24446_CANNON, LOU_20000121 (2)

CAMA and DREDGE AND FILL
G E N E R A L
PERM I T
as authorized by the State of North Carolina
N° 24446-c
CAA �c• o.
Department of Environment and Natural Resources and the Coastal Resources Commission
in an area of environmental concern pursuant to 15 NCAC CAI H. t2cr�
Applicant Name LdxA C' NAAcyJ % OARy-J-AY eAM Phone Number 25t-
Address -* 1�
City Ae� 3e" State ram! � zip '-s 5t
Project Location (County, State Road, Water Body, etc.)C?Aie,. (• ; PDSACg,�T" -n -rv4i✓ CbJFc,.tSP1Ce or
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Type of Project Activity 1j�gz, 'EXISM G t'tEX . A (IFT. xl(co -;:-r. 'Pt et v�cm AZOFr. xZz:�>rr.
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cubic yards
Boat ramp dimensions
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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.
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applicant's signature permit officer's signature
2 t eft P. 'Z --' kM.Ze,V
issuing date
expiration date
01 H • �2G�1
attachments
In issuing this permit the State of North Carolina certifies that this project 1�b.cb
is consistent with the North Carolina Coastal Management Program.
application fee

ADJACENT RII'ARIAN PROPERTY OWNER STATENIENT
(FOR A PIERIA100RING PILINGSIBOATLIFTIBOATNOUSE)
I hereby certify that I own property adjacent to JAJ. LoU ( 5 CA-tj rU o N °s
(Name of Property Owner)
property located at �— ! L,So ?In t N 7—
(Lot, Blood, etc.)
on (f2 C1\11" �t U 1✓ YL. , in QLf—� 6eP, J C_12 4rU:9M , 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/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.
I do wish to waive that setback requirement.
DESCRIPTION Al\-D/OR DRANN'M OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
C�-J,jQD
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Signature I l
Print or Type Name
z 5a - -�a 9�
Telephone Number
Date: % / a -- O d

ADJACENT RIPARIAN PROPERTY OWNER STATEnE, NT
(FOR A PIER/AIOORING PILINGS/BOATLIFT/BOAMOUSE)
I hereby certify that I own property adjacent to VJ . Lpyi S C,�!-�V tU D �l 's
(]Fame of Property Owner)
property located at I t_S 0 fV
(Lot, Block, Road, etc.)
Nr WOO DS
on I (Z E=N'r t L iZ , in tW O C—CfQ CRAU5 1, , N.C.
(Waterbody) (Town and/orCounty)
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/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.
I do wish to waive that setback requirement.
DESCRIPTION A-ND/OR DRA«'r G OF PROPOSED DEVELOP.N1EtiT:
(To be filled in by individual proposing development)
Signature
Cl A-) G-
Print or Type Name
11-63�;5�/�
Telephone Number
Date: C b 0