13376_SMITH, IRVING & BURNS, SCOTT_19950210

CAMA AND DREDGE AND FILL ,-.. �, P -
GENERAL 133 7 iD
PERMIT
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
Applicant Name —ili1 —PhoneNumber
Address
City. t' �*-F State Zip
Project Location (County, State Road, Water Body, etc.)
Type of Project Activity
PROJECT DESCRIPTION
Pier (dock) length
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(SCALE:
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Groin length
number
Bulkhead length
max. distance offshore
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Basin, channel dimensions
cubic yards
Boat ramp dimensions
ITIN
/Y
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.
i.`
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.
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 - i • C, -'
cC> tit--
application fee

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER)
I hereby certify that I own property adjacent to
Trying L- Smith 's property located at
1111 Canal Drive Lot 16A Block 20A)
(Lot, Block, Road, etc.)
on Myrtle Grove Sound , in Carolina Beach , 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. I understand that a pier must be set back a minimum
distance of fifteen feet (15') from my area of riparian access
unless waived by me.
I do not wish to waive that setback requirement.
I do wish to waive that setback requirement.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing developemnt)
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Sign ;tre
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Jerry B. Johnson
Print or Type Name
458-4976
Telephone Number
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