28883_COLLISON, WILLIAM_20011106

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Applicant Name
Address
City
CAMA and DREDGE AND FILL
G E N E R A L `�
'9
P E R M I T
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
Phone Number
State `,n; zip
Project Location (County, State Road, Water Body, etc.) i, . -✓
Type of Project Activity:..
PROJECT DESCRIPTION SKETCH
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(SCALE:
Pier (dock) Length}
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Groin Length { i t, <:�
:�'
A
_
number ,t �, r
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ZAN
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Bulkhead Length'
max. distance offshore '
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Basin, channel dimensions
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cubic yards
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....._
Boat ramp dimensions
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.
other
16
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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, imprisonment or civil action; and
may cause the permit to become null and void.
This permit must be on the project site and accessible to the permit of-
ficer when the project is inspected for compliance. The applicant certi-
fies by signing this permit that 1) this project 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.
In issuing this permit the State of North Carolina certifies that this project
is consistent with the North Carolina Coastal Management Program.
I applicant's signature
r
i
issuing date
permit officer's signature
expiration date
4/i.
attachments
application fee

WILLIAM A COLLISON JR 6F�'*deS'93 4691
CHRISTINA S COLLISON
PH. 252-636-3580 j 7�/
4706 MULLEN RD (Ati/ -_i L / _S/L' --o- 66-112/531
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NEW BERN,NC 28560 01901
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BRAN BANKING ANb TRNST CO ANY II ^� `
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RN, NORTH OLINA
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i:05310112 L':S L9t,8965 L6'l' 4691

ADJACENT RIPARIAN PROPERTY OWNER STAMIENT
(TOR A PIER/MOORING PILINGS/BOATLIFT/BOATIIOUSE)
I hereby certify that I own property adjacent to ��;Lliw,. C6 hC,f Xf, 's
(Name of Property Owner)
property located at Ay) a f _j"11 &i 9,Q
(Lot, Block, Road, etc.)
on IFUftT W,yG"t in 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 nd objections to his proposal. I understand that a pierlmooring
pilings/boatlift/boathouse must be set back a minimum distance of fifteen feet (15') from my area
of riparian access unless waived by me.
I -d no wish to waive the setback requirement.
I _d9 wish to waive that setback requirement.
---------------------------------------------------------------------------------------------------
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
sew
A—t f
- -.----------------------
Signature
Print or Type Name
Zs _;�- —6 3 — 1 —7
Telephone Number
toL_
Date:

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(TOR A PIER/MOORING PILINGSIBOATUMBOATMOUSE)
I hereby certify that I own property adjacent tot(,
(Nxw of rroVt1di 0wt"l
property located at y) o 6 -M,,11 r') ?1'0
(Lot, Block, Road, etc.)
on Al FJjtf W, �JErc , in S-&, ti_(. CIF...) , 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 nif objections to his proposal. I understand that a pier/mooring
pilings/boatlift/boathouse must be set back a minimum distance of fifteen feet (15') from my area
of riparian cess unless waived by me.
I -dno wish to waive the setback requirement.
a
h
I OiQ wish to waive that setback requirement.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be felted in by individual proposing development)
1
1
Sig ature
(,,:, -9 C -� 210
P ' Type N e
b a
/V
elephone Number
Date: c�