7950_CLARK, LINWOOD_19910405

Applicant Name
Address
City
CAMA AND DREDGE AND FILL o r c 9 5 Q
GENERAL Gt�", X��
PERMIT E �/
as authorized by the State of North Carolina,
Department of Natural Resources and Community Development, and the o s l Resources Commission
in an area of environmental concern pursuant to 15 NCAC 7
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Phone Number 7a6 r�S�b
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Location ()�ounty,�6tate Road, Water Body, etc,.)
Type of Project Activity
r
Zip
PROJECT DESCRIPTION
Pier (dock) length
SKETCH
(SCALE:
—In
P
+ f
i !3
—_
Groin length.
number
Bulkhead length ~'
max. distance offshore
Basin, channel dimensions
cubic yards
Boat ramp dimensions
Other JAW
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'vY /2u' i, JI
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.
C�
y- S Y/
attachments .
issuing date
L
/ applicant's signature
permit officer's signature
7—�;_ 9i
expiration date
In issuing this permit the State of North Carolina certifies that J/ L ( J.,
this project is consistent with the North Carolina Coastal application fee_ ,I
Management Program.

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to
Is property located at
( Name/ of Property
///\/fi
ty Owner ))F0/ /L/// /
Lot, Block, Road, etc.
on a1LA-1114&Z in
(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
-------
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
/PJq � o/1'w cx.'o
3 off'
//It'j. C�� 9
Sign ture
Print or Type Name
7)- n5-�'7
Telephone Number

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
Ihereby certify that I own property adjacent to
11
L N '4 6 e� C l a �� 's property located at
(Name of Property Owner)
Y C."o
Lot, Block, Road, etc.)
on �6 115s'��� CPSI ('c� in { N ��- �� , 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.
-- _- c--- G-; ii 1=- ------ ------ --- --' - -
DESCRIPTION AND/OR DRAWING OF PROPOSED DEILLOPMENT.
(To be filled in by individual proposing development)
11
Ur-
Ex1 0
St �
�.Xlslli✓v-
r
Signature
1 Vl�w psS 6)C7
Print or Type Name
Telephone Number

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