25592_ADCOCK, JEFF_20000607

CAMA and DREDGE AND FILL
G E N E R A L
PERMIT �y
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 Zip:,
Applicant Name
Address
City
Project Location (County, State Road, Water Body, etc.)
2,0 N" -
Type of Project Activity 14-62o '
State
Phone Number
PROJECT DESCRIPTION SKETCH- -
Pier (dock) Length r __ _ C ' `F ,11 " `4 , .
zip
..
Groin Length
number
i.
T ,L
O
J
Bulkhead Length
max. distance offshore
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n' I e o
Basin, cha ne
tt
t
i
S
CL
PW
i IT
cubic yards
A.,
Boat ramp dimensions
t
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
application fee

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Wachovls Bank, N A (3t�
BayboZ N1.28515
For "
=' Jos Z;enLha�
:053LOL5291: 0789 2LL5
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CLASSIC

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ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIERIMOORING PILINGSIBOAMFT/BOATHOUSE)
I '/
I hereby certify that I own property adjacent to 's
(Name of Property Owner)
property located at AJE066 Txl
(Lot, Block, Road, etc.)
on _111 �Ns6 9T Eit in OR-7AL C/°Awt 1, e- 2 e—. , 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/boadiftlboathouse 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.
50.
I do wish to waive that setback requirement.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual pmposing development)
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Signatures G-� X/
Print or type Name 5d m vet P. y6dlO w5k"
Telephone Number //II�
Date: � � C �w

FEELER OPEN SCHCOL Fa<:3363708270 May 19, '00 15:42 P.01/01
G - - - - ADJACENT WARYAN P'ROPEFt`ff OWNER 4y" i . A
I hcrebY =%ifj► tbet I mm adjs�nt to � pr y Ow>rts)
ptopenY wea w at
oft.
on _.".(.Y� rrfit. CY" n "&or Cotoly)
ryvrtarbody)
t he paropvai� at fiat
Hie Ass dacriw to tne. as 3boWY3 b�+, the tit prerlrnaenir�
Jocadotl, and, I have 00 *ectLms to his
pwnZw,bosdd born "roust be set bea a mioiMM dtOWM of ftfW m fact (15') ham MY tact
of riparian acc.ss ass rvsuived by M.
wiA to waive W k requiltmlot.
w uh to waive that as"ck wqww000l-
--------`DESCR7nON AND/Olt DRAWING OF pROPOMEVEWT1
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go
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z-�Apae Number