24310_ZDEP, JOHN_19991214

CAMA and DREDGE AND FILL �� o
,.� G E N E R A L VIM, 24310 --
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
Phone Number
Zip
I /) (SCALE: )
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-
1
applicant's signature
permit officer's signature
lies by signing this permit that 1) this project is consistent with the local issuing date expiration date
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. attachments
In issuing this permit the State of North Carolina certifies that this project . " t4
is consistent with the North Carolina Coastal Management Program. application fee

A.DJ�CE�V I' RIPARI�'� PROPERTY OWN STATEMENT
I hereby certify that I own property adjacent to ,�je,X�7 ,s
(Name of Property Owner)
prop- located at � 'D eli;i Sc�`/ %x--
(Lot, Block, Road, etc.)
(Waterbody) (Town and/or County) ly
He has described to me as shown below, the development he is proposing at that location,
and, I have no objections to his proposal.
DESCRIPTION AND/OR DRAWIlV"G OF PROPOSED DEVELOPMENT
(To be filled in by individual proposing development)
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('PzJGc.> t' i .BPS/G
P.�hsed Ox:
Ste'
Cv_ /5 V, /
Signature
Print or The Name
7�e" S �23 3
Telephone Number
Date:

ADJACENT RIPARLAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to
% S
(Name of Property Owner)
property Located at ,wT ,5��'� K �� /J/ C/6�
(Lot, Block, Road, etc.)
on in .56?C' i C�%et _'
�i L : j% , 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..
DESCRIPTION AND/OR DRANNT G OF PROPOSED DEVELOPMEiV-T
(To be filled in by individual proposing development)
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Print or Type Name
aid - 7�6 �-
Telephone Number
Date: dp--- gel—
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DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORNI
Name of Individual applying for Permit:
Address of Property:-
(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 describer) 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
G� 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.
WAIVEYSECTI
I understand that pi ,dock, ooring pilin , brea ater, oat house, lift or sandbags must be
set back a mini m di ance o 15' from m area o cress unless waived by me. (If you
wish to waive t e setba yo mus/th5'
the ap opriate lank below.)
I do wish waiveetback requi meat.
I do not wish to w15' setback requirement.
Snature Date
1,45Z/E Do 4�Y s
Print Name �j / /� /�
_r,(ucaC — 1 b �l J 14
Telephone Number With Area Code