25534_LEONARD, CARY_20000519

CAMA and DREDGE
I
.� G E N E
PERM
as authorized by the State o
Department of Environment
in an area of environmental
Applicant Name
Address
AND FILL 25534
R A L
I T
f North Carolina
and Natural Resources and the Coastal Resources Commission
concern pursuant to 15 NCAC
City State
Project Location (County, State Road, Water Body, etc.)
Type of Project Activity
PROJECT DESCRIPTION SKETCH
Pier (dock) Length ;�_ :_ T
Groin Length
number
Bulkhead Length
max, distance offshore
Basin, channel dimensions
cubic yards
Boat ramp dimensions
Other
Phone Number
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 become null and void.
This permit must be on the project site and accessible to the permit of-
ficer when the project is inspected for compliance. The applicant certi-
fies by signing this permit that 1) this project 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.
In issuing this permit the State of North Carolina certifies that this project
is consistent with the North Carolina Coastal Management Program.
Zip
issuing date
(SCALE: , .. )
applicant's signature
permit officer's signature
expiration date
attachments
application fee

Al
A1
DAVID SIMPSON CO i� r ,I
NSTRUCTION CO. INC.
800 BROAD ST.
P•O- BOX 590
ORIENTAL, NC 28571
14296
t� 471
BANCITIZENS
BANKF'rst Cilizons Ban,{ T_ Compan "
Bayboro, NC z851s y DOLLARS 0 „°
FOR �eD
O 14 296rr' r;0 5 3 100 30 i•--
"__--- 0 .0 0 4 71 10 p 7
------0 7 9 --
n• _.-- __ i
PAY
TO THE ORDATE.
nDER OFF

r
PAMLICO COUNTY BUILDING INSPECTIONS
P.O. BOX 776
BAYBORO, NC 28515
(252) 745 - 3861
ADJACENT RIPARIAN PROPERTY OWNERS STATEMENT EPN#
I HEREBY CERTIFY THAT I OWN PROPERTY ADJACENT TO MR. GARY LEONARD
NAME OF LANDOWNER PROPOSING DEVELOPMENT
ON CANAL OFF WHITTAKER CREEK
IN ORIENTAL LOT #
COMMUNITY
TAX PARCEL #
SEA VISTA
SUBDIVISION, IF APPLICABLE
COMPLETE DESCRIPTION OF HOW TO LOCATE THIS PROPERTY 604 WINDWARD DR.
ORIENTAL, NC 28571
THIS PROPOSED PROJECT: REPLACE THE EXISTING DOCK AS SHOWN ON THE ATTACHED
DRAWING.
FOR A PIER, CHECK ONE OF THE FOLLOWING:
1� I WISH TO WAIVE THE 15' MINIMUM SETBACK FROM MY RIPARIAN ACCESS.
I DO NOT WISH TO WAIVE THE 15' MINIMUM SETBACK REQUIREMENT
SEE ATTACHED DRAWING
After this form is completed by the landowner proposing the project, a copy is given to the adjacent landowners for their
consent and signature, a forms are then returned, along with a building plan and other applicable required information,
to the building inspecribn office fop ilding permjeopplication/processing.
SIGNATURE DATE
PRINTED NAT1E

9 O.c.
I
I
1
I
1
1
I �
I
I
I
9 f O.C.
9 ` o_ c.
F-X / TT/N D k
'mab
0
0
n
0
0
I
1
f'
1
1
2 %s S
1
/
N

PIaY12 '30 12:4�-FI~1 NLBEF.T V MET7 JF' F.`,.L
PAMLICO COUNTY BUILDING INSPECTIONS
P.O. BOX 776
BAYBORO, NC M15
(252) 745 - 3861
AOIACENT RIPARIAN PROPERTY OWNERS STATEMENT EPN#
I HEREBY CERTIFY THAT I OWN PROPERTY ADJACENT TO MIL GARY LE-ON,ARD
NAME OF LANDCWNER PF�CPGSING DEVEI.OPMEW
ON CANAL OFF WHITTAKER CREEK
IN ORIENTAL LOT V SEA VISTA
COMMUNITY SUBDMSION, IF APPLICABLE
TAX PARCEL #
COMPLETE DESCRIPTION OF HOW TO LOCATE THIS PROPERTY 604 WINOWARD OR.
ORIENTAL, NC 28571
THIS PROPOSED PROJECT: REPLACE THE EXISTING DOCK AS SHOWN ON THE ATTACHED
DRAWING.
FOR A PIER, CHECK ONE OF THE FOLLOWING:
I WISH TO WAIVE THE 15' MINIMUM SETBACK FROM MY RIPARIAN ACCESS.
100 NOT WISH TO WAIVE THE 15' MINIMUM SETBACK REQUIREMENT
SEE ATTACHED DRAWING
After thls form is completed by the landowner Proposing the project a copy is given to the adjacent landowners for their
consent and signature. the forms are then returned, along Oth a building plan and oOer applicable regUhed Informatlon,
to the building inspection office for budding permit applicetio T/processing,
SIGNATURE _ � DATE
P�viftftED NAME �. lLi� _ V k� — �