13825_RAMSEY, COBELL_19941020

CAMA AND DREDGE AND FILL
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GENERAL
PERMIT r _c
as authorized by the State of North Carolina
Department of Environment, Health, and Natural Resources and the Coastal Resources Commission
in an area of environmental concern pursuant to 15A NCAC // %., tr
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Applicant Na �� % 1j� r -- 2 ' Phone Number
Address`' j 1•
City 'J- �^ State Zip
Project Location (County, State Road, Water Body, etc.),a
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Type of Project Activity 4A
DESCRIPTION
Pier (dock) length
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number
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max. distance offshore
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Boat ramp dimensions
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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 be-
come null and void.
This permit must be on the project site and accessible to the
permit officer when the project is inspected for compliance.
The applicant certifies by signing this permit that 1) this pro-
ject 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.
i/ applicant's signature
permit officer's signature
fc- ;�,_ 1 J -;
issuing date expiration date
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attachments /12 �+ �y , !P � `f
In issuing this permit the State of North Carolina certifies that
this project is consistent with the North Carolina Coastal
Management Program.
application fee 47 t' • 0 t ,F1 f "

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BARBARA B. RAMSEY
NCDL 1637353
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66-152I531 CC
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0889
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P O BOX 189 919-728-6565
HARKERS ISLAND, NC 28531
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PaY To The
Order
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WACHOVU
Dollars
Wachovia Bank of North Carolina, N.A.
Harkern In and. N(: 28531
Memon�
1:OS3LOLS291: S469
3SOS6011■ 0889
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ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to
� 9&-LL e- • /CA&/S L q 's property located at
(Name of Property
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(Lot, B
, Road, etc.)
on �iFCI� u n1 c} 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)
a sp 10 000 00() o0c)�
(� 0 b o a o t o
,�ate5L
Signature
Print or Type Name
72$'-Acz'>%.5-
Telephone Number

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