23239_KING, KELLEY_19990903

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CAMA AND DREDGE AND FILL I-V
GENERAL 23239
PERMIT /Uf(
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 d /`<`� _ Phone Number +'ai 3�y-y77 k77 I/
Address
City �i(I,Yle'. • State A.JC Zip
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Project Location (County, State Road, Water Body, etc.)
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Type of Project Activity pro v vP iY V0 C Crl'c--�mS
PROJECT DESCRIPTION
SKETCH
(SCALE:✓
)
E•ier'(dock) length
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jl
Groin length
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CA / C_...
—1
number
Bulkhead length
_ (
_t>10
`,tii%
max. distance offshore
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C4 .4• b� Q C�
Basin, channel dimensions
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�+
cubic yards
Boat ramp dimensions
Other
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'QU l )?,-I 4'
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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, "' y
applicant's signature
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.
attachments
permit officer's signature
issuing date expiration date
In issuing this permit the State of North Carolina certifies that ey / 6 (0
this project is consistent with the North Carolina Coastal application fee
Management Program.

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ERIC B. ELLIS 1610
NCDL 65047 PH(252)726-6775
205 NOTTINGHAM DR. > 66-30/531
MOREHEAD CITY, NC 28557 Date 133
Pay to the
Order of ., I $
— Dollars
FiRsT CITIZENS-
Fir'D .rdi.iB— , N. . 2851 Company
J jra+��,,it� AtiviUc OcaM, N.C. 28512
For jD .Z—qL 3 5- C Ch J -- - -- — -- — ---- --- -- --- "r
,:0 S 3 L00 300i:00 L 3 L 7 4 48 7801I' 01610
GUARUTANSISAFETY BLUE ESBL
9

ADJACENT RIPARIAN PROPERTY OWNER STAITVM
(FOR A PIERIUNCOVERED BOAT LIFI)
I hereby certify that I own property adjacent to
(dame of Property Owner)
property located at
(Lot, Block, Road, etc.) _
on C�4 .✓ 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/uncovered boat lift
must be set back a minimum distance of riftern fe e (:S') from my area of riparian access unless
waived by me.
I do not wish to waive the setback re.:uL ..:neat.
I do wish to waive that setback requirement.
DESCRIPTION : -N-D/OR DR NOD G OF PROPOSED DEVELOPMENT:
(To be filled in by individ:lal proposing development)
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S770
ttire
1%2
Pam' 1 Te l I � tq)
TeIephone Number
Date: ` 11 /(? 9

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIERIMOORING PILINGSIBOAYLIFT/BOATHOUSE)
I hereby certify that I own property adjacent to s
ame of Pr erty Owner)
property located at
u /cxF _
(Lot, Block, Road, etc.)
on .yar ( , in �_ , Ae- X , 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)
l
Signature
- flb a Y, Y, k'44 re
Print or Type Name
2rlj �0- �0 (�z �L7
Telephone Number
Date:V—'� — 6 9