15990_KLEIN, DONALD_19960326

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r CAMA AND DREDGE AND FILL` 0190- C
GENERAL
PERMIT
as authorized by the State of North Carolina
Department of Environment, Health, and Natural Resources and the Coastal Resources Commission
in an area of environmental concern pursuant to 15A NCAC L?
Applicant Name f`t1l�O//'%%<> Phone Number 9e9 2v9-t7�91
Address .St
City ��. i % i° State NC Zip •:�,IeS 6 %
Project Location (County, State Road, Water Body, etc.)
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Type of Project Activity (Up ��/ i717 i% tSu/1-Alrd 1'A9 con1i.aa,
PROJECT DESCRIPTION I SKETCH
Pier (dock) length
Groin length
number
Bulkhead length
max. distance offshore
Basin, channel dimensions
cubic yards
Boat ramp dimensions
Other
J
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 be-
come null and void.
This permit must be on the project site and accessible to the
permit officer when the project is inspected for compliance.
The applicant certifies by signing this permit that 1) this pro-
ject 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
issuing date expiration date
attachments //OG
In issuing this permit the State of North Carolina certifies that this project is consistent with the North Carolina Coastal application fee •�` S`G�+- —YO c,'Z-
Management Program.

DANIEL J. FOLEY, JR. 3082
NCDL 802651 PH 919-633-3613
300 FORT RD
NEW BERN, NC 28560 / 66-152/531
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PAY ToORDER OF J // !Y GV, — 9
secmiry �••mra•
o:i:u• as war.
Wachovia Bank of North Caroli a, ` NA
New Bern, NC 28:1 � l V—. W
_ox ��, ' G Pc1s990
A:0531015291: 5803 6831,7311' 0 2

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POBOX 776 PAMLICO COUNTY BUILDING INSYECTIUNS 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 Ye Building Inspections,
Office.for building permit application/processing.)
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
F. PN if_�
1 hereby certify that I own property adjacent to
K A �.�J ' s on _17Qyw:.3 pg, 1.
Name of landowner proposing development body of water
in/nealew U,Lot# Of
community ---� �"'
Subdivision, if applicable
Tax Parcel IL— off SR Complete description of how tc,
locate this property:T
.�T
P-6 _ . P - ,
The proposed project, a —
and the location tion
described to me as shown in the drawing below rand I have no objections
been
to the proposal.
P, A PIER, CHECK ONE OF THE
O wish to waive the 150 minimum setback from FOLLOWING: riparian my
P ait access.
1 DO NOT wish to waive the 15, minimum setback requirement.
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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Date Signature C.