22555D - Keene

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CAMA AND DREDGE AND FILL
GENERAL ?.i. l 22555 - i)
PERMIT
0 as authorized by the State of North Carolina
Department of Environment, Health,and Natural Resources and the�astal Resources Commission
in an area of environmental concern pursuant to 15A NCAC 7 '/?O
Applicant Name Tv''"` f xeeve Phone Number(9'7) 7 3- 3(y)a
Address -7 U 5 ale 5 "F.
p,0 . 7j0' (va, Pm,- QI Stat9
sre° C�� Zip 075-J y
Project Location (C unty, State Road,Water Body,etc.)�UU 9 ," J � ���y
Ar
"- _644-:frt c,4-AAL 0&I/c/o 6vizio_. / r
Type of Project Activity ,If(/ r
,rA/P COi0,I; di- ( ub -7/7 ,i)a0 sI-& /i 4'6( y
PROJECT DESCRIPTION SKETCH (SCALE: / r'do ' )
Pier(dock) length r)(ib ivetv � L
Groin length
fIvj
number (�
Bulkhead length Vi
max.distance offshore ` i 3,C
Basin,channel dimensions I
cubic yards F`Q
Boat ramp dimensions
Other pi I I J'n e 1---,...,,..
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4. S-j I L f yl
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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,
applicant's signature
imprisonment or civil action; and may cause the permit to be-
come null and void.
----ttc./2,..--\._
This permit must be on the project site and accessible to the i permit officer's signature
permit officer when the project is inspected for compliance. ^ /���
The applicant certifies by signing this permit that 1) this pro- )1 0 /- 13--°6 011
ject is consistent with the local land use plan and all local issuing date expiration date
ordinances, and 2) a written statement has been obtained from adjacent riparian landowners certifying that they have no
attachments 7711. 4206
objections to the proposed work.
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91,'19/2E�t99 11:ds� 9198347999 KEE�E INSURANCE PAGE ©2
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A P AD O D'I'I 2 T pN
Name Of Individual
Applying For Petit: _ oxat 'cl�✓/ 'if 143-
Address Of Property: 3Ya�--
/ I �/� E' �+� O, SOX GPL. ✓.a GA NC
(L t or Street r Y aunty)
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, Street or Road, Cat Count
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I here-by certify that Z awn property adjacent to
referenced property; The individual a ], the above-
described to me as h � �g for this wit has
des are r shown on the attached drag the dery
-el be.P 000sin A description or drams oparae=tt
s
- provided ded Vitt Ibis losses_ g' with -nsians
2 have no objections ,
.,ectiaas to th=.s 'proposal.
Y ,.aave o -i i - w
' e�nQ
Wi 'n o No -p 7 ' 1e tt
ys 840 r c
o z e 'nt oft 0 3 a -
o II 4 e N D
s 0 =`Yon 'f y :-va n 11bt 1 fi r� i.,? EC't 't
ildicsuull
2 understand that a Pier, dock,
aoo rin c -_Lings/
bre 3kwa.Ler boat
house, lift ar sandbags must be setba� a dista.nceof 15'
my area of ripa4�� access unla.ss waived by sae.. you wish
w ve. the setback, mast initial the aoa•apria blankbetaw. )
y,,r
317.°
I do wi.Sh to wove the ,,$•setback re ;
�-meat_
'- I �° WiEi ►o wive he 1a5'Set ack requirement.
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1 grat e �
r� ate 7II.4 Orr ,res
' Z., - 4� m�.�LN %"‘-r go Fy 974 •Cr
" rant Name
TeleDnone Number A •�
ea Cade 9/9-,26ey_3?dam
ber With
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DIVISION OF COASTAL
I
ADJAC:E T RIPARIAN PROPERTY OWNER Np T FIC ON WAIvER FORM
Name Of Individual Applying For Penn /4
Address Of Property: ocrX
1L.i4-re A./c
(Lot or Street ;, Street or R.pa , City & County)
I. hereby NC �/7 ` y� f, 2
certify t nP t I own ?�
referenced property_ _ property adjacent to the
described to op as. Thewn on dividual. applying for this Permit has
described.
proposing_. tmethe attached drawing the developmenthat
shouldy are A description or drawing, lions,
provided with this letter_ dimensin___PJ: ons,
have no objections to this p
rQpQSZ_
If vDu have obi ecti ons to what ;
Division Coastal -s be±nQ proposed
N`enaQemen.t 1 -please t,.to the
wilmi ncrton North. Carolina, 284.05 2� �rdi nal Drive
of receipt of this or call 910 39 tension
days obrectiDn if s notice_ No response is -3900 wthe 10
you have been t • considered the samA
y •
_n notified bV Certified I�,a1 1
�R SECTION
I �de<rstand that a vier,house, lift f L or sandbacs ,, dock, moorinG pilings, br=a]L-�v j
n
h us my if t ro mist beset back a minimr�,,, ncEa boat
riparian access unle_c J"""` Q1St=T' Ce of 4 h
to waive---the setback, iT,� waived by tee_ �= you �
(_� sh
below;)
you must t1 the appropriate blank
lK
X do wish
to waive the 2S'Setback requirement_
I do not w h to
ti.aive the 'S'Sa`,b
aCLE regEi =,Cant_
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S gma tore
gt-lam PrinT1 ��t�
Name_
S ottr e rzY .0`
Tel ephone Number With Area- Coo._
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