21093_DENSIESKI, ADOLPH E_19981204

CAMA AND DREDGE AND FILL ai��
GENERAL j °'
PERMIT'` `�_Cc$.
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��? 14l
Address
City State - zip-�
Project Location (County, State Road, Water Body, etc.) +`
Type of Project Activity
— u "
Z o� 1c �t 1 �r \ •• i t N I
PROJECT DESCRIPTION
SKETCH
(SCALE: ry, •{.�-
)
Pier (dock) lengthn��:'.�,`�i�
`
Z ✓ 5'� �.
�rI\{l (�lJ1 7'O f:
L
Groin length
\
r
number
Bulkhead length
max. distance offshore
�1
-- • -----
--- >
: '
Basin, channel dimensions
_
`
cubic yards
(
24
Boat ramp dimensions
Other
ii''r'�
1
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.
applicant's signature
permit officer's signature
4 7)uc .4
issuing date expiration date
attachments
C>-7 }--k • \:9v0
In issuing this permit the State of North Carolina certifies that
this project is consistent with the North Carolina Coastal application fee
Management Program.

66-30/533 1 24
ADOLPH E. OR SHIRLEY E. DENSIESKI
408 MIDDLE ROAD
RIVERHEAD, NY 11901
1
po�n.iehm�ex�
FIRST CITIZENS 473 Tiered InsuredDMney Marke( Savings
13ANKFirslCitinns Balk & Trust Company
Ar,.hoa, N.C. 28510 /
LIMS 3 100 001:4 7 280 L96 S011' 0 124

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Pamlico County Building Inspections
P.O. Box 776
Bayboro, N.C. 28515
(919)-745-3861
Adjacent Riparian Property Owner Statement Epn#
I hereby certify that I own property adjacent to O'D a �-q 4 E "-I�< tv S \ Z 5 1� � `s
Name of landowner proposing development
on &JL(J S �Y2� is in/near Lot# l of
Community Subdivision, if applicable
Tax Parcel # /� b 1 off SR/oa ,� gk
Complete description of how to locate this property: e4k �!YY�,>7 n �� D r� / to jo
R,42 Pv� 5
This proposed project, ag► m p and the location has been described to me as
shown in the drawing below and I have no objections to the proposal.
Draw the proposed structure in the space provided below. List the size of the structure and
measured distances from the adjacent property lines, other structures on the property, and the
road, water, etc.
After this form is completed by the landowner proposing the project, a copy is given to the adjacent landowners for
their consent and signatures. The forms are then returned, along with a building plan and other applicable required
information to the Building Inspections Office for building permit application/processing.
Signature
Date ,) ,

Pamlico County Building Inspections
P.O. Box 776
Bayboro, N.C. 28515
(919)-745-3861
Adjacent Riparian Property Owner Statement Epn#
I hereby certify that I own property adjacent to � Vc' 1 V `s
Name of landowner proposing development
r?? 1 J
� I '
on l) I f ��(P�� in/near Lot# T of i YC+ (e-,s �t y �' s ► e�
Community Subdivision, if applicable
Tax Parcel # ) D S `6' — off SR 1 U UJ . 's'e
Complete description of how to locate this property: �P I/e %�CY} KI �0�- �� /DDT
esf
This proposed project, a , and the location has been described to me as
shown in the drawing below and I have no objections to the proposal.
Draw the proposed structure in the space provided below. List the size of the structure and
measured distances from the adjacent property lines, other structures on the property, and the
road, water, etc.
After this form is completed by the landowner proposing the project, a copy is given to the adjacent landowners for
their consent and signatures. The forms are then returned, along with a building plan and other applicable required
information to the Building Inspections Office for building permit application/processing.
Signature '; Date A'