19908_HOOTEN, JOHN_19980616

CAMA AND DREDGE AND FILL ,r
GENERAL V 019908 --�
C
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
State
Phone Number
Zip
jo-�! (SCALE:
i 21
1
I
i
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.
issuing date
attachments 7�J
applicant's signature
permit officer's signature
expiration date
In issuing this permit the State of North Carolina certifies that
this project is consistent with the North Carolina Coastal application fee
Management Program.

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ADJACENT RIPARIAN PRO Ty OWNER STA
TETIENT
(FOR A PIERXIVCOVERED BOAT I.IFI)
I hereby certify that I own properly adiaee-rit to
(Name of Property Owner)
Property located at �`
(I 4 hA g Rjad, etc./ZZ in . - /'C 0
on (!f' &
(Waterb o dy) P�� N. C
(Town and/or Y) �'
He has described to me, as '10v� below the devel location, and, I have no objections ins .F.��`� � � ' opme�rt he is propo -Lig a.i g'
must be set back a �` I understand that a piec/unc �e .ed boat i ;
minimum distance Qf f�; t °.. � fez (IS') from my area of riparian aof.,ess Ulf,�s
waived by me.
V
I &—n-q wish to waive the g-g ,7k requirement.
14Q wish to ul3jve that , ,:A Cquirement.
DESC'RIPIION AND/OR I RASA ING 0-'F PROPOSED D `
PM1�V'�
(To be filled in by �,gwjj proposing development)
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in?�7 'Q a/-�
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Signature -
Print or Type Nam
c
Z ?cy
Telephone Number
Date: �'/ -- / O - 9 ,-S>

ADJACMIT RIPAPJAN PRO'?,F�AJITY OWNER STATEM[EW,
(FOR A PIEWG,XC, j,,L,,RF ,D B0A,7-'ryFn
I hereby certify that I own pMfjCjIY at,
.aar,t tr
(Dame of
PrOPcrtY located at Property Owes)
on —7Z - 4
(Waterbody) G I 'a -- C w, . and/or Y %��t � _, 1�.�;,
Y)
He has described to me !is b J-aow, th'��
location, and, I have no objection, davelOPInclit he is
na to i" that pIg zt�
rnust be set back a minimum distance1 W'P?IJtrStand a piexl
of f:` f uhc,')'v-e- ttd boai
j ali�a�il awUs
1 !IQ—nX wish to waive ',he icquirement.
42 wish to v,'3jIC tal, .-aiuirenjent.
— — ------------
DESCIUFTION AND/OR
]D'kA vs'NCr 01F PROPOSED 4 DEVEIA�PW
(TO be filled in by 15�- ;: - -*-,7 pro
rT— - , posing deoelopment)
GV
J
a
Ip 14'e
a
�z 41.1114114 6 oe�
Print or Type Naz�e-
-t'
T(4r-ii'pi�h�o�ne
Number
Dam: