23212_WILDER, NELSON_19990823

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CAMA AND DREDGE AND FILL
GENERAL INV 23212
PERMIT _t ;,.. � , �
as authorized by the State of North Carolina
Department of Environment, Health, and Natural Resources and the Coastal Resources Commiss on
in an area of environmental concern pursuant to 15A NCAC
Applicant Name
Address
City
Project Location (County, State Road, Water Body, etc.)
Type of Project Activity
PROJECT DESCRIPTION SKETCH
Pier (dock) length
Groin length
number
Bulkhead length
max. distance offshore
Basin, channel dimensions
cubic yards
Boat ramp dimensions
Other
I
State
Phone Number
Zip
(SCALE: )
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This permit is subject to compliance with this application, site
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drawing and attached general and specific conditions. Any
violation of these terms may subject the permittee to a fine,
- -. applicant's signature
imprisonment or civil action; and may cause the permit to be-
i
come null and void.
This permit must be on the project site and accessible to the
permit officer's signature
permit officer when the project is inspected for compliance.
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The applicant certifies by signing this permit that 1) this pro-
ject is consistent with the local land use plan and all local
issuing date expiration date
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 permit the State of North Carolina certifies that
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this project is consistent with the North Carolina Coastal
application fee
Management Program.

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ADJACENT RIPARIAN P.ROPERI-y OWNER STATENEENU
I hereby certify that I own property adjacent to ✓ f
_s
(Name of Property Owner)
property located at_
Road, etc.)
in
�'X&
�'ae ody) (Town and/or County)
He has described to me as shown below, the development he is proposing ac that'
and, I have no objections to his iuposal.
DESCRIPTION A:ND/,).c? ]DRAWING OF PROPOSED DEVELOPDTFii'_-
(To be fillP,' i-: by i4dividual proposing development)
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Signa e L;
Prin - or Name
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Telephone umber
Date: — _ 1

r _ _ AD.TArFNU RI[PARIAN P OP' -
q` 'WNFM S'I'AT'EI1IENI'
I hereby certify that I own property adjacent to 61
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(Name of Property Owner)-
property located at
C /% eX.)
on in -il
(Waterbody) � , N.C.
(Town and/or County)
He has described to me as shown bck ea., the development he is proposing at that locati--,Y- ,
and, I have no objections to his propom
DESCRIPTION AND/OR.1 OF PROPOSED DEVELOPYIEN'T
(To be filled in by r-, proposinb development)
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'Signature
Print or Type Name
Telephone Number
Date: