18480_REYNOLDS, SAM_19971015

CAMA AND D N DREDGE AND FILL
GENERAL �e� 08480 _
PERMIT (-°yll
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 yNot..
Address3�s,.7.
Cityf'
Project Location (County, State Road, Water Body, etc.)
Type of Project Activity
PROJECT DESCRIPTION
Pier (dock) -length C `
Groin length
number
Bulkhead length
max. distance offshore
Basin, channel dimensions
cubic yards
Boat ramp dimensions
Other
SKETCH
^� Stated
JJ:
-41
c`C• C-✓. P)',4
)O+
Phone Number 9� p, S39?
zip 2 76 IL--'
(SCALE: A/,,)0j, )
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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.
i
�
,,
apol icant's,tiQnatu re
..� /r �� /�Y fit• //
1 permit officer's signature
issuing date expiration date
attachments t7% // 1200
In issuing this permit the State of North Carolina certifies that
this project is consistent with the North Carolina Coastal application fee
Management Program..,
i

BROAD CREEK 66-30/531
CONSTRUCTION INC 471 2831
PH. 919-249-0523
11 CR ITTW COURT �0 - S-195 2
MERRITT, N NC 28556
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orclero �Z $
FIRST CITIZENS.T,
A IIQ K First -Citizens Bank & Trust Company
Bayboro, N.0 28515
' may Sul s "pA&/F
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OCT 01 '97 0 : 1AM Di --I PLAPIT S F.
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ADJACENT - RTPMJM QROPERTY__OWNZR STATEMENT
I hereby certify that I own property adjacent to 2
property located at Lr,r 1Z,-_29Z Z"'L CA b,I� �y� ��+!UL7_ 0) 63r _Sj�L)D++J._►_6_rm'
� //��,, (lot, block, road, etc)
on _ - lCC CIL C _ in _ _ 1�� LiT`r
(body of w ter) (town) - -
North Carolina in K�riU LC� County. The proposal has been described to
me as shown below; the development, a (�ie bul ead cttYre, and the
(circle one)
proposed location, and I have not objection to the proposal.. I under --
stand that if the development is a pier, it must be set back a minimum
distance of 15 feet from my area of riparian access unless waived by me.
I doido not ish,to waive that setback requirement.
(cir _ e)
Description and/or drawing of proposed development: (to be filled in by
individual proposing development). INDICATE THE SIZE AND LOCATION OF THE
STRUCTURE AND THE DISTANCE BETWEEN EACH PROPERTY LINE AND THE WATER. •.
LL,T 13
L oY I Z_
Lo-r ii
(Original, must be retained in the Insp tion pa went)
Signature

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—0(T 01 "37 06:22AM 'ICI PLAI IT ��.:.,._.....__..__.... � X�:�� :x_.:.......... ,..._. ....,....... .F..�.. ....... .
ALQ42EV RIPARIAN PROPERTY OWNER STATIgM
I hereby certify, that I own property adjacent to iz
property located at (L�2 , ZgZ I� ,niT cy_1 �r`�c� Vm
.I -� (lot, block, road, etc)
on _ in
( body of w tier) (town)
'North Carolina in '
ta� County. The proposal has been described to
me as shown below; the development, a pier bulkheadlstructure, and the
(circle one)
proposed location, and I have not objection to the proposal. I -under-
stand. that if the development is a pier, it must be set back a minimum
distance of 15 feet from my area of riparian access unless waived by me.
3:'d dv not wish.to waive that setback requirement.
'-ircle one)
Description and/or drawing of proposed development: (to be filled in by
individual proposing development). INDICATE THE SIZE MM LOCATION OF THE
STRUCTURE AND THE DISTANCE BETWEEN EACH PROPERTY LINE AND THE WATER. --
L . I— cot
V
C_1 �
I
..7
LOT 11
(original roust be retained in the InepOction artmezifk)
14
5ignalure
Date -