23853D - Bostic

CAMA and DREDGE AND FILL e,v ;1-V f (/) C �, D� S l
G E N E R A L ' 23853 _
PERMIT ,es i ' _ J'u °I2 (,/ Li4-
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`7 1-/ . //vv £9 _ (A; 2 c/
Applicant Name R, S "i3aS-4C Phone Number 3 #-' 3 r
Address )Q`/0 -i?a S t
City Si^ 4' ' ( i 4 `/ State 'i/ C Zip —)a VVS
Project Location (County, State Road, Water Body, etc.) f✓w° , /I c:1j 4C,B-c/ Ma,/- 0/14i) f C./.4, 4 I
O/t S/"--' (am)
Type of Project Activity 3tA1K'Aeelf-) 11'.67,/.4.0 e"`-' _.i 7, 1ir ) if
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PROJECT DESCRIPTION SKETCH (SCALE: / 1. d 0 )
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Pier(dock)Length '
111111
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Groin Length11111 mill
1111
number
Bulkhead Length J r
max.distance offshore :r—mt
d ' rlge
Basin,channel dimensionsOM
--,.. ..
cubic yards
.,‘ ,6 i t .1 111
l _fi � ,
Boat ramp dimensions r *
OtherAlitill
.......
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MIN
This permit is subject to compliance with this application, site drawing 7
and attached general and specific conditions.Any violation of these terms
may subject the permittee to a fine, imprisonment or civil action; and // / applicant's signature
�
may cause the permit to become null and void. L. ,
This permit must be on the project site and accessible to the permit of- �; 6)"--
permit officer's signature
ficer when the project is inspected for compliance. The applicant certi- 6 - _ ?(, _ OG �(p�
fies bysigning thispermit that 1)thisproject is consistent with the local y y�
g g 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 2 a- //r_.>v
have no objections to the proposed work. attachments
In issuing this permit the State of North Carolina certifies that this project 4//OO- (,C/ 1 Jo
is consistent with the North Carolina Coastal Management Program. application fee

_ti_iiNit .Li rE Klyll l UU1YJf LJ'fER FORM
I•t
- APPLICANT NAME: 1)O IZ,1 S Bp$ ;C
ADDITIONAL NAMES:
'eccy (A.I 1S- _
DESIG:
-- ---- AECEW 1 .F••S t 'PT- • DEVELOP AREAr• -D.O {-- PROJ DESC:P - I ) -•
(will only take 6) • (Will only take 1)
WORK: 3tk S .
(Will only take 4) •
MAIINT: 1 ,
(Will only take'4)
IMP:. {�(T S,v. ! -
(will only take 6)
• 9°5 % 1b0 - •
ACTION E:,....?4,Tici_oN
DREDGE&FILL REQUIRED: G�r�(O� �6U iCAMA MAJOR DEVEL,REQUIRED: -A-�'Ca"Od / Z�

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cal - �_ fl1l DONAL!:P HELMS.COW--i ME`.s4,71,
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�O RT> NORTH CAROLINA 2 8 4 4 5
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A FER/
I hereby certify that I own property adjacent to f .c•//vi al)
(N
e of Property Owner)
C
property located at 10 3 ' 1 L- J i,Q
(Lot, Block, Road, etc.)/�
on (7i l
m / , in ? Itl -I- -Lh1 , N.C.
(Town andlo�r County)
y)
He has described to me, as shown below, the development a iiiiiis roposing at that
location, and, I have no objections to his proposal. I understand that al' Ai ti edheat-lift
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 AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
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OLccp 1 , I ' -D 2' i Croat of ...
'J$ 31i nS 6,9a- 41,
Signature
EXtb IrtS -SkaWail OaAll.(10(A-1' .
i\‘V w - Dory l3o i- �Oqn 7 `i.�i
�' Print or Type Name
Telephone Number
Date:

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_ NELVA R.AL1"33tJRY.COUt!CI.MENIE!E',
LA . . Ve yz.'- Q ri, , , a(r DEXTER BLIZZARD,CCU!dC!L 7.7S:r,5bcR
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a_ . ," / � DONALD H,LUTHE1 COUNCIL 64Eb16Ef4
�. - (,� ftDOUGLAS C.MlEDLIPI,COUNCIL k;E�i:Ei
�O R�� �,, NORTH C A R O L I N A 2844 5
• _
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIERIUNCOVERED BOAT LIFT)
P
I hereby certify that I own property adjacent to R t 5 5 (1 's •
(Name of Propert Owner)
property located at 7 Li I 3 JJ (_S C( 11
1Q
. (Lot, Block, Road, etc.)
i
on , in —�/P/ r/ � , 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/uncovered boat lift
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.
b
I do wish to waive that setback requirement.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
iN/cep e �19- et, ' •/ oldby - r !,:tat J opgzoy , ® - .
0411-6,, //.I,,,,-
a, j gE f ,,, Signature
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4) _z7ttrrorz-c-------r J exar 1 (-92-,44m-,*--Ly
Print or Type Name
1 /0/71/7,9,<-- 1,4.r/
T elephonc Number .
Date:

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