27819_WHITE, THOMAS III_20010223

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CAMA and DREDGE AND FILL ,$
G E N E R A L��' �'
19
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 Phone Number
Address
City State zip
Project Location (County, State Road, Water Body, etc.)
Type of Project Activity
PROJECT DESCRIPTION SKETCH At"(< 0-
Pier (dock) Length
Groin Length
number
Bulkhead Length
max. distance offshore
Basin, channel dimensions
cubic yards
Boat ramp dimensions
Other
PT (SCALE: Nt. 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 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.
applicant's signature
permit officer's signature
issuing date expiration date
attachments
application fee

NORTH CAROLINA DEPARTMENT OF
ENVIRONMENT AND NATURAL RESOURCES
TERE BARRETTCOASTAL MANAGFME
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DIVISION OF COASTAL MANAGEMENT NCDENR
HESTRON PLAZA 11, 151-8 HWY. 24
MOREHEAD CITY, NC 28557
PHONE [phone] FAX [phone]
[e-mail]
./

RICHARD C. FLOWERS (.� a 79(9 3 3 7 8
NCDL 1550043 o/ 88 152/531
212 BAYVIEW BLVD i
ATLANTIC BEACH, NC 28512 Date
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ADJACENT RIPARIAN PROPERTY OWNER STATE'i 1ENT
I hereby certify that I own property adjacent to TO", `i tx ot�-
(Name of Property Owner)
property located at Z 16 '9 `1 I v J
(Lot, Block, Road, etc.)
on G ll.L So w , in %(
Vaterbody) (Town and/or County)
�s
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 DEVELOP -'VENT
(To be JVled in by individual proposing development)
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Print or Type Name
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Telephone Number
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FAX
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