13048_KOLOGY, GARY_19940413

CAMA AND DREDGE AND FILL
GENERAL��
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 ! ��f 'n
Applicant Name r�gg I i / N Phone Number,
Address`
City.
Project Location (County State Road, Water Body, etc.)
Type of Pr(oject Activity I/Y /n , roe k— -7 I
1' - i' r' r •l l -r c _
State J�`- zip -
>_ 4 e
r
t-_ n— 4 i e e_.
PROJECT DESCRIPTION
Pier dock) length
SKETCHY/ ft>,
9�
1'
-,J
(SCALE:
A/
)
—,)-
7
number
Bulkhead length;Jrl
O
—f�
I
ax. distance offshore
Basin, channel dimensions_
cubic yards
Boat ramp dimensions
Other.
I
I
!
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.
T applicant certifies by signing this permit that 1) this pro -
is consistent with the local land use plan and all local
o finances, and 2) a written statement has been obtained from
adjacent riparian landowners certifying that they have no
objections to the proposed work.
j applicant's signature
G permit officer's signature
'4" 1 i -- '/ !/
issuing date expiration date
attachments Z
e
In issuing this permit the State of North Carolina certifies that ! LL 1)
this project is consistent with the North Carolina Coastal application fee i L t' t �/
Management Program.

GARY G. KOLOGY
PAULA W. KOLOGY
TAR CREEK P O BOX 655
ORIENTAL, NC 28571
Pay To The
Order Of
Wachovia Bank of North Carolina, N.A.
ISulboru, C '?ri515
Memo G Pc- ) 3oy8
1:0 5 3 LO L 5 2 91: 0 788 20 900
66_1521531 CC 016
Dollars
I

IMPORTANT
To
O �P
Date Time
WHILE YOU WERE OUT
M
of
Phone aq
Q
AREA CODE NUMBER EXTENSION
Message. G
R � of A
Sig 'd
TELEPHONED
PLEASE CALL
CALLED TO SEE YOU
WILL CALL AGAIN
WANTS TO SEE YOU
URGENT
RETURNED YOUR CALL
N.C. Dept. of Environment. Health, and Natural Resources
�v v(Printed on Recycled Paper

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I/hereby certify that I own property adjacent to _�iit/C�/ O,CQry y dpJ � o to G
J'Zo 0'0 J 's property located. at SS/P /.317 Xo7-10&
(lot, block, road, etc.)
on /�/Z C&g2g4 in /ce , N.C.
(body of water) town and/or county
The proposal has been described to me as shown below; the -development, a
Qbulkhead L structure, and the proposed location, and I have no objections
ircle one)
to the proposal. I understand 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 JWdo not wish to waive that setback requirement.
Description and/or drawing of proposed de�elepralt: (to be filled in by individlra.l
R-cpming cbv cpmrlt. )
(Original must be retained in the Inspectirn Dep rtmait)
Signature
Ms. Sarah M. Williams
Rte. 1, Box 85
Grantsboro, NC 28529
1 tviease Yrint)
r

ADJACENT RIPARIAN PROPERTY OWNER STATII,4ENT
I hereby certify that I own property adjacent to (,,4& C, v- i'YA I Lu K-1.
's property located. at W3 ,SiP 13/ i
on /iJ,� (Z 5�,� in A(lot, block, road, etc.) �/i1 � / C D I N.C.
(body of water) town and/or county
The proposal has been described to me as shown below; the development, a
pier�'e)
L structure, and the proposed location, and I have no objections
to the proposal. I understand 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 4Wdo not wish to waive that setback requirement.
Iessiptirn and/or drawing of rxq eed develcprmt: (to be filled in by individual
proposing de�elopmt.)
J

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
Ihereby certify that I own property adjacent to �iQIC(/ G O,LQty y cL /-.,0A4 GJ
's property located at S/P /.3/ %
(lot, block, road, etc.)
on - /�/� C�G.E� in /CO , N.C.
(body of water) town and/or county
The proposal has been described to me as shown below; the -development, a
Qbulkhead L structure, and the proposed location, and I have no objections
ircle one)
to the proposal. I understand 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 d do no wish to waive that setback requirement.
Des:ription and/or drawing of proposed de�el.c pra t: (to be filled in by individL l
p-q:osing dev cpnent.)
/1, /a el
It)
***********************
(Original mzst be retained in the Inspection Deprbrent)
SignAture
Name ( lease Print)
t

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to
's property located at W3 ,S'P /3/ %
(lot, block, road, etc.)
on ,� ,C C/e � �� in p��1 � / C D N.C.
(body of water) town and/or county
The proposal has been described to me as shown below; the -development, a
pier bulkhead L structure, and the proposed location, and I have no objections
to the proposal. I understand 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 d ao no wish to waive that setback requirement.
Deg::ripticn and/or drawing of prcpcsed dewlcp-Ert: (to be filled in by individual
prgmsi g develcpTr=lt. )
*****************
(Original must be retained in the Inspectiarn Dep3rbra t)
Signa re
14,, Its 1)� ,iq Ale S
Nam Please Print)
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