16292_P., HERMAN & POWELL, BETSY_19960516

CAMA AND DREDGE AND FILL
GENERAL �oP
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 C"2A, /200 y
Applicant Name e7 #r `� _751V 2 Phone Number 7/2- 22 4- ,2 7i S/
Address•. -
City a _�` /%ia� r" State /V(— Zip S
Project Location (County, State Road, Water Body, etc.)
Type of Project Activity a. Z21'-)",, r e ;/ a -Q k /A '% " � /
PROJECT DESCRIPTION SKETCH (SCALE:
Pier (clock) length
Groin length k�oTt,V L) Y4-k r a4
number
Bulkhead length
max. distance offshore —
Basin, channel dimensions
cubic yards
Boat ramp dimensions
Other
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 ail local
ordinances, and 2) a written statement has been obtained from
adjacent riparian landowners certifying that they have no
objections to the proposed work.
permit officer's signature
!/0 1/lr0 /9(r0
issuing date expiration date
attachments 1 .2.& 12co
In issuing this permit the State of North Carolina certifies that r
this project is consistent with the North Carolina Coastal application fee.'
Management Program.

BROAD CREEK CONSTRUCTION INC. 6/95 1481
112 Creekview St Ph 919-249-0523 _ 636-30/531
JJ Merritt, NC 28556
PAY IODiEOIWEIiofAl Z. `�/v• V v
v � sany Dawn:
FIRST CITIZENS „
13AD A *j�! Fhst-CItIzens lank k Twsf Company
K layboo, NC 28515
/j 6p-0142y.3-C
':0 S 3 L00 3000, ? l LO 2 26 74n'
CHARLANa
� elaNEy

POBOX 776 •PAMLICO COUNTY BUILDING INSPECTIONS BAYBORO, N.C. 28515
[phone]
i
(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 the Building Inspections'
Office
for building permit application/processing.)
j
is :ADJACENT RIPARIAN PROPERTY OWNER STATEMENT EPN# i
`` I hereby certify that I`own property adjacent to
<.
—+�+ A►� r, 4 pca j0V%i V_ ' s on (V
Name of landowner proposing development body of water
}
PIT, (05" BoX1.t9 C.OLLWTiry ct-c_(B
►Dkl
inlnear?kI.
.ICD=Lou W940t#J(_ of M f-4IF—
community Subdivision, if applicable
Tax Parcel # 7,406 off SR i L2 . Complete description of how to
locate this property: %'� (a 5 s G x 119 CG t.4_ 1.iT(Z/
'DA `.
i
The proposed project, a and the location has'been
described to me as shown in the drawing below and I have no objections
to the proposal.
i
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.
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.
oil _� 7 -- w
Z
�-
W
3
�
6AP>iC1�i6 --�
2rinted Nameo ;��i�� H A try Date / ��/S Signature S
G

•
I,
0
i
POBOX 776 -PAMLICO COUNTY BUILDING INSPECTIONS BAYBORO, N.C. 28515
[phone]
.i
(After this form is completed by the landowner proposing the project,
a 4opy 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 the Building Inspections,
Office for building permit application/processing.)
f�l ADJACENT RIPARIAN PROPERTY OWNER STATEMENT EPN#
I hereby certify that I own property adjacent to
Nam of landowner proposing development body of water
c4.-t
in j arC0 966u NTVgtot#_LQ of M i "*-i 5-So r r 8r: A-�_, 14_ 1,l c ,
Icommunityl �� Subdivision, if applicable
Tax Parcel # 74 0 6 off SR I) 2,3 . Complete description of how to
locate this property:
The proposed project, a and the location has been
describedito 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.
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.
i
..i
8�
O p
i
0
� o �
wRT�� Ev65_ _
t p7
f GA6tous
printed Name }{ I f Date14 f!j-gignature `,j jjriL �l �IY�1J4�...+✓'J.
J
i
0
r
c
d
0
CC
cc
G