General Permits (7568)

CAMA and DREDGE AND FILL
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
PROJECT DESCRIPTION SKETCH
Pier (dock) Length
Groin Length
number
Bulkhead Length
max. distance offshore
Basin, channel dimensions
cubic yards
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.
Phone Number
zip
issuing date
(SCALE:
applicant's signature
permit officer's signature
expiration date
attachments
application fee

THE RIGHT WAY
J. T. SMITH
ss—as/sat 1537
0282027235
CHAROLETT M. SMITH
228 SUNSET DRIVE 252-393-7883
DATE!G�-J
SWANSBORO, N7 28584
PAY TO THE
s V V r d
ORDER OF
DOLLARS
Sum-
Centur Banks
Cape Carteret, N 58411 •�
l� — M IVI'
MEMO fiMO
1:0e3l013501:0 28 20 2 7 2 3 L 5 37

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIERIMOORING PILINGS/BOATLIFT/BOATHOUSE)
I hereby certify that I own property adjacent to
(Name of Property Owner)
property located at�� l
(Lot, Block, Road,
L�,�
on (l in �� - E '��- r- N.C.
(Waterbody) (Town andor 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 understands , that_ a pier/
pilings/boatlift/boathouse must be set back a minimum distance of fifteen (15') from my ar
of riparian access unless waived by me. .1UIV 1 9 2000
I do not wish to waive the setback requirement.
I do wish to waive that setback requirement.
COASTAL MANAGEMENT
MOREHEAD
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be , filled in by individual proposing development)
Signature
Print or Type Name
Telephone Number
Date:

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIERIMOORING PILINGSIBOATLIFT/BOATHOUSE)
I hereby certify that I own property adjacent to f ;A' �, -_ u T 1 9 X00
(Name of Propxr Owner)
property located at , 't
(Lot, Block, Rdad, etc.)
on in :L ( >�i�-� N.C.
(Waterbody) E(To" 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/boad ft/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 do wish to waive that setback requirement.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
Signature
Print or Type Name
Telephone Number
Date: A5 J L A _ ,22 EGG

ADJACENT RIPARIAN PROPERTY OW S'ER STATEMENT
(FOR A PIERIMOORING PILINGS/BOATLIFT/BOATHOUSE)
I hereby certify that I own property adjacent to/ , ���' /-,s
(Name of Property Owner)
property located at 2 C -3 k a, " /, ,
(Lot, Block, Road, etc.)
on , 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/boadi.ft/boathouse must be set back a minimum distance of fifteen feet �J�JUNIcL9
'
of riparian access unless waived by me. ILI
I do not wish to waive the setback requirement. I2000
I do wish to waive that setback requirement.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be , filled in by individual proposing development)
t CuJ '00-0C hEQ O
M(A� N M D,'F C z v fJ
, C --? M P, L
Print or Type Name
Telephone Number
Date: ` , . -d) >

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIERIMOORING PILINGS/BOATLIFT/BOATHOUSE)
I hereby certify that I own property adjacent to cflqe�N-A ' s
(Name of Property Owner)
property located at 1c 3 1 , .;
(Lot, Block, Road, etc.)
on , inCL, QL CL�L- - Q N.C.
(Waterbody) own 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
pff ngs/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.
JUN
I do wish to waive that setback requirement. '
COASTAL n i
Mom'
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
rnr-)(N f1lD � I I JUN 1 9 2000
�<� Nnn L_
Print or Type Name
Telephone Number
Date: