7846_BURNS, ROBERT_19901106

CAMA AND DREDGE AND FILL
GENERAL
PERMIT
7846
Coi
as authorized by the State of North Carolina,
Department of Natural Resources and Community Development 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
(SCALE: )
Pier (dock) length
Groin length .
number
Bulkhead length?'
max. distance offshore
Basin, channel dimensions
. t
cubic yards
Boat ramp dimensions
J�
Other
This permit is subject to compliance with this application, si e
drawing and attached general and specific conditions.
/ ('
violation of these terms may subject the permittee to a fiAne,
applicant's signature
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's signature
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
issuing date expiration date
ordinances, and 2) a written statement has been obtained from
adjacent riparian landowners certifying that they have no
objections to the proposed work.
attachments
In issuing this permit the State of North Carolina certifies that
this project is consistent with the North Carolina Coastal
application fee
Management Program.

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ADJACENT RIPARIAN PROPERTY OWNER STJITEMENT
(FOR A PIER)
I herebyrertify that I own property.adjacent to
0� F� I� RN S Is property located at
(Name of Property Owner)
(rot, Block, Road,, etc. )
on �.l) ► l.�f'Q1j R F�F l� in /_Qi2hi u�,. N.C.
((�aterbody) (Town /or County)
f,E: has described tome, as shown below, the development he -is
!:_oposing at that location, and, I have no objections to his
.:,-oposal. I understand that a pier must be set back a minimum
Qiszance of fifteen feet (151) from my area- of riparian access
u:lless Waived by me.
_ V I do'not wish to waive that setback requirement.
I do wish to waive that setback. requirement.
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DESCRIPTION AND/OR DRAWING OF PROPOSED DWELOPMENT;
(To be filled in by individual proposing development)
1 "
Signature
Print or Type Name
`telephone Number

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER)
I herebyperti.fy that I own property.adjacent to
Is property located at
(Name of Property Owner)
(Lot, Block, Road, etc.)
on tLxQ1J (2RF�l< , inAJF-vD F , N.C.
(Waterbody) (Town ands/or County)
F!e has described to me, as shown below, the development he is
_:_Oposing at that location, and, I have no objections to his
:�oposal. I understand that a pier must be set back a minimum
diszance of fifteen feet (151) from my area -of riparian access
unless aived 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 DWELOPMENT:
(To be filled in by individual proposing development)
J�f2.0wa i
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natu e
Print or Type Name
Telephone Number

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