7748_DOBRITE, CLINTON_19901002

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CAMA AND DREDGE AND FILL
GENERAL
PERMIT
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 2'-' ' ! k '
Applicant Name 1' '� �'�� Phone Number
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Address
City t �� State i'` Zip
Project Location (County, State Road, Water Body, etc.) 1' f �' i'i j)1 `E l' "'! 2 "1
LY Ile,
Type of Project Activity
PROJECT DESCRIPTION SKETCH (SCALE: 1
Pier (dock) length
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Groin length i
number
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Bulkhead length
max. distance offshore —1
Basin, channel dimensions
j. cc
cubic yards
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Boat ramp dimensions I
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Other ' �q } �� I plc, / J4",1_i7! —�-�'
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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.
i I applicant's signature
/41
I permit officer's signature
k
A C -
issuing date expiration date
attachments
In issuing this permit the State of North Carolina certifies that
this project is consistent with the North Carolina Coastal
Management Program.
application fee AyO NL

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to(" -s
property located at 1S -L
(lot, block, road, etc.)
on MAO MAID'e C190AL in ATL-1/4T1 C kN, N.C.
(water body) (town and/or county)
He has described to me as shown below the development he is proposing
that at that location and I have no objections to his proposal. I
understand that a pier must be set back a minimum distance of 15 feet
my area of riparian access unless waived by me.
&Orcle
do not wish to waive that setback requirement.
one)
Description and/or drawing of proposed development: ( to be filled in
by i ividual proposing development)
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Name
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Phone Number