21547_BRANT, BARBARA_19990329

CAMA AND DREDGE AND FILL N
GENERAL 1V 6 021 547 _..' c
PERMIT
as authorized by the State of North Carolina
Department of Environment, Health, and Natural Resources and the Coastal Resources Commission c
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 f 6 L
PROJECT DESCRIPTION SKETCH G. �',�' (SCALE: )
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Pier (dock) length / p 01 � �� 5�(
19
Groin length- )f
number
Bulkhead length
max. distance offshore
Basin, channel dimensions
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cubic yards "f
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Boat ramp dimensions
Other
7—
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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.
applicant's signature
This permit must be on the project site and accessible to the
4-' permit officer's signature
permit officer when the project is inspected for compliance.
3—�
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
,t�'� ,
this project is consistent with the North Carolina Coastal
application fee
Management Program.

66-112/531 2019
5113066549
BARBARA A. BRANT o' �(
LIC. 7504862 PH.252-225-1525 fah
1874 HIGHWAY 70 �� U
STACY, NC 28581 `
0220,
617 N NC 28ET
BEAUFORT, --
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100531011211:5113066549n■ 201
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UNJED STkTES POSTAL SERVICE
First -Class Mail
Posta e & Fees Paid
usFM—F'. 3-i-
Permit No. G-10
• Print your name, address, and ZIP Code in this box •
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SENDER:
I also wish to receive tone follow-.
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❑ Complete items 1 and/or 2 for additional services.
ing services (for an extra fee):
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Complete items 3, 4a, and 4b.
❑Print our name and address on the reverse of this form so that we can return this
1 ❑Addressee's Address
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d
card to you.
❑ Attach this form to the front of the mailpiece, or on the back if space does not
2. C1 Restricted Delivery
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permit.
❑ Write 'Return Receipt Requested' on the mailpiece below the article number.
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O The Return Receipt will show to whom the article was delivered and the date
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delivered.
3. Article Addressed to:
4a. Icle Number
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❑ Registered [D Certified
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❑ Express Mail ❑ Insured
for Merchandise ❑COD
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El Return Receipt
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7. Date of Del`
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5. eceived B . (Pr' t N me
8. Addressee's Address (Only it re uested and
fee is paid)
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ign (Addressee or Agent)
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PS Form 3811, December 1994
102595•99-8-0223 Domestic Return Receipt

ADJACENT RIPARdAN PROPERTY OWNER STA
(FOR A PIER/MOORING PILINGS/BOATZIFT/BOATHOUSE) i }^
I hereby certify that I own property adjacent to Z A -H '0 A k -A � F, A 0111
s
(Name of Property Owner)
property located at 1 c 1 (-( C.
(Lot,
Road, etc.)
- - a 4 ,/ K, <<
Are 1
�R��et-�__--
('Waterbody) I (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. .r undPrr="at a pier/.,,.,
PihngSPboaffift %oathvuse-must be a
15') from -my area -
of riparian access unless waived by me.
I dQ setback requirement.
I & wish to V
-------------------
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be JWed in by individual proposing development)
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-------------- `- ------- `----- V----------------- 1-� 1._—_ '--------
Signature
Print or Type Name
Telephone Number
Date: L 2 2