HomeMy WebLinkAbout26194_GLOVER, ANNIE & WESLEY, DANIEL_20010530A2
CAMA and DREDGE AND FILL 5P
G E N E R A L
PERMIT
as authorized by the State of North Carolina
I
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 (Count)4 State Road, Water Body, etc.)
Type of Project Activity
PROJECT DESCRIPTION SKFTCH
Pier (dock) Length
Groin Length
number
Bulkhead Length
max. distance offshore
Basin, channel dimensions
cubic yards
Boat ramp dimensions
Other
Phone Number
Zip
i (SCALE: )
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
.. . .
PERSONAL MONEY ORDER NOT VALID UNLESS MACHINE IMPRINtED 7512
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_ MEMO MERCHANTS EXPRESS MONEY ORDER COMPANY
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CASHIER READ RMS ON REVERSE - NOT VALID OVER $500 U.S. DOLLARS
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ORDER OF Z),
PAYEE READ TERMS ERSE YA THRO Ban L. es a 5 9.9
SIGN E ADDRESS (•,,. /J! _Sf /'/
By -SM AGREES TO BE D B E TfRMS AND CONDITIONS AND SERVICE CHARGE AS SET FORTH ON THE PURCHASER'S RECEIPT
VALIDWit OVER FIVE HUNDRED U.S. DOLLARS
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t lAl,� a A I_ A I A A X .1. [ A A I A_ 1- 1 1. A E I 1 l- i� 1 1 I/ 1 I L 1 k_, l\ lJ L L 1 1 .L_- 1 L-L—. I I
(FOR A PIER/MOORING PILINGSIBOATLIITIBOATHOUSE)
I hereby certify that I own property adjacent to
(Name of Property Owner)
prope.-y located at ��� ��-1 �N E2 .S l lyEA %'
(Lot. Block, Road, etc.)
on �GyN ��'� -L K, , in -,Je4 u A C N.C.
(Waterbodv) (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 pie?/mooring
pRirngs,boadift/boathouse must be se- back a minimum distance of fifteen feet (15') from my arPw
of riparian access unless waived by me.
I do not wish to waive the setback requirement.
I du wish to waive teat setback requirement.
DESCRIPTION AND/OR DRAWLNG OF PROPOSED DEVELOPMENT:
(To be filled in by indii,idual proposing development)
--------------------------------------------------------------------------------------
44
Signature
(4J a ac e-IJ, �� 0
Print or Type Name
7)*
1
Te!eohone Number
Date: _ '5 — Z4—
J,
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i J._AJ,I . A I - l -,. I I Al \. A A. , A A ,_I _ I. I A A. J I I_ I\ I I I J I I I� I .I \ l) I t ). I A- - , IJ.-_ I.
(FOR A PIER/MOORING PILINGS/BOATLIFT/BOATHOUSE)
I hereby cer-ify that I own property adjacent to/�I��'V s
(Name of Property Owner)
property located at 7-
(Lot. Blocic, Road, etc.)
on 69 , in Is '64 4 ��e-� N.C.
(Waterbodv) (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 g5;boadift/boathouse must be se -back a minimum distance of fifteen feet (I5) from my area
of riparian access unless waived by me.
I do not wish to wa;%e the setback reauirement.
XI d(2 wish to waive tr:at setback recuirement.
DESCRIPTION AND/OR DRAWLNG OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
--------------------------------------------------------------------------------------------------------
ci
Signature
Z'-d/,j, ,8_ "she
Print or Type Name
2 5.�- - 7,. 9 - ,P- -7
Te!ephone Number
Date:
� 1057 067
� 10 36
a� 0979
531
. INDEXED
ON
7306.18
D�
i ri3� 4261
147�� 60
4123
a140
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30442
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Location: (( �, ` , �`� Field Rep.
Phone: �] �� � ',(,, Date of REport:
Description of Project: �� Q - )-C cr
Date Project Reportedly Comp?`ete: IIn
(Z� Do the mE sured dimensions of the a-EVElopment . di ffEr from those
indicated In the pErmit .and_,workplat?, YES / NO i-iGVE all per -,,it
conditions been satisfied? -,/Y'Es / No '
COMMENT :
-
(2) E= c?"i �c �10ri am Erosion Control: Hcs pE=it sc=QE_ CT'c55c
Cr C�.�tEr"w15E s�a_9l i ZE^ all G15tLIri�Ed a?'c=5: Yc=�No --
3
COM_`ENT :
I
(3) Fut- e McnitorinQ and enforcement Action: I.- s L_ T it-' r f�.E_ i _^.VESt1Qat10P_
or En=OrcErEnt action needed? Yes /-No
CO=— NT :