27994_MARTIN, RODNEY & PATTY_20010517

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CAMA and DREDGE AND FILL W(-w /
G E N E R A L 27994 ­
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 Phone Number
Address
City State zip
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
Boat ramp dimensions
Other
711i1 .. . ;t is vidiinrt to rmmnlinnra with thic annliratinn. Sitp 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
(SCALE:
applicant's signature
permit officer's signature
expiration date
attachments
application fee

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PAYTOTHE
ORDER OF.
3124
SHELLFISH 2O00
421 CEDAR POINT BLVD. PH. 252-393-7777
CEDAR POINT, NC 28584
CENTURA BANK
88-85/531
DATE r 1 / 0 l
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OLLARS 6)
FORS a'7g4qNP
II'0000 3 l 2 411' j:0 5 3 L 0 0 a 501:0 213 20 2 7 l u'

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DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Individual applying for Permit: �p°`� E �l :J FAA f T %\A
Address of Property./ �� G fZak
_
(Lot or Street #, Street or Road, City & County)
I hereby certify that I own property adjacent to the above referenced property. The individual
applying for this permit has described to me as shown on the attached drawing the development
they are proposing. A description or drawing, with dimensions, should be provided with this
letter.
V I have no objections to this proposal.
If you have objections to what is being proposed, please write the Division of Coastal
Management, Heston Plaza II, 151-B, Hwy. 24, Morehead City, NC, 28557 or call (252) 808-
2808 within 10 days of receipt of this notice. No response is considered the same as no objection
if you have been notified by Certified Mail.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boat house, lift or sandbaLls must be
set back a minimum distance of 15' from my area of riparian access unless waived by me. (If you
wish to waive the setback, you must initial the appropriate blank below.)
I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
Sisznat Date
Pant Name
J - `�
r `�u� _. �joo
Telephone Number With Area Code

DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Individual applying for Permit: - d E l
Address of Property:- �� J C E F�` 6
-�A-)c 2�fj
(Lot or Street #, Street or Road, City & County)
1 hereby certify that I own property adjacent to the above referenced property. The individual
applying for this permit has described to me as shown on the attached drawing the development
they are proposing. A description or drawing, with dimensions, should be provided with this
letter.
I have no objections to this proposal.
If you have objections to what is being proposed, please write the Division of Coastal
Management, Hestron Plaza II, 151-B, Hwy. 24, Morehead City, NC, 28557 or call (252) 808-
2808 within 10 days of receipt of this notice. No response is considered the same as no objection
if you have been notified by Certified Mail.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boat house, lift or sandbags must be
set back a minimum distance of 15' from my area of riparian access unless waived by me. (If you
wish to waive the setback, you must initial the appropriate blank below.)
R _ I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
- D /
*,n�ature Date
x ILSE /?1c?1JA9Q S o� clY
Print Name
Telephone Number With Area Code