22259_FRANCIS, NANCY_19990602

0
N" G�
CAMA AND DREDGE AND FILL Cr
GENERAL _N$ 222259
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 Phone Number
Address
City State
Project Location (County, State Road, Water Body, etc.)
Type of Project Activity
Zip
lV
69
PROJECT DESCRIPTION
SKETCH (SCALE:
Pier (dock) length
Groin length
number
Bulkhead length
t
j1a
max. distance offshore
Basin, channel dimensions
i
cubic yards
tr
Boat ramp dimensions
t
,k
f t _i ✓:. -... k 7
Other
i
i
ooc pis: . J_
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. NL_
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 signature
I permit officer's signature
I
issuing date expiration date
attachmentsOU
r_ a
application fee

ordrr o/
NANCY FRANCIS
BARBARA L. HECKMAN
NCDL 2284121 25634338
102 HICKORY
NUT COURT pH.
0 19-393-3313
TNC 857
66-85/531 225
0280144278
-3 - y66
'f�alr
$ '6
. Ilnrs
so+ Go-
Centura Bank -
Cape Carteret, NC 28564
Alemo
�.0S3LOOa50i:02a0Lis 427a1" 0225 aE.=Es�mr�

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/MOORING PILINGS/BOATLIFT/BOATHOUSE)
I hereby certify that I own property adjacent to /ice �C� 1� [S 's
property located at /V f ��%_ iD Z IlA/CA1011C
(Lot, Block, Road, etc.)
on OS4f �le %1J in NC
(Waterbody) (Town and/or County)
He/She has described to me, as shown below, the development he/she is
proposing at that location, and, I have no objections to his/her proposal. I understand that
a pier/mooring pilings/boatlift/ boathouse must be set back a minimum distance of fifteen
(15') from my area of riparian access unless waived by me.
I do not wish to waive the set back requirement.
I do wish to waive the setback requirement.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
set back from property line I
Boat
Lift
O
I I
i
� p0
J
1
gp +
Signature
Print or Type Name
Telephone Number
Date: .S " :? � qy

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/MOORING PILINGS/BOATLIFT/BOATHOUSE)
I hereby certify that I own property adjacent to f,/ Hew,&j is
property located at 3 y /OZ: (/ /f.)Gt T 64(e j
(Lot, Block, Road, etc.)
o in C� /(���iC��� NC
(Waterb dy) (Town and/or County)
He/She has described to me, as shown below, the development he/she is
proposing at that location, and, I have no objections to his/her proposal. I understand that
a pier/mooring pilings/boatlift/ boathouse must be set back a minimum distance of fifteen
(15') from my area of riparian access unless waived by me.
I do not wish to waive the set back requirement.
I do wish to waive the setback requirement.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
set back from property line
—16 —
__13_
Boat
Lift
O
� I
i
I po
I
-90+--
'�,rA
6.
Print or Type Name
zs�-- AFJ — Z& s1
Telephone Number
Date: s