116 2379
147 CONVENT AVE
BENNINGTON, VT 05201
p�
19 /�
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PAY TO C /� %0 r A/ �, 2 Q�
OF ORDERER OF I �P
DOLLARS
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VERMONT
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ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to 0/m li JPrl ✓I t FC r rl i Tr- 1 P_ Property
(Name)
located at ��et /S :A N M o Pr;nct S on
(LottI#, Block, Road, etc.) --ii�� f ay
��
0-h4 bFco cf P P, f\ in F�iilJn4� Yvf `,tayee. l,Z�';;f✓) N.C.
( Body of Water) (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 fifteen feet (15') from my area of riparian access unless waived by me. ( check one
of the Following) eP
I do not wish to waive that 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)
signature
print name
/-S�10 - 41,F9 -
phone number

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to )Opt, 'kJe-nr'Uf �e1' t IS�iP�roperiy
. f (Name)
located at � cT I k5 �{�& (Name)
located &2 1- on
�a �^ (Lot #, Block, Road etc'..) /
C 1WIPt aDf" �i�c°ek, in / /��/o "7< OraVPM 61W)Y> N.C.
( Body of Water) (ToA 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 set back a minimum
distance of fifteen feet (15') from my area of riparian access u ess wait/ me. ( check one
of the Following) ('c��l:Trtti� I r-O+�L I dOe-- ,
`✓ I do not wish to waive that setback requirement. 0111l
I do wish to waive that setback requirement.
Description and/or drawing of proposed development: ( TO BE FILLED
PROPOSING DEVELOPMENT) 1-1)
pent name
-- L1-c34,�I
phone number
C LO,�eJ