23166_CIESICKI, JANE L_19990813

CAMA AND DREDGE AND FILL Ce
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GENERAL � 6s -
�PE`
RMIT
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
A AA..,��
City
Project Location (County, State Road, Water Body, etc.) —
Type of Project Activity
PROJECT DESCRIPTION SKETCH
Pier (dock) length
I
1
Groin length
number
Bulkhead length
max. distance offshore.
Basin, channel dimensions
cubic yards
Boat ramp dimensions—
Other
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State
Phone Number
Zip
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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,
applicant's signature
imprisonment or civil action; and may cause the permit to be
_
come null and void.->cp
This permit must be on the project site and accessible to the
permit officer's signature
permit officer when the project is inspected for compliance.
//11
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
this project is consistent with the North Carolina Coastal
application fee
M
Management Program

,JAN-E L. CIE 1CKI
CHARLES D. HALEY
P O BOX 341
ORIENTAL, NC 28571
66-30/531
473
Date*L4&,-Iw
211
Pay to the
Order
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FYRSF CITIZENS 4»
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For
1:053L003001:004717S4732411' 00211
Opahe/Lwkan GUAROIANW SAFETY BLUE WBL

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CAMA
25'L�a
August 16, 1999
Jane L. Ciesicki
P.O. Box 341
Oriental, N.C. 28571
Dear Jane:
Attached is General Permit #C-23166 to construct a 6.5' X 10.5' floating dock, a 3' X 10' ramp, and to
install 2 tie poles on your property located in the Dixie Landing Subdivision, Arapahoe.
In order to validate this permit, please sign all three (3) copies as indicated. Retain the white copy for
your files and return the yellow and pink signed copies to us in the enclosed, self-addressed envelope.
Your early attention to this matter would be appreciated.
Sincerely,
n
Scott Jones
Coastal Management Representative
SJ/rcb
Enclosures
North Carolina Department of Environment and Natural Resources James B. Hunt Jr., Governor • Wayne McDevitt, Secretary
Division of Coastal Management Donna D. Moffitt, Director
Morehead City Office • 151-B Hwy. 24 / Hestron Plaza 11 Morehead City, NC 28557 • Phone [phone]

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ADJACENT RIPARIAN PROPERTY ORNER STATEMENT
(FOR A PIERIMOORING PILINGS/BOATZIFT/BOATHOUSE)
I hereby certify that I own property adjacent to P�(1�� 1 S I G1� 's
it (Name of Property Owner)
property located at H 14
(Lot, Block, Roa ,etc.) '
on ' Aw in C
(Waterbody) (T, N.C.
own and/or Count )
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
fifteen piiings/boadift/boathouse must be set back a minimum distance of feet (15') from my area
of riparian access unless waived by me.
I do not wish to waive the setback requirement.
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I do wish to waive that setback requirement.
DESCREMON AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
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Stw11� H
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a o --mo-sI-0 P'lk't,�
ft
Proposed addition of 2 pilings,
a float w/ ramp and electricity Signature C,
and water on existing dock. �_
Print or Type Name J d
Telephone Number
Date: Yl l9 �'

ADJACENT RIP1k1 AN PROPERTY ORN.ER STATEIVIEIVrr
' (FOR A PIERIMOORING PILINGS/BOATLIFT/BOATHOUSE)
I hereby certify that I own property adjacent to ':�F fV;. L , 1�51�� 's
I t (Name of Property Owner)
Property located at H q 4
(Lot, Block, Road, etc.) '
on CAW , in C , N.C.
(Waterbody) (Town and/or Coun )
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/boadift/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.
-11.
I do wish to waive that setback requirement. A U G ? 3 1999
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
u. (To be flUed in by individual proposing development)
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ecQ s1r, ,1►'' � ��'
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Proposed addition of 2 pilings,
a float w/ ramp and electricity
and water on existing dock.
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Print or Type Name
_�, qy--D `7/D
Telephone Number
Date: