13084_OVERHOLD, SANFORD_19940601

CAMA AND DREDGE AND FILL
GENERAL ra�
13084
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 '
Applicant me 2s "I�' Z -" + i Phone Number / t' / s7 LT —
Address tol.;o V.
City, f_y U, a,,;, T
Project Location (County,
Type of Project Activity _
PROJECT DESCRIPTION
Pier (dock) length
Groin length
number
Bulkhead length
distance offshore
Basin, channel dimensions
cubic yards
Wad, W ter Body, etc.) L- e- '1
SKETCH �, rv, ?T
Boat ramp dimensions r
Other
+3l
_ State `r Zip.
This permit is subject to compliarice 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. r
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 -
*is consistent with the local land use plan and all local
1nances, 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
L7 permit officer's signature
issuing date expiration date
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attachments
In issuing this permit the State of North Carolina certifies that
this project is consistent with the North Carolina Coastal application fee' �� 2 (.j�
Management Program.

THIS DOCUMENT CONTAINS AN ERASURE
SS+ENSITTI VV(E FACE. ATTEMPTED ALTERATIONS WILL
�APPEAR
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PAY THE SUM OF
NOT GOOD OVER $300.
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PAY TO THE
ORDER OF L/ f--pe-*+o—
Issued by
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ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIERIUNCOVERED BOAT LIFT)
I hereby certify that I own property adjacent to 'S
(Ijame Property Owner)
r n n 1
property located at
(I.ot, Mock, Road, etc.)
on , in a -� � ►LetcQ, ,� N.C.
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/uncovered boat lift
must be set back a minimum distance of fifteen feet (15') from my area of riparian access unless
waived by me.
f/ I do not wish to waive the setback requirement.
I do wish to waive that setback requirement.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
Signature
CIF R (;/- L.. �_-Aw "'Iz bS
Print or Type Name
It -?ZC- :�4 7 �
Telephone Number
Date: - 2 `F - 9 K

ADJACENT RIPARIAN PROPERTY OWNER STATEIMEENT
(FOR A PIERI UNCOVERED BOAT LIFT)
I hereby certify that I own property adjacent to 's
(NaMe of Property Owner)
property located at
(Lot, Block, Road, etc.)
on , in f�LgI ; N.C.
(Wa erbody) (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 not wish to waive the setback requirement.
I do wish to waive that setback requirement.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
Oe7&z-r i6r�� 1,-- 11
Signature
Print or Type Name
Telephone Number
Date: ��' /