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CAMA AND DREDGE AND FILL o ��
GENERAL 214
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
Address
City
Project Location (County, State Road, Water Body, etc.)
Type of Project Activity
PROJECT DESCRIPTION I SKETCH
Pier (dock) length
Groin length
number
Bulkhead length
max. distance offshore
Basin, channel dimensions
cubic yards
Boat ramp dimensions
Other
:L 2
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.
State
attachments
application fee
Phone Number
issuing date
Zip
(SCALE:
applicant's signature
permit officer's signature
expiration date

JOHN B. BURNETTE 896
eeJJJ 6476 Wood Lake Rd Ph 561-747-8299
Jupiter, FI 33458 / p 71-7331/2749
Date 'r 1 q'S BRANCH 222
Pay D N I $
ro r1,e c)rder car Sv
Dollars F........
Deieiia on back.
Philips Federal Credit Union
Riviera Beach, Florida 33404 2670
PAYABLETRRO PROPSFEDEP LCREDTUN .
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1: 2 7 4 9 7 3 3 16i:
8000 10 7 7 7 10 08 96
O RARIAND
SIGNET

John B. Burnette
121 Carrot Island Lane
Beaufort, NC 28516
May 3, 1999
NC Coastal Management
Ref:
Property at 274 Old Causeway Road (Radio Island), Beaufort, NC 28516
Attached are the approval forms from my neighbors on each side of the property.
I wish to install a boat lift to replace the pilings which I now use to moor the boat.
I would like an inspection and approval as soon as possible.
Sincerely,
L 3 31
John B. Burnette
Home Telephone [phone]
Home Facsimile [phone]
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ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIERIMOORING PILINGS/BOATLIFT/BOATHOUSE)
I hereby certify that I own property adjacent to TO H N 0 , � P,9 M FLa L . 43 U R-N a-7m 's
(Name of Property Owner)
property located at Z) 4- OLD GAvsEyvAy 20fi:
(Lot, Block,
a09U)�-Q.r
etc.)
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CGjR?�7�T �v�7y �Bg��me,-Pc�G�&) , 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)
.SIL e (�--rrt+cwe-D
MAY 0 3 1999
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Print or Type Name
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Telephone Number
Date:

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ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIERIMOORING PILINGSIBOATZIFT/BOATHOUSE)
I hereby certify that I own property adjacent to S�"� 13, � PogM1-La L. i3vR,r„E-m 's
(Name of Property Owner)
property located at Z
OLD G905EwA,
(Lot, Block, Road, etc.)
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on ?(LEw,3 7-rGA'D0r0c+0C) , in Cg27b'7t&,-' GeUN7,-J iBanL-1P-c,-P4.N67 314Y) ,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.
"A
I do wish to waive that setback requirement.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
Sc E 6:�-Trt-c4-01
MAY 0 3 1999
Signature /
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not or Type Name
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Telephone Number
Date: �•�

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