94-0009_Marina, Sailcraft_19960529

LICO COUNTY INSPECTION DEPARTMENT
P.O. Box 776 GF Receipt No. 96 28
Bayboro N.C. 28515
745-3861
1
Date 6 20 96
7ju5 1gcc5
Received of HARDEMAN (FOR FRAZER)
10-3345-000 Re -Inspection Fees
10-3496-000 C.A.M.A. Application
10-3345-001 Subdivision Fees
10-3830-000 P1an.Brd.Books,etc.Misc.
Total Paid
itRs�eee�ee�ee•N�e�PeP7fAt6{n$..
$.00
$50.00
$.00
$.00
$.00
$50.00
For:
CAMA MINOR MODIFICATION -- FIFTY DOLLARS AND NO CENTS
Received By

ply •
POBOX 776 •PAMLICO COUNTY BUiLD1NG 1NSPECTIUNS BAYBORO, N.C. 28515
[phone]
(After this form is completed by the landowner proposing the project,
a copy is given to his/her adjacent landowners for their consent and
signatures. The forms are then returned, along with a building plan
and other applicable required information, to t, e Building inspections'
office for building permit application/processing.)
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that 1 own property adjacent to
on
Name of landowner proposing development body of water
. f
in/near �i /��(�� Loto of
community Subdivision, if applicable
Tax Parcel �� g`� ff SS Complete description of how to
locate this property:
The proposed project, a 104-'1271tl 43'U! /; and the location has been
described to me as shown in the drawing below and I have no objections
to the proposal.
FOR A PIER, CHECK ONE OF THE FOLLOWING:
I wish to waive the 15' minimum setback from my riparian access.
I DO NOT wish to waive the 15' minimum setback requirement.
•f**�*#,r****�*a*�*f***+r�****�rte,r**�**�**:t*:�ste**+e**r**e*f*e****�rri,�t*
Draw the proposed structure in the space provided below. List the size
of the structure and measured distances from the adjacent property
lines, other structures on the property, and the road, water, etc.
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Led N-urS4E [N, -7 11 A Zc-6c, Date S- Z? `i(,Signature __.__..