26907_KOURY, BRAD_20001018

R
CAMA and DREDGE AND FILL69M' -'
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
Project Location (County, State Road, Water Body, etc.)
Type of Project Activity
State
PROJECT DESCRIPTION SKETCH '
Pier (dock) Length ;77• ,,.emu _. <
Groin Length
number
Bulkhead Length
max. distance offshore
Basin, channel dimensions
cubic yards
Boat ramp dimensions
Other
Thic --it is ciihiort to rmmnlinnr-a with this annlir-atinn. 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.
Phone Number
Zip
issuing date
(SCALE: „ )
applicant's signature
permit officer's signature
expiration date
attachments
application fee

902
°T
CARL HEVERLY
NCDL 6078185 PH 252-354-7154 66-30/531
7306 CANAL DR �j .� Q� 135
Date
EMERALD ISLE, NC 28594
�
Pay to the / t
Order of o
Dollars 8 �•�^�
0 FIRST CITIZENS 13,
1" ■r S.1t.r path C 2857 ust Company
B(1L �I l� Saltar Pslh, N.C. 28575
3,rod�y _NIP
For ------
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_ ___-„�� GUARDIAN®SAFETV BWE JIM
pDlwrke Amerlrnn

09/14/00 THU 09:10 FAX [phone] SJA MCAS IWAKUNI
Z002
ADJACENT RIPARIAN PROPERTY OWNER STAB
(FOR A PIRRIMOORING PIUNGSIBOATLIp'T/BOATHOUSE)
I hereby certify that I own property adjacent to rQQ 's
(Name of Property wner)
property IocaW at %o Z Z_ So �,.t -Dr;v 0
(Lot, Block, Road, etc.) -
onIAc�a , in _✓� (� 1 , N.C.
(Waterbody) (Town and/or County)
He has described to me, as shown below, the development he is proposing at thac location,
and, I have no objections to his proposal. I understand that a pier/mooring
pilingsjbi tiiftlboathcuse must be set back a minimum distance of fifteen feet (15') from my area
of riparian access unless waived by me.
I dodo nat wish to waive the setback requirement.
I dQ wish to waive that setback requirement.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPNMNT:
(To be filled in by —d dual proposing development)
63
i go
dee ?
ignature
PETER R— COLLINS
LTCOL USNIC
Print or Type Name
5".3--
Tvlephone Number
Date: /'`/ S e 06

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/MOORING PILINGSIBOATLIFT/BOATHOUSE)
I hereby certify that I own property adjacent to ]3 1 k4, c r V I
(Name of Property caner)
Property located at 7 r Z Z Ste° cc , c D�- " ✓ Q- ,
(Lot, Block, Road, etc.)
on 7,46,Le Sort , in h_ 2.✓a �S L-0- , 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 -�
pilings/boatlift/boathouse 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 dQ wish to waive that setback requirement.
DESCRIPTION AND/O1�2AWING OF PROPOSED DEVELOPMENT:
(To be filled i4 bA individual proposing development)
�pr
Ne.�,) b©a.+ 1 4 �
u6t r jeep
Signature
Print or Type Name
Telephone Number
Date: C