28990_ELLIS, HOWARD & CAROLYN_20010927

CAMA and DREDGE AND FILL
G E N E R A L
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
Address
City State
Project Location (County, State Road, Water Body, etc.)
Phone Number
zip
Type of Project Activity c ru r u ; k y' r; ; ci.-r`
j
i
190
PROJECT DESCRIPTION SKETCH ,
Pier (dock) Length AJ 4. 1 i (`
Groin Length ,
number l .A'
(SCALE:
i`jcnc
)
e ,
Bulkhead Length
max. distance offshore
a
p, e, r
+
Basin, channel dimensions
Ll.• �
i
f ,
cubic yards
Boat ramp dimensions 7
Other
µ
7c( T
r
'
* .
►
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.
applicant's signature
permit officer's signature
issuing date expiration date
attachments
application fee

HOWARD AND CAROLYN ELLIS &;X�jTj0 8171
NCDL 615889 NCDL 1774438 66-7704/2531
918 MURPHY FARM RD _Date
MERRITT NC 28556
PO BOX 37749 RALEIGH, NC 27627
Pay for oe 1-) 1
Ord
CJr1 J Dollars
State Employees' Credit Union
Apm North Carolina
45
For
ac;:i L??n49i:0aC304797133au' 8 L7 L

ADJACENT RIPARL-�N PROPERTY OWNER STATEMLE1"N'T
(FOR A PIER/MOORING PILINGS/BOATLIFT/BOATHOUSE)
I hereby certify that I own property adjacent to H ©w ct I _d /q • 6-- ( I , ' J 1". 's
property located at 9 18 /1-1 14 -to i
on 6 a; /� L "4—
(Waterbody)
(Name of Property Owner)
Ad 13 3 2-)
(Lot. Block, Road, etc.)
,in Paw,/,co c�
(Town and/or County)
. N.C.
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 pie -./moor -In
pili=/boatiift/boathouse must be se: back a minimum distance of fifteen feet (15') from my area
of riparian access unless waived by me.
llV4A— I do not wish to waive- the setback requirement.
/1J I d-Q wish to waive t;.at setback requirement.
DESCRIPTION AN-D/OR DRAWLNG OF PROPOSED DEVELOPNIENT:
(To be filled in by individual proposing development)
G ,.` 9 tG�y- pp
©rF-Plr re- cc, ke
�CA ut GS'2 -�- (..! 49-U 1cJ
% -(ea i .
xntst1615 �E-tok-)ct,'aJ/C'/Y
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PIy �e-r-N pfOF'�t�,� ����Q�� ekC{ d f-
LI
i
n ature /"
Print or Type Name
zs1-zLi�-I—oel�i
Telephone Number
Date: Sept Z 0 a

ADJACENT R.PARL-t PROPERTY OWNER STATEMENT
(FOR A PIER/MOORING PILINGS/BOATLIFT/BOATHOCSE) S`7 0 7 2001
I hereby certify that I own property adjacent to �Oi-�ye > �j S �� h 's
(Name of Property Owner)
property located at 9 I � �� r �� %--c, �— ,., e d 2-
(Lot, lock, Road, etc.)
on �� �L"e�— , in PC, t l, c u N.C.
Waterbody) (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/mooring
pdin gs/boatlift/boathouse must be set back a minimum distance of fifteen feet (15') 1 om my area
of riparian access unless waived by me.
1(
/ I do not wish to wa:v.- the setback requirement.
I dQ wish to waive t;.at setback requirement.
DESCRIPTION AND/OR DRAWLN- G OF PROPOSED DEVELOPME- T:
(To be filled in by iindividual proposing development)
+C) 1191a - '--alot edo�-
��eert
C - of c cC). i-
Pneari/lkt-tf
CclO
�-
A Lt p- a r
Signature
Print or Type Name
2s� -7 4s'� .32-
Telephone Number
Date: Se�J-- 2-c7 C3