28007_DOSTER, ROBERT_20010518

CAMA and DREDGE AND FILL /
G E N E R A L �d L J07r-
PERMIT
as authorized by the State of North Carolina
' ��of91�g
Department of Environment and Natural Resources and the Coastal Resources Commission
in an area of environmental concern pursuant to 15 NCAC
Applicant Name ' Phone Number '
Address
City State zip cli
Project Location (County, State Road, Water Body, etc.) G
Type of Project Activity
PROJECT DESCRIPTION SKETCH
(SCALE:
A%0'
)
Pier (dock) Length r i! x R M t - _ �}t
fly
I
_..,, ._ .
Groin Length t al i (
number
Bulkhead Length
max. distance offshore {
Ifa
r eel
a
Basin, channel dimensions
m
cubic yards M.._
t ifs A„
?
€
t'v
JLr�,.
€
Boat ramp dimensions
i
a
Other \
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P
£
1
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f i f !I I t Ltt'i
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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
may subject the permittee to a fine, imprisonment or civil action; and y:e
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 t'� ,I ,++s•�,
have no objections to the proposed work. attachments
In issuing this permit the State of North Carolina certifies that this project t tf :y p ad. ! r
is consistent with the North Carolina Coastal Management Program. application fee

R.N. DOSTER
MARY S. DOSTER 0 411
MORTGAGE ACCT.
607 WEBSTER ST. 66-770412531
CARY, NC 27511��
PAY TO THE
ORDER OF $ �y
0
� m�ma.e.
State Employees' Credit Union DOLLARS �••..,'•
�r.e
43 COJ1; NorthACarolina
�77
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FOR 9 O dDOR 086 068940 1 7u■
04LL

ADJACENT RIPARL- N PROPERTY OWNER STATEMENT
(FOR A PIER/MOORING PILINGS/BOATLIFT/BOATHOUSE)
I hereby certify that I own property adjacent toTO 9 Et( — A/ -PGS-�dZ 's
(Name of Property Owner)
property located at L 0
DIV S`1,0 R GS
(Lot. Block, Road, etc.)
on , in Dig R F I X✓ — , N.C.
(Waterbody) (Town and/or County)
He has described to me, as shlown below, the development he is proposing at that location,
and, I have no objections to his proposal. I understand that a pie -/mooring
pilings/boatlift/boathouse must be se: back a minimum distance of fifteen feet (15') from my area
of riparian access unless waived by me.
I do not wish to wa-,-e the setback requirement.
I .Q wish to waive t .at setback requirement.
DESCRIPTION AND/OR DRAWENG OF PROPOSED DEVELOP`IEN-I':
(To be filled in by individual proposing development) �L
A/�e
L 9/-/,
2
s/
o
k
--------
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f m
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Signature
t or Type Name
Telephone Number
Date: L.J — ? 6 — j-�--'-

ADJACENT RIPARL-V PROPERTY OWN TR STATEMENT
(FOR A PIER/MOORING PILINGS/BOATLIFT/BOATHOUSE)
I hereby certify that I own property adjacent to ��o B � Rf N - 2os �r L, I
l c(Name of Property Owner)
property located at L �+ f /�111,,/T 11� t dAtf J h U F L' S U
(Lot, Block, Road, etc.)
on /►'1 /i f'�/ ,�i� , in l /✓ , N.C.
(Waterbody) (Town and/or County)
He has described to me, as si'lown below, the development he is proposing at th location,
and, I have no objections to his proposal. I understand that a pie:, mooring
pilings/boatlift/boathouse must be se: back a minimum distance of fifteen feet (15') from my area
of riparian access unless waived by me.
° gnk
C� Frye\
✓Z I do not wish to wa:;ve the setback requirement.
I ,u wish to waive t1.at setback recuirement.
DESCRIPTION AND/OR DRAWM OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
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IMF pf�
L-�q
5�- 75
lip
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Print or Type Name
—33
Telephone Number
Date: - /�—O