27976_ROBERTS, WILLIAM M_20010508

CAMA and DREDGE AND FILL 27976
--� G E N E R A L� ,►1��r" . �j -
PERMIT
as authorized by the State of North Carolina
Department of Environment and Natural Resources and the Coastal Resources Commission
in an area of environmental concern pursuant to 15 NCAC
Applicant Name
Address
City
Project Location (County, State Road, Water Body, etc.)
Type of Project Activity
Phone Number V 95
State zip 0
�.r } N :�c f• ri.
PROJECT DESCRIPTION SKETCH
Pier (dock) Length
Groin Length
number
Bulkhead Length
max. distance offshore
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Basin, channel dimensions
cubic yards y {
Boat ramp dimensions ti 5
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Other
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This permit is subject to compliance with this application, site drawing X
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-
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 that this project L 0 , a t 1V9 ,-el
is consistent with the North Carolina Coastal Management Program.
application fee

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PA y NC 28557
TO THE
O� R OF_�--
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02301 � O 66-112/531
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FOR MOr�EN� pNCp me R E2a55.7
.< I,•0000 3 99i►. '' 7 DOLLARS 0
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ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
2- 6-2 - -- 9"--1 ys
I hereby certify that I own property adjacent to zr1 Mi AW5,11A1L, XdJE fE S 's
(Name of Property Owner)
property located at 30�- aC C�4�s�li/9y ��-
(Lot, Block, Road, etc.)
on 46W6 .Spc' x1V , 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.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(To be filled in by individual proposing development)
�0 if)A,dE i AiE V41f,4tic'C.
SiQna e
! L
Print or Type Nam
i=Z0
Telephone Number
Date: ?

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
Z sz - 1Is6 -- V,? <'3
I hereby certify that I own property adjacent to hM• A�Xlc(S-111( L- � Eit 's
(Name of Property Owner)
property located at C 4r-a Gv�Y
(Lot, Block, Road, etc.)
on Rd'a,!E �X1u.►%;> , in ��Glr�.Gi �GE.9�'H , 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.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(To be filled in by individual proposing development)
L?O ti/q ✓ �' NC �s
Signature
f/.,,kL sE 09/�G Y
Print or Type Name
(33,C) ss7 - �'s
Telephone Number
Date: `SZ9 /,,�7/

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