21010_ROSE, VERNON_19981008

CAMA AND DREDGE AND FILL
GENERAL S 021010
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 I ,
Applicant Name V4. rtU': "`"
Address t -� 1��' �1�'': s` �'i.57y /4' Jz
Phone Number
/1i2 - 116- e12 1'5
City (`"'' -' '
Project Location (County, State Road, Water Body, etc.)
State N c zip
Type of Project Activity :-�,\rcf.14',
ic,o 7 T.
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PROJECT DESCRIPTION
Pier (dock) length
-Groin length
number
Bulkhead length
max. distance offshore
Basin, channel dimensions
cubic,yaTds
Boat ramp dimensions
Other
SKETCH _, ,
t
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.
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applicant's signature
permit officer's signature
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issuing date expiration date
attachments
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In issuing this permit the State of North Carolina certifies that Y . C"D
this project is consistent with the North Carolina Coastal application fee
Management Program.

LIBERTY
LINDA OR WAVERLY D. SHORE
DBA PAMLICO MARINE CONST. Q�( 3119
HER NCDL 4789098 HIS 3266479 l v 19 `-U
PH. 919-745-7992 66 7796/2531
P.O. BOX 163, DIXON RD.
VANDEMI�E fRE, NC 28587 r PAY TO THOF _ _ I �O O O
ORDER
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1:253177968i: 00 17 4 6 L 19

NORTH CAROLINA DEPARTMENT OF
ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF COASTAL MANAGEMENT
04
NCDENR
JAMES B. HUNT JR.
October 9, 1998
GOVERNOR
yid^.•::i;;
Waverly Shore
WAYNE MCDEVITT
P.O. Box 163
SECRETARY
9
Vandemere N.C. 28587
;5
Dear Waverly:
DONNA D. MOFFITr
DIRECTOR
Attached is General Permit #C-21010 to construct 100 ft. of bulkhead on the property
of Dr. Vernon Rose, in the community of Maribel .
In order to validate this permit, record Dr. Rose's address in the appropriate area of the
permit and please sign all three (3) copies as indicated. Retain the white copy for your files
and return the yellow and pink signed copies to us in the enclosed, self-addressed envelope.
Your early attention to this matter would be appreciated.
MSJ/rcb
Enclosures
Sincerely,
Scott Jones
Coastal Management Representative
MOREHEAD CITY OFFICE
HESTRON PLAZA II 151-B HIGHWAY 24 MOREHEAD CITY NC 28557
PHONE 2S2-808-2808 FAX [phone]
AN EQUAL OPPORTUNITY / AFFIRMATIVE ACTION EMPLOYER - 50% RECYCLED/10% POST -CONSUMER PAPER

08%20.98 12:00 FAX [phone] FIRST CITIZENS
Front Demo To: jam Pwtin late= arAWB Tierce I[h0258AM
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Page 1 of 1
Al PvOp ti Owner st7Urc�
SIUNA
I berek*y certiPc tltal 1 oww. ptOprs y adiacrnt [o _�%/f &%P*e ,f x Oss"
N.wm of 1mmde, wn er prop —n@ d-Ckkv
prt inharar
counnatrity — uhdirisioa ifappit®
Tat Parmw _ off- SR
Cotupime desedption of how to 10mc, this mmputy----.-
Thispropmedjxm4ccLa �gil f 1c ,6O1D and the }pc�tiori has been drs�.hed W me gs
shaven m the drawingbclow and 1 bavc m OtOCCUOfts to the p■opOSAL
for a Plar> chcr-k the Following:
I vnSL to waive the 15' tt mio nm mAxC c fiom my TiP- arxess
I do not wish to %mve the IS' scdmck requi runx- ,
Draw the pt opowd strut ue xn ute spat prvelftd below_ List tht size of the gm=m attd
mrasurced ,SsLunom rrom the adaumL prupc ty tines, Wliar structures an ffic property. and t1-
road. water, e
After toes fwm is cow pki d b) the Imrrlp„~z Prig the txoymt a tugs- is gs'en to the
lsmdvvr+em for heir consou mW stets- Tbo forum& ate tficn rcturped along wAh a bt" ding Plan
and other apptKable regmjed wfwombon to the EmWing IMP. OCrxx for b--Jkbn p—Wt : ophc mhW

Adjacent Riparian Property Owner Statement
SIGNATUAO�YDATE 1p /
I hereby certify that I own property adjacent to ",&��0^� �OS Lf
Name of landowner proposing development
on in/near Lot" of o Gtl/ r
Community I Subdivision, if applicable
Tax Parcel# off SR
Complete description of how to locate this property
This proposed project, a f - /t lIeW and the location has been described tome as
shown in the drawing below and I have no objections to the proposal.
For a Pier, check 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.
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.
A-V
%l BSc �tfLt7l'
After this form is completed by the landpwner 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 Insp. Office for building permit application/
processing.