21070_SELF, JOSEPH_19981020

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CAMA AND DREDGE AND FILL Yr,4 0
GENERAL N" OU070 -�-PERMIT.{:��A�
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 ) �_d f a v o'
Applicant Name Tr
-Phone
Number
3 I �6 3
Address '" /� �'y i 7
City—";
State �%/" �.
zip :2 k
Project Location (County, State Road, Water Body, etc.) r
Type of Project Activity
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PROJECT DESCRIPTION SKETCH ( )
Pier (dock) length
Groin-iongth
fi.v r
14-
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 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.
r\ /
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applicant's signature
permit officer's signature
issuing date
Al
attachments ' '
P '-'/
expiration date
l a��
In issuing this permit the State of North Carolina certifies that
this project is consistent with the North Carolina Coastal
Management Program.
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application fee. �1i 1,. 'j 3 �1�

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NEGOTIABLE ONLY IN;TflE U.S: AND POSSESSIONS
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ADJACENT RIPARTAN PROPERTY OWE STA
(FOR A PPIER/UNCOVERED BOAT' JJF� � �
I hereby cep, that I own property adjacent to
wner)
Property located at P"t
its B!� Ck, Roads etc.,)In
- y
�n � _
�dt;,'�'
f gtea�,� _ - .�,� �, N.C.
('town and/or C®�,t�3
He lkss de��..K.���.1 g, m�9 � shown below, the devel
location, and, .I have; fFy: obj � ,ins to his .oPm�'�t ��' P��+osYng at that
must d set e. a na mirnun, distance of fifteen feet (15) from understand that .a f .1c"Uncov�d boat lift
waived by me. Y of r,�a .an access unless
I -d-Q--°9 'wilt' tQ waive the setback requirement.
waive that setback requirement.
BESCI IpT� Sri A%,IID/())p DRA►WING OF c.
PROP` ,�
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PriDt or Type Name
Telephone 1Vu.nter '--'
Date: n- �1' �

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AA.T.ACIENT REPARLAM 13 ROPERTY 0W7,Me, STATEMENT
(FOR A PIERIUNCOVERED BOArzj
hereby certify that i own property adjacent to
s
property located at 'r
(L04 BIOC14 Road, etc.)
on
(Waterbodj�- in
....................... N.,
(Town, w
t -i
F`-s described to me, as shown below, the de,,,a Y)
l0catidn, an-C, ' 'have no objections to his proposal. (-Pgr�dnt he is Proposing at that
must best back a minimum distanc a PiMr/uncovered boat a
,e of fi
fteen f
waived. by feet (15') ftaxy, jqy am of riparian access
unless
1 Sk—P-21 wish to waive the setback requirement,
-d.Q wish to waive that setback rNWmmuj,,4,,.
AND/OR DRAWING OF PROZ,,Dq-�--
Cro bf_rzued in by
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Print or Type Name
Telephone NU�Mr
Date:
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rEI UPMENT:
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