13841_STEVENSON, HAROLD_19941109

CAMA AND DREDGE AND FILL
GENERAL
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 ��'� A/ 00
Applicant Name FfC7,n,— &� J
r's^A
Address k� � ��' �1=�::•��
�-
City. State
Project Location (County, State Road, Water Body, etc.) h�'f'w' l �� r �•
'* `9 ,
Type of Project Activity
PROJECT DESCRIPTION I SKETCH
Pier (dock) length
Groin length
pumber
Bulkhead'length
max. distance offshore '
Basin, channel dimensions
cubic yards
Boat ramp dimensions
Other
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.
Phone Number WL 796
A) C zip
(SCALE:, )
applicant's signature
r-
i permit officer's signature
issuing date expiration date
attachments cW / V. / / 0 o
In issuing this permit the State of North Carolina certifies that
this project is consistent with the North Carolina Coastal application fee A.x� x
Management Program.

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that
)roperty
' -(body of water) (town)
forth Carolina in Pamlico County. The proposal has been described to me as shown below;
he development, a pier/bulkhead/structure, and the proposed location, and I have no
(circle one)
,bjections to the proposal. I understand that if the developnent is a pier, it must
,e set back a minitmm distance of 15 feet fiat my area of riparian access unless waived
)y Rte. I. clo/do not wish to waive that setback requirement.
(circle one)
- t**********ssssssssss�►*ss�,►*,t,�***ittrrt******,t�**,�****�****�***+t�,r*�*,r*�*+r***,r,r**+r,r****,r* r**
cril)tion and/or drawing of proposed development: (to be filled in by individual
'roposing development.) INDICATE THE SIZE AND LOCATION OF THE STRUCTURE AND THE
' [S'TNt'CE BL'IWEEN EACH PROPERTY LINE AND THE WATER.
� �+r*�****««*�v�****w*********�*********sir***+r*****re***+r*err►*+�**rt**�****,tf.**,t***+t,t�,r«:e�.+ *„ t
(Original must be retained in the Inspection Department)
c?a e
Name (Please Print)----- ...

ADJACENr RIPARIAN PROPERTY OWNER STATEMENr
I hereby certify that I own property adjacent to
>roperty located at 61aeSc- z-J/hJ
(lot, block, roaA etc.
'n Aluo� Je V in
(body of water) (town) '
forth Carolina in Pamlico County. The proposal has been described to me as shown below;
he development, a pier/bulkhead/structure, and the proposed location, and I have no
(circle one)
,bjections to the proposal. I understand that if the development is a pier, it must
,c set back a minimum distance of 15 feet from my area of riparian access unless waived
y rre- I do do ts waive that setback requirement.
(cirnoe .(,scription and/or drawing of proposed development: (to be filled in by individual
,Mposing development.) INDICATE THE SIZE AND LOCATICN OF THE SiRUC URE AND THE
'[STITCC BMWEEN EACH PROPERTY LINE AND THE WATER.
AP PY 96-JK heJ �- 6
610 f�
U Q04,611i �
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45)a-A�-
(Original must be retained in the Inspection Department)
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'Siggn ure
Name (Please

DAVID V. HODGES NCOL 01999167
EXPENSE ACCOUNT 745-7018
BOX 148A
MERRITT, NC 28556
FIRST CITIZENS -"
!' Pitl CnRem Bank ! 1-1 CMipany
on.nim, ec sesn
�:053 LO 300�.►+'7 00 2 2616-"- 0657
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