18483_JENNINGS, TED_19971029

O
CAMA AND A
DREDGE G AND FILL
GENERAL �a
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 >9 49�j6 U
Address
City State t Zip 2 r j-
Project Location (County, State Road, Water Body, etc.) ir>• u. //G. , , Gi
Type of Project Activity —// ,c ,� sS '_—Dee.
PROJECT DESCRIPTION I SKETCH
Pier (dock) length
Groin length
number
Bulkhead length
max. distance offshore
Basin, channel dimensions
�� 1
rr-
cubic yards '
i
Boat ramp dimensions
Other
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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,
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.
(SCALE:
lY"J"'/ 1.},rk
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`: applicant's signature
/ permit officer's signatu;�
iG'-?rf 9-1
issuing date expiration date
attachments / 12 0
In issuing this permit the State of North Carolina certifies that
this project is consistent with the North Carolina Coastal application fee
Management Program.

CHARLES T. JENNINGS
DOROTHY L. JENNINGS
588 CREEK PLACE ROAD 919-249-0563
ARAPAHOE, NC 28510
Wachovia Bank of North Carolina, N.A.
BuVburo, NC 28515
Memo (2100-
1:0531015291: 0782 20063011' 5896
5896
66.1521531 CC
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NO
Dollars

POBOX 770 PAMLICO COUNTY BUILDING INSPECTIONS BAYBOKO, N.C. 28515
[phone]
(After this form is completed by the landowner proposing the project,
a copy is given to his/her adjacent landowners for their consent and
signatures. The Corms are then returned, along with a building plan
and other applicable required information, to Ye Building Inspections,
Office for building permit application/processing.)
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT EPNO
I hereby certify that I own property adjacent to
`9A16&d4,MS on 71)awSoar
Name of landowner proposing development body of water
in/nearJ�A & - / k U Lot41 of
community Subdivision, if applicable
Tax Parcel #i off SR 13 O 2 . Complete description of how to
locate this property: 15A 8 _Q2e-e-k< 24, Ate- k90 Y40
The proposed project, a 1 O&r L4F-i 1000F , and the location has been
described to me as shown in the drawing below and I have no objections
to the proposal.
FOR A PIER, CHECK ONE OF THE FOLLOWING:
.� I wish to waive the 15' minimum setback from my riparian access.
i DO NOT wish to waive the 15, minimum setback requirement.
****•*,r#��r**.**•**�•*,�•*****r�*�*w,►�*w�*•*:**.ems*•�r**t*r*•*r�*#*aeo*,t:*
Draw the proposed structure in the space provided below. List the size
of the structure and measured distances froe the adjacent property
lines, other structures on the property, and the road, water, etc.
f'i f!-ir2 v 1 � �,i is i✓ e✓ / •v � � .�l �,,.�;�,,.��:� --
`J d AJ A-1 IL/ a -A Date ��� signature

06/26/1397 17:22 919-249-0600 ALLAN T SHEPHERD CO PAGE 02
KBOX 776 b'A"L'" UOU14TY HUIL1JING INSVECT1UN:; BAYtORD, N.L. 28 15
[phone]
(After this fora is completed by the landowner propoeing the project.
a copy is given to his/her adjacent landowners for their consent and
signatures. The torts are then ,returned, along with a building plan
and other mWieable required information, to tpe Nuilding inspections'
office for building pt mit appjicationlprocesaing,)
ADJACENT RIPARIAN FROpZRTy OWNER STATEMENT
Ei'Nn
I her4by certify that I Own property adjacent to
N®s! of Iandoaner on
proposing development body of water
in/near
Loth of
co�un i ty
Subdivision. if applicable
Tax parcel d off "
• Cosplete descriptiait of how t<,
Locate this property:
22te proposed project, a �—w_
described to me ag shown s �Os� and the location has been
to the in the drawing below at►d I have no
proposal. objections
F0* A PIER, CHECX ONE OF T" wish to waive the 15, FOLIAitING:
mink# setback iron my riparian access.
----Z NOT wish to waive the 15, siniswi setback requirement,
••ff•f!!lAfflq*!!!f►♦eflA•flffArarrA!!!M*Nltff»fflM/f*Affrlfl�ff/AMff�AAf•
Draw the proposed structure icl the s
Of the structure aa,d ma pace provided below. List the size
structures lines, other st agured distances from the adjacent property
on the Pi'opert
f'l attd the read, water, etc.
$oAT L, -7 QooF I
—� Si cinOtU
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