28935_CORBITT, ALBERT_20010905

Applicant Name
Address
CAMA and DREDGE AND FILL �U
G E N E R A L
PERM I T
as authorized by the State of North Carolina
Department of Environment and Natural Resources and the Coastal Resources Commission
in an area of environmental concern pursuant to 15 NCAC
Phone Number
City State zip
Project Location (County, State Road, Water Body, etc.)
Type of Project Activity
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PROJECT DESCRIPTION SKETCH
Pier (dock) Length 1
Groin Length
gt
numbed
Bulkhead Length
max. distance offshore
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,:
";
(SCALE.
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)
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Basin, channel dimensions
cubic yards_
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Boat ramp dimensions
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Other
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RL
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This permit is subject to compliance with this application, site drawing
and attached general and specific conditions. Any violation of these terms
applicant's signature 1
may subject the permittee to a fine, imprisonment or civil action; and
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may cause the permit to become null and void.
This permit must be on the project site and accessible to the permit of-
5 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'is
consistent with the North Carolina Coastal Management Program.
application fee
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ADJACENT RIPARL-kN PROPERTY OWNER STATEMENT
(FOR A PIER/MOORING PILINGS/BOATL MBOATHOUSE)
I hereby certify that I own property adjacent to W"4x 's
(Name of Property Owner)
property located at X3 � I.�tAe�� l� /
(Lot. Block, Road, etc.)
on �r.Q, G�.�,.
, in , N.C.
(Waterbody) (Town and/or unty)
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 fiftet-n feet (15') from my area
of riparian access unless waived by me.
I do not wish to waive the setback requirement.
1� I Q wish to waive t :at setback requirement.
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DESCRIPTION ANC/OR DRAWM OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing develo ment)
�OlD
1
L
AD d<
t4l- p
'44fi'�i 14.
Print or Type Name
5;95Z-0Q
Telephone Number
Date: 9 D
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ADJACEN-T REPAR.LAN PROPERTY OWNER STATEMEti r
(FOR A P1ERI'MOORING PILINGSIBOATLIF1IBOATHOUSE) r
I hereby certify that I own property adjacent to
Aaeoperty O6"�
�jproperty located at �t"—..� / � �
(Lot, Block, Road, etc.)
c
in , N.C.
I
on (Waterb d) (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 pien'rnooring
pdinzsih-oatlift/boathouse must be set back a minimum distance of fifteen feet (17') from ray are;:
of riparian access unless waived by me.
I do not wish to wa:.e the setback requirement.
I da wish to waive tl.at setback re^11irement.
DESCRIPTION AINIXOR DRAWLNG OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
Print or Type Name
Te?ephone Number +�-
Date: