28165_EICHARD, TIM & DOORMEN, FRANKIE_20010712

CAMA and DREDGE AND FILL
G E N E R A L fS5��
PERMIT
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
Applicant Name wtu. Phone Number
Address -.4; A-0 c
City
State rJ1 zip ►
Project Location (County, State Road, Water Body, etc.) '�+ 6 . levw'ly a? 5-2 rl.af� vt_
Type of Project Activity
PROJECT DESCRIPTION SKETCH P"
(SCALE:
NcNf
)
�;
Pier (dock) Length ;� i( r 4,{ t r {,rt
,. ..... .....
Groin Length
......... .. .. :... ..,,..„
,....
A.
•�
N
number
Bulkhead Length 1
�(
max. distance offshore
Basin, channel dimensions
cubic yards
tom') 1' '++
{
Boat ramp dimensions
m t
?
�
r
Other
I
t �
i
1
0t
(
t
'
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 become null and void.
This permit must be on the project site and accessible to the permit of-
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
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.
In issuing this permit the State of North Carolina certifies that this project
is consistent with the North Carolina Coastal Management Program.
issuing date
applicant's signature
permit officer's signature
,
expiration date
attachments
' iG rPt! -rJ ,tl c-i_,
application fee

ERIC B. ELLIS NCDL 65047 988
JASA M ELLIS PH(252)726-6775
205 NOTTINGHAM DR.
MOREHEAD CITY, NC 28557 Date / ©/ ss-3oi1333
Pay to the
Order of
_ Dollars
PIARST CITIZENS 133
J�AA Al V Fi anti Sea Bank 8 851 Company
� l� Allantie Beach, N.C. T,U.1
For
1:0 5 3 L00 3001:00 L 3 L 7448 780u'
O L 9 8 8
_ GUARDIAN® SAFETY BLUE ESBI

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIERIUNCOVERED BOAT LIFT)
I hereby certify 'that I own property adjacent to � rz_k)/',#� 's
(Name of Property Owner)
property located at -n'-- / 0
(Lot, Block, Road, etc.)
on b d d P/Ie- xI—eS , in C74/%"J N.C.
(Waterbody) (Town and/or County)
He has described to me, as shown below, the development he is proposing at that
Iocation, 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)
�,ignatur
Print or Type Name
Telephone Nu ber
Date: ��

ADJACENT RIPARLA-N PROPERTY OWNER STATE-N ENT
(FOR A PIER/MOORING PILINGS/BOATLIFT/BOATHOUSE)
I hereby certify that I own property adjacent to����i,
(Name of Property Owner)
Property located at rrl ,
(Lot, Block, Road, etc.)
on /�� �. �—�,,�� t-� , inN.C.
Waterbody) (Town and/or County)
He has described to me, as si',own below, the development he is proposing at thatt location,
and, I have no objections to his proposal. I understand that a pit-lmooring
pilin¢s/boadift/boathouse must be set back a minimum distance of fifteen feet (15') from my area
of riparian access unless waived by me.
I Sao not wish to ware the setback requirement.
I S14 wish to waive that setback requirement.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPME`T:
(To be filled in by individual proposing development)
�l Sianature
Print or Type Name
2 s z .353—s'i/i ——
Telephone Number
Date: (6- /7_ G /

MONITORING & COMPLETION REPORT 1
[CAMA Major Development & State Dredge & Fill Permits]
PERMITTEE'SNAME: arm E'cAd'd f- f-a,1k?ktyoo�n�aa PERMIT# ael6S-C
LOCATION: SZz PO"(011 bf ,•e FIELD REP. f r.-
PkS
PHONE: Z Flo- 3987
DATE REPORTEDLY COMPLETE: 8 -3o - of
1) Do the easured dimensions of the development differ from those indicated in the permit and workplat?
YES/PkJ one].
COMMENT:
2) SEDIMENTATION &EROSION CONTROL: Has Permittee seeded, grassed, or otherwise stabilized
all disturbed areas? vjj5NO [circle one]
COMMENT:
3) FUTURE MONITOR & ENFORCEMENT ACTION: Is further investigation or enforcement
action needed? YES/ O circle one].
COMMENT: