28864_WILLIAMS, JACK_20011115

CAMA and DREDGE AND FILL
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G E N E R A L
P E R M I T
as authorized by the State of North Carolina
Department of Environment and Natural Resources and the Coastal Resources Commission
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in an area of environmental concern pursuant to 15 NCAC -
Applicant Name Phone Number
Address
City State zip i
j Project Location (County, State Road, Water Body, etc.) l
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Type of Project Activity r.. k i 1f'+I/
PROJECT DESCRIPTION SKETCH
(SCALE:
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Pier (dock) Length
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Groin Length
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Bulkhead Length 1
max. distance offshore
+b hl
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Basin, channel dimensions
cubic yards ;
Boat ramp dimensions
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Other
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This permit is subject to compliance with this application, site drawing
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and attached general and specific conditions. Any violation of these terms"
' " r r applicant's signature
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-
permit officer's signature
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
issuing date expiration date
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.
attachments
In issuing this permit the State of North Carolina certifies that this project
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is consistent with the North Carolina Coastal Management Program.
application fee

WILLIAMS ELECTRIC CO.
P.O. BOX 236
BEAUFORT, NC 28516
PAY `j D
TO THE0Z-1A
ORDER OF/
1i'0 L 50 4 511' I00 5 3 100a 501:0 M 2000 5 3 411■
CENTURA BANK
MOREHEAD CITY, NC 28557
66-85
531
DATE
011045
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AMOUNT
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MP

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ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/MOORING PILINGSIBOA TLIFTIBOA THOUSE)
I hereby certify that I own property adjacent toyV LC�4� �5�`,
(Name of Property Owner)
property located at � / Y) .
(Lot, Block, Road, etc.)
on in
( aterbody) (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/mooring
pilings/boatlift/boathouse must be set back a minimum distance of fifteen feet (15")
from my area of riparian access unless waived by me.
I do not wish to waive the setback requirement.
I do wish to waive that setback requirement.
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DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
Sign ,tufe � /
Pr' 77 e® t�a 39
Telephor� Number /
Date: