13854_SOUSA, ALVIN_19951128

CAMA AND DREDGE AND FILL
GENERAL
PERMIT
.38 4
1
as authorized by the State of North Carolina
Department of Environment, Health, and Natural Resources and the,goastal Resources Commission
in an area of environmental concern pursuant to 15A NCAC 7t/
Applicant Name Phone Number `Ir
Address
City - l�ir� zr. n /� State J, ^ Zip
Project_ Location (County, State Road, Water Body, etc.)
r.
Type of Project Activity �1,r r1 ?C Gt- ` ' • ^ �' �. �f �+s. C s S /�; ,�� �, f
PROJECT DESCRIPTION
Pier (dock) length01
SKET (SCALE:
1 % ? 1
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7 5-
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Groh -length10
number
Bulkhead length
max. distance offshore
Basin, channel dimensions _
cubic yards
Boat ramp dimensions
Other10
This permit is subject to compliance with this application, sit
drawing and attached general and specific conditions. An
violation of these terms may subject the permittee to a fin(
imprisonment or civil action; and may cause the permit to b(
come null and void.
This permit must be on the project site and accessible to th-
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.
C" G
issuing date expiration date
attachments �! / ( 211
In issuing this permit the State of North Carolina certifies that
this project is consistent with the North Carolina Coastal application fee 6-0. e24 '�'. 0 �a 16 b 1�
Management Program.

1 -900 5o
Flu, 000
Pos
5 0 0 0
6 0964852263 941128 285601
POST OFFICE U. S DOLLARS AND CENTS
YEAR MONTH. DAY
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ADJACENT RIPARIAN PROPERTY OWNER•STATEMERT
(FOR A PIBR)
I hereby cer//t11ify that -I own property ad acent 'to
Err :s J e¢ ' 6 property
Name
located at �c?-��, C�: — i>z c. '7 on
(Lot, Block, Road, etc.)
r AN2/7,1 �` u` li
in /u ,r�o 1lelrl-' ceyc ti'J , N.C.
(Water Body) (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 (151) 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 DEVELOPMENT)
ignature ,
ct) Name
Phone Number

MAY - 2 3- 9 4 M O N 12 -3 15 COMMERCIAL- OFFSET INC. 02
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i bMbENT RIPARIAN PROPERTY'OWNER"'STATEMEi7'I'
(k'OR A PIE RR1
I hereb certify that •x Owri <
to 10 Y //11 property ad j ac�nt � to • .: ; : - .
pro.part.
located at VT o 41
on,
(Lot, Block, Road, etc.)
_•_/UdFZIl� u9 v 1 PAZ, in IJ ,r�D ,g rl-) z'�
(Water Body) (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 >>is
Proposal. I understand that a pier must be set back a minimum
distance of fifteen feet (151) from my area of riparian access
unless waived by me.
I do not wish to waive that setback re,7uirement.
V I do wish to caaive that setback requirement.
Description and/or drawing of proposed development: (To I3E
FILLED IN 13Y INDIVIDUAL PROPOSING DEVELOPMENT)
q -a 31
Phone Number

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