8024_FULCHER, COY GRAY_19910523

J--_
CAMA AND DREDGE AND FI LL ` 8024
GENERAL (W �f
PERMIT eelew
as authorized by the State of North Carolina,
Department of Natural Resources and Community Development ko.ast;��mission
in an area of environmental concern pursuant to NCAC
PhoneNu/rfiber
Type of Project Activity
I PROJECT DESCRIPTION I SKETCH (SCALE: ) I
Pier (dock) length
Groin length
number
ulkhead length
max. distance offshore
Basin, channel dimensions
cubic yards
Boat ramp dimensions
Other
i
/1 L
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-fnay 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.
applicant certifies by signing this permit that 1) this-prb-
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.
In issuing this permit the State of North Carolina certifies that
this project is consistent with the North Carolina Coastal
Management Program.
\M
appucanrs signature
i permit otticer's signature
issuing date expiration date
attachments
application fee

y
%YJ
D
v
615
y
d - cooTj?�
P
76
• � i i I i I i I t f � _—f _--� —�^
I I I I --

C-6 Fv4c. ,fx-
I
N�i.NC•
i
�r ov
% J�l I e �f
Q� �
be) ct(� 4 b ,
44
I
P.0. P2
Al EW �E �

ADJACENT RIPARIAN PROPERTY 014NER STATEMENT
( FOR A PY 1R )
I hereby certify that I own property adjacent to
N
(Lot, Dlock, road., etc.
's property
�Al
(A 01?f"I li I c in % AJ 9-r:t Ca1P0 )&� N.C.
(Water Body) (Town -nd/or County)
He hLs 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
disti:.nce of fifteen feet (151) from my area of riparian access
unle:zs 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
FILLLD IN BY INDIVIDUAL PROPOSING DEVLLOP1M=- )
r,LJv"-7
3 113 �S"
Phone Number

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER)
I hereby certify thatI own property adjacent to
's property
I /�Namd q'�
at J E K Q N/2"IGll U/715A: �� on
(Lot, Block, Road, etc.)
�i c'R cp li I- i n /4JAJ ggifn& cz.2z) N.C.
(Water Body) (Town nd/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)
�%/f ,07�. !/e0Al✓'-7
Phone Number

CL79ERAL PMZHIT APPLICATION INFORMATION
APPLICANT'S tLiJiE:
K __.-.ING ADDRE_:S :
--10 U FalG4&
(Fi_s t) (Last)
�S2a (17R,c>rr 0fZ vk- ��•
(PERMAtu Etr'T )
/F,W— 0501-1 STATE ZIP
Tia"HONE: WORK HOME
CONTRACTOR'S IZAME:_ LFT TELEPHONE NUMBER
PROJECT LOCATION: N.C. Hwy. 120 SR # Road/Street Name QQiC.,F w,, APrV V.
Waterway Name 3Q i (!W C(?f ritC County OP00 0J
Town Aj ffA4) 126140 Subdivision
PROJECT ACTIVITIES:
PIER: Total dimensions of pier from MHW to platform
(Length) (Width)
'T' or 'L'-head platform
(Length) (Width) (Number of Mooring Piles)
Water depth at end of pier
1
F T HOUSE/BOAT LIFT: Length Cn y
Number of Piles
#2
l',jt a l l e-ngth
A.,Lrage distance waterward MHW
Maximum distance waterward MHW
Total length
Average distance waterward MHW
Maximum distance waterward MHW
RIPRAP: Total length
EXCAVATION: [MAINTENANCE 'ONLY']
Number of Mooring piles
Width J2
:eater Depth 3
Base width from MHW
Length Width Depth of Cut
Adjusted water depth on MLW Existing water depth(s)
Estimated Cubic Yards (length x width x depth/27)
Type of spoil: Sand Mud
Dragline Backhoe Hydraulic
lII. 3:iK S TRUCTU.RES :