23669_DEAL, WILLIAM_19991129

CAMA and DREDGE
G E N E R
PERM
as authorized by the State o
Department of Environmen
in an area of environmental
Applicant Name
Address
t
AND FILL
I T
f North Carolina
and Natural Resources and the Coastal Resources Commission
concern pursuant to 15 NCAC
City State
Project Location (County, State Road, Water Body, etc.)
Type of Project Activity
Phone Number
Zip
PROJECT DESCRIPTION SKETCH (SCALE:
Pier (dock) Length i I I s 777
--.
Groin Length
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
applicant's signature
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-
permit officer's signature
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
issuing date expiration date
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
In issuing this permitthe State of North Carolina certifies thatthis project
is consistent with the North Carolina Coastal Management Program.
application fee

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Pamlico County Building Inspections
P.O. Box 776 .
Bayboro, N.C. 28515
(919)-745-3861
edihcent R;narian ProPrty Qwner Statement Epn#
I hereby certify that I own property adjacent to
Name of landowner proposing development
on in/near Lot#— of —3
Comm y Subdivision, if applicable
Tax Parcel #.
off SR
Complete description of how to locate this property:
e—
This propoIV
sed project, and the location has been described to me as
shown in the drawing below and I have no objections to the proposal.
Draw the proposed structure in the space provided below. List the size of the structure and
measured distances from the adjacent property lines, other structures on the property, and the
road, water, etc.
�pDD6ac,� i
`OD
After this form is completed by the landowner proposing the project, a copy is given to the adjacent landowners for
their consent and signatures. The forms are then returned, along with a building plan sad other applicable required
information to the Building Inspections Office for building permit application/processing.
t
Signature Date /V0 V' y

Pamlico County Building Inspections
P.O. Box 776
Bayboro, N.C. 28515
(919)=745-3861
Ad-jacent Riparian Property Owner Statement Epn#
I hereby certify that I own property adjacent to r 1 4� `s
Name of landowner proposing development
oin/near Lot#2_ of. S-,O-
Community Subdivision, if applicable
Tax Parcel # off SR
Complete description of how to locate this property: ,
This posed project, a '� d the location has been described to me as
shown in the drawing below and I have no objections to the proposal.
Draw the proposed structure in the space provided below. List the size of the structure and
measured distances from the adjacent property lines, other structures on the property, and the
road, water, etc.
After this form is completed by the landowner proposing the project, a copy is given to the adjacent landowners for
their consent and signatures. The forms are then returned, along with a building plan and other applicable required
information to the Building Inspections Office for building permit application/processing.
Signature
l/ Date IIZL