27884_LYNN, TERESA_20010416

CAMA and DREDGE AND FILL l �,� 2,7884 r�
G E N E R A L
PERM I T
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 Phone Number 7 03AI
Address �!
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City State zip
Project Location (County, State Road, Water Body, etc.)
es-! r'+r� vYip eII��� �' r•
Type of Project Activity _'a (I
PROJECT DESCRIPTION SKETCH
Pier (dock) Length -it
IIt
Groin Length
number
Bulkhead Length
max. distance offshore
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Basin, channel dimensions j
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cubic yards
Boat ramp dimensions
Other
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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
le
application fee

1925
ERIC B. ELLIS NCDL 65047
JASA M ELLIS PH(252)726-6775 66-30/531
205 NOTTINGHAM DR. 133
MOREHEAD CITY, NC 28557 Date
Pay to the
Order of
N
Dollars 6 ,�.w,�.
"RST CITIZENS 133
r��111 Flrsl-Cilizons Bank &Trust Company .1
N � Allan4c Boach, N.C. 28512
L' _ NF'
For � L�
L0030011:00 13 L744878011' 0 19 25
GUARDSAFETBLUE et
OC'IwrAe llmarl�wn -

ADJACENT RIPARL- N PROPERTY OWNER STATEMENT
(FOR A PIER/MOORING PILINGS/BOATLIFT/BOATHOUSE)
I hereby certify that I own property adjacent to f.-r-r,� , /—YV v I
(Name of Property Owner)
property located at 4t)'--t v; r k) 2 f4
(Lot, ock, Road, etc.)
on its , in ���-�'��� 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/boadift/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 waive the setback requirement.
I da wish to waive that setback requirement. ^/ j4�.✓&e-
T
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DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOP:VIE`-T:
(To be filled in by individual proposing development)
14* wit MI, ec*witt
1 p. ,,i; `� Wit i ✓DNS ��
. ZIC Lz:n- &4� &-
Signature
/��� Print or Type Name
�L.,S utj %J
Telephone Number
Date: -7,1 `4- (

ADJACENT RIPARLA N PROPERTY OWNER STATEMENT
(FOR A PIER/MOORING PILINGS/BOATLIF (BOATHOUSE)
r
I hereby certify that I own property adjacent to 'y _� 1 Z- /r4,4, 's
(Name of Property Owner)
Property located at ,;'� / / /�'<< 0 L/ ; & 0
(Lot, Block, Road, etc.)
on �;� , in "Gi�,�`� C, - .� , 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 se, 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 d-4 wish to waive that setback requirement.
DESCRIPTION AND/OR DRAWEI;G OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
i
Signature
a--? IF A Ke s;�. iA-
Print or Type Name
So, � W) I .1
J,s'a 4'Sa�-a��7
Telephone Number
Date: -313 0/Q,