23204_PREVETTE, GRADY_19990816

CAMA AND DREDGE A ' co1
DG AND FILL
GENERAL lVel 23294
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.)
State
Phone Number
HE
Type of Project Activity
i �
T
PROJECT DESCRIPTION SKETCH (SCALE: )
Pier (dock) length
Groin length
number
Bulkhead length
f� N
max. distance offshore f
rr-
Basin, channel dimensions
( YY
cubic yards
Boat ramp dimensions j
Other
t;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.
V applicant's signature
permit officer's signature
issuing date
attachments I,-r f I -, J r f l 0 /'
expiration date
application fee
-

GRADY M. PREVETTE JR
JACQUELINE H. PREVETTE
DBA PREVETTE ASSOCIATES
402 WOODLAND DR PH 910-273-1677
GREENSBORO, NC 27408
TO OR a CN ORDERROOF
ACHOVIA
2598
66-49/531
DATE
W
Wechovla Bunk, N.A.
Cn -b—, NC 27420
FOR 1+ � �S� -- � --
1:0 S 3 L004941: 3 S69 4 L 709911' S9
O HADLAND
—J $ s 0. cc F
Ixn.i.Alts

ADJACENT R] PARL4,N PROPERTY OWNER STA
" (FOR A PIERIMOORING PILINGS/BOATLIFT/BOATHOUSE)
I hereby certify that I own property adjacent to L, J K�
s
(Name of Property Owner)
property located at
on 6kJ A (�
(Waterbody)
Sri N, 5a.t')
(Lot, Block, Road,, etc.)
. in c.44 G4
(Town and/or County)
N.C.
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 beset back a minimum distance off fteen feet (15') from my area
of riparian access unless waived by me.
I do not wish to waive the setback requirement.
'A
I do wish to waive that setback requirement.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
4S-zVar e
Print or Type Name
5 Z-- L� -_0 Z)
Telephone Number
Date:

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/MOORING PILINGS/BOATLIFT/BOATHOUSE)
I hereby certify that I own property adjacent to L.T V'911 14J,
LK w / E
s
(Name of Property Owner)
property located at
on CAQ.A &
(Waterbody)
y// // I Si On/
(Lot, Block, Road, etc.)
—' in T , N. C.
(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.
'A
I do wish to waive that setback requirement.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
fA
Signature
el-' r N S
Print or Type Name
aSZ ay? -5-
Telephone Number
Date:

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