21541_TAYLOR, ROBERT_19990504

CAMA AND DREDGE AND FILL
GENERAL N® O21541-C._
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
Applicant Name
Address
City
Project Location (County, State Road, Water Body, etc.) I
Type of Project Activity 02 17
Phone Number ) ,2- ?a%
State /� Zip
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PROJECT DESCRIPTION
SKETCH F (Z
P;tA
(SCALE: )
Pier(dock) length
Groin length
j L+
number
C4
Bulkhead length
V
max. distance offshore
L
Basin, channel dimensions
T
cubic yards
Boat ramp dimensions
i
Other
r
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.
In issuing this permit the State of North Carolina certifies that
this project is consistent with the North Carolina Coastal
Management Program.
applicant's signature
permit officer's signature
issuing date
.✓
attachments �
application fee
expiration date

Mr. or Mrs. Robert D. Taylor 10-70 66-30/531 7943
DL 648213 Ph 252-504-2274
1162 Sea Cate Drive (/
Nefuport, NC 28570 I I
PAY TO THE
�ORDD R OF — - - ✓ - -
o �IADk for: Micro Print signature line, gray type and Iinework. First Citizens Bank logo on back. If not present, do not cash.
HRST CITIZIJNS 005 CharterQest
JAN K First -Citizens Bank & Trust Company
n 1 Be 1" N.C. 26516
1:0 5 3 LOO 30040000 5 7 6 20 L 2 211- 079L, 3 /

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/MOORING PILINGS/BOATLIFT/BOATHOUSE)
I hereby certify that I own property adjacent to -ak)�r , �,L y 411 Is
(Name of Property Owner)
property located at _ /4 �� lr �A y0' h '
(Lot, Block, Road, etc.)
on
(Waterbod) , N.C.
Y (Town and/or County)
He has described to me, as shown below, the development he is proposing at that
location, and, I have no 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 access unless waived by me.
I do not wish to waive the setback requirement.
I do wish to waive that setback requirement.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
Signature
Print or Type Name
-26 -1-2- - � -) ' ' '--
Telephone Number

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIERIMOORING PILINGS/BOATLIFT/BOATHOUSE)
I hereby certify that I own property adjacent to4)Y'�K/'s)-," 's
(Name of Pro erty Owner)
property located at �
(Lot, Block, Road, etc.)
on NL;t r - t L � � , 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 no 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 access unless waived by me.
I do not wish to waive the setback requirement.
I do wish to waive that setback requirement.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
4
ab...w. v
Print or Type Name
Telephone Number
Date: �. �: rC `1