18658_STRAWBMULLER, JUSTUS_19980325

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CAMA AND DREDGE AND FILL
GENERAL I 1 8658 -�
I FRMIT
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 Zip
Project Location (County, State Road, Water Body, etc.)
Type of Project Activity
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PROJECT DESCRIPTION SKETCH (SCALE:
Pier (dock) length # "j
Groin length
number
Bulkhead length
max. distance offshore
Basin, channel dimensions
cubic yards
Boat ramp dimensions
Other
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This permit is subject to compliance with this application, site
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drawing and attached general and specific conditions. Any
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violation of these terms may subject the permittee to a fine, I
applicant's signature
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's signature
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
issuing date expiration date
ordinances, and 2) a written statement has been obtained from
adjacent riparian landowners certifying that they have no
attachments
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 application fee
Management Program.

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SERIAL NUMBER
YEAR, MONTH, DAY
OFFICE PAY TO POST U S. DOLLARS
CHECKWRITER AND CENTS
ADDRESS REA
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USED FOR
NE QTIABLE ONLY 1N U.-AND POSSESSIONS
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ADJACEq'r RIPARIAN PROPERTY OWNER STATE31ENT
(FOR A PI'ERI UNCOVERED BOAT LIFE
I hereby certify that I own property adjacent to Tc�r`u"17rr��r�r�?r:i6_l �r s
(blame of Property Owner)
property located at 4,<�
(Lot Block,, v Road, etc.)
on in L 0�c? 1. N.C.
(Waterbody) (Town andfor County)
He has described to me, as shown below, the development he is proposing at that
location, and, I have no objections to his proposal. I understand that a pierluncovered boat lift
must be set back a minimum distance of fifteen feet (15') from my area of riparian access unless
waived by me.
i
-' I do not wish to waive the setback requirement.
I dQ wish to waive that setback requirement.
DESCREMON AND/OR DRAWING OF PROPOSED DEVELOP..NMNT:
(To .he filled in by individua proposing development)
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Signature
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Print or Name
Telephone Number
Date:

ADJACENT RIPARIAN PROPERTY OWNER STATEMM
(FOR A PIER1VNC0VERBD BOAT LTFn
I hereby certify that I own property adjacent to T1STuS 'S
(Name of Property Owner)
property located at Z-ot /�-3f )1 L
(Lot, Block, Road, etc.) ,
on l )14) 6 , in /ti'r ry�: f
(Waterbody) , N.C.
(Town and/or County)
He has described to me, as shown below, the development he is proposing at that
location, and, I have no objections to his proposal. I understand that a pier/uncovered boat lift
must be set back a minimum distance of fifteen feet (15') from my area of riparian access unless
waived by me.
._.� I do 291 wish to waive the setback requirement.
I dQ wish to waive that setback requirement.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be ,filled in by individual proposing development)
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Print or Type Name
elephOne Number
Date:-44
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