7944_EDWARD, J B_19901231

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CAMA AND DREDGE AND FILL �-c� - ? 9 4 4
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
Annlicant Namp
Address i
City State
Project Location (County, State Road, Water Body, etc.)
Type of Project Activity
PROJECT DESCRIPTION I SKETCH
Pier (dock) length
Groin length
number
Bulkhead length
max. distance offshore
Basin, channel dimensions
cubic yards
Boat ramp dimensions
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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.
attachments
Phone Number
Zip
(SCALE:
�•L� applicant's signature
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permit officer's signature
issuing date expiration date
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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 OFA ER STATEMENT
I hereby certify that I own property adjacent to
Name gf Property Owner
C
's property located at
(Lot, Block, Roi0i,
�etc.) /1�'
on /V�f"�/L / /11G r- in /Gib - f r- 7 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.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
Signature
Print or Type Naive
Telephone Number

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