28824_KIMBALL, GILL_20010913

Applicant Name
Address
City
� eft
CAMA and DREDGE AND FILL
G E N E RA 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
Phone Number
Project Location (County, State Road, Water Body, etc.)
Type of Project Activity
PROJECT DESCRIPTION SKETCH _.
Pier (dock) Length
Groin Length
number
Bulkhead Length
max. distance offshore
Basin, channel dimensions
cubic yards
I Boat ramp dimensions
Other
State
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.
E
issuing date
(SCALE:
9S24
applicant's signature
permit officer's signature
expiration date
attachments
application fee

.:..
W G KIMBALL 15 6 2
PH 252-728-1224
1729 ISLAND RD (a 7 _ 66-152/531 CC
HARKERS ISLAND, NC 28531 Dole ! l
Pa To The
�—DoII ars
%AGH-om
Wechovle Bank, N.A.
I Wke. 1.1—d, NC 28531 Q� T
Memo�c>°��
------..... !w.
1:05310L5291: 5465 11446211s L562
O DARI ND 1999

ADJACENT R.IPARLA.N PROPERTY OWNER STATEMTEIN47
(FOR A PIER/MOORING PILINGS/BOATLIFT/BOATHOUSE)
I hereby certify that I own property adjacent to LJ - i� . �� �` /� 's
(Name of Property Owner)
property located at 1-7 3 q I-) /-:�- 0- X 5 P-1, .
(Lot. Block, Road, etc.)
on F5Ac-!-' Scs -,w<f ,in CA(I -'-i fK 2-T� 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 as/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 wai,.-e the setback requirement.
I dQ wish to waive ti:at setback requirement.
DESCRIPTION AND/OR DRAWriG OF PROPOSED DEVELOPtiIE.NT:
(To be filled in by individual proposing development)
4 i5
Signature
A ,ti r -r A /� , I �(_ i- A ti )
Print or Type Name
ZS2—-7Z8-l2--2L-4
Telephone Number
Date: 8- 1 S- U 1

ADJACENT RIPARL-kN PROPERTY OWNER STATEMENT
(FOR A PIER/MOORING PILINGS/BOATLIFT/BOATHOUSE)
I hereby certify that I own property adjacent to V--� - G . ('-, 1 MI3 h t �- 's
(Name of Property Owner)
Property located at 1 4 ' 'W tZ l CA-t-
(Lot. Block, Road, etc.)
on C 1< S u " d , in C ,4--&4 c a x.-T- , 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
pilings/boatlift/boathouse must be se, back a minimum distance of fifteen feet (15') from my arer
of riparian access unless waived by me.
I do not wish to wai%-e the setback requirement.
I dQ wish to waive t1-at setback requirement.
DESCRIPTION AND/OR DRAWD G OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
f I
;4
L� 1
-------------------------------------------�------------------------ ---- -------------
Print or Type Name
Telephone Number
Date: _ee —/,SRO/
l�

PERMITTEE' S
LOCATION:
MONITORING & COMPLETION REPORT
[CAMA Major Development & State Dredge & Fill Permits]
PERMIT #
FIELD REP.
PHONE: DATE REPORTEDLY COMPLETE: C�
DATE OF INSPECTION d Q
1) he measured dimensions of the development differ from those indicated in the permit and workplat?
YES O [circle one].
COMMENT:. p 1�
2) SEDIMENTATION & EROSION CONTROL: Has Permittee seeded, grassed, or otherwise stabilized all
disturbed areas? YES/NO [circle one]
COMMENT:
3) FUTU NITORING & ENFORCEMENT ACTION
needed ES O [circle one].
COMM l ) V q C) Trr
Is further investigation or enforcement action