27559_MENCHES, JOE_20010223

• CAMA and DREDGE AND FILL
G E N E R A L -- 2�5�� �t.. .
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 (SCALE: )
Pier (dock) Length — mm jjji
Groin Length
number
Bulkhead Length
max. distance offshore
Basin, channel dimensions
cubic yards I
Boat ramp dimensions
Other
I
- t t
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
application fee

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ADJACENT RIPARLAN PROPERTY OWNER STATEMENT
(FOR A PIER/MOORING PILINGS/BOATLIFT/BOATHOUSE)
I hereby certify that I own property adjacent to ��,�,��, (f s
(Name of Property Owner)
property located at G t # y �S �, �, f t s ✓v t,,�: ,
(Lot, Block, Road, etc.)
on /y i, i6o 1e , 2 / t';"� , in 6 /9 r T4- 2 � z , 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 d-Q wish to waive that setback requirement.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
'5 e— /,�T7%9e- f/ FJv t
Signature
Print or Type Name
Telephone Number
Date: V-- �(�,- Cb k

2643
CHARLES R. MENCHES EYos 2 �SSy 66-152/531 CC
MARY C. MENCHES / o ! Z 3 ad
252-726-1763 Uule
1506 SCOTTS LANDING
MOREHEAD CITY, NC 28557
Pay To The
QI'CiC'l' Of � oaiwn. "oacx.
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Wachovia Dank: N.A.
Nj,_j, nd Cuy. NC 285.57 ,
Menlo Z 6 1 IT2
l:053 lots 29': 5466 L
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2128311■ 2643

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