25681_SOUNDVIEW HOA_20010302 (2)

CAMA and DREDGE AND FILL
G E N E R A L
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
IPROJECT DESCRIPTION SKETCH
Pier (dock) Length I I�
Groin Length
number
Bulkhead Length
max. distance offshore
Basin, channel dimensions
cubic yards
Boat ramp dimensions
Other
State
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 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
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.
Phone Number
zip
(SCALE:
applicant's signature
permit officer's signature
issuing date expiration date
attachments
application fee

19PAY
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ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to
rf . `j . p A o ,-_ - property located at
name of property owner
Lot, Block, Road, ect.
on ��, ., a"�, ., �Ng1 �i/ .r ciJ, in ��� �P�P . f , N.C.
water body ( Town 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.
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Description and/or drawing of proposed development:
(To be filled/in by individual proposing development)
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Telephone number

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to
7�PiPP,r#r L,;i,r property located pit
// ( nam�7e of property /owner ) 2 / / /
Lot, Block, Road, ect. )
on in a,e ���e�f � N.C.
(Water body) Town or County)
He has described to me, as shown below, the development lie i
proposing at that location, and, I have no objections to his proposal.
Description and/or drawing of proposed development:
(To be tilled in by individua proposing development)
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Signature
Print or Type
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Telephone number
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ADJACENT RIPARIAN PROPERTY OWNER S1 ATEMENT
1 hereby certify that I own property adjacent tc:
61J,Q,'y-'b property located at
name of property owner
ZD /Z ��cfocv ,l _�-6y.Acldt-ru
Lot, Block, Road, ect.
on Ssur�v;,,w �/r/ , in (2ex J� _, N.C.
( Water body) ( Town or Co unty)
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
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Print or Type
Telephone number
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ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
1 hereby certify that I own property adjacent to
1, 1, property located at
/ name of propertty+ owner
Lot, Block, Road, ect.
on ��y. �.. (-i, 4 ( , in C4,e& ,r f _, N.C.
( Water body) ( "Town or County)
He has described to me, as shown below, the development lie is
proposing at that location, and, I have no objections to his proposal.
Description and/or drawing of proposed developme>t:
(To be tilled in by individual proposing development)
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Signature
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Print or Type
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Telephone number