23648_COVINGTON, CLAUDIA W_19991101

iv-,,I/T
CAMA and DREDGE AND FILL
G E N E R A L4�4s_ c
PERM I T
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 '/�"'��� �y' PhoneNumber
Address
City �> �G l'/7 State �A % Zip
Project Location (County, State Road, Water Body, etc.)
�y'l✓i � '"' i �iiL•�/'? � � %f ��(La l � C �!C(C l t y .l%'(T �(� l � � `� ,, r - O��/! 'r %�'/� /"c1 J t t�
Type of Project Activity
This permit is subject to compliance with this application, site drawing
and attached general and specific conditions. Any violation of these terms _ ,'applicant's signature
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
permit officer's signature
expiration date
attachments
,r
If
application fee

A
�CLAUDIA W.=COYINGTON��_ -- 7-n -g
--=NCOL-6-196267
---919=247-69.12 _ 66-763/53i=CC"-
=P-0-BOX-1073
=A,TLANTJC=BEACH;-NC=28512_- - - --

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/UNCOVERED BOAT LIFT)
I hereby cer-dfy that I own property adjacent to. ra QE 1' o v,' --To,1/ 's
(dame of Pro ertv Owner)
property located at SG /V K ; rv6�o(V 111vc
(Lot, Block, Road, etc.)
4 on K")!57o ,j 4V E. v✓tniS/�t (� "V'q / in /��/A,/�"' — I h , 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 objer;ions to his proposal. I understand that a pier/uncovered boat lift
must be set back a minimum distance of nLeen fe-t (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 requLrement.
DESCR=O-N A-ti-D/OR DRAuZNiG OF PROPOSED DEVELOP-NE-N-T:
(To be filled in by individual proposing development)
n
d
�� lK here
0
yi�7T61l hi
,-/ J. �//may
*ilnt or Type Name
Telephone dumber
Date:
0
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ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIERIUNCOVERED BOAT LIFT)
I hereby certify that I own property adjacent to mope.] M.0a vl`&Q it/ 's
(dame of Pro rty Owner)
property locatzd at 5- IV, K, M5',O v
(Lot, Block, Road, etc.)
� N� s�. r on �E�vS/_, in i��109.17 N.C.
(Waterbody) (Town and/or County)
4
He has described to me, as shown below, the development he is proposing at that
locau' ari, and, I have no objec:ions to his proposal. I understand that a pieriuncovered boat fir
must be set back a rnini��um distance of n`t��e`n fit (IS') f:-om my area or riparian ac:4ss unless
waived by me.
I do not wish to waive the setback -ecuir e,ment.
V I do wish to waive that setback reCuirement.
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DESCRIPTION A-N-D/OR DRAVVD G OF PROPOSED DEVELOP-N ENT:
(To be filled in by individual proposing development)
'�A.
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All
Siona e
- mint or Type Name
T�l�� hone Number
Date:
11