7819_FOUSHEE, SAMMY C_19901026

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PERMIT
as authorized by the State ofNorth Carolina,
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Department ufNatural Resources and Community Development and the Coasta| Resources Commission
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inanarea ofenvironmental concern pursuant u,l5NCAC
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City State
Project Location (County,State Road, Water 8ndy'ctzj ' ^
Type ofProject Activity '
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Zip `
PROJECT DESCRIPTION SKETCH . (scxLs: )
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Pier (dock) length
Groin length
—
number
Bulkhead length
Basin, channel dimensions
cubic yards
Boat ramp dimensions
Other
This permit is subject to compliance with this application, site
drawing and attached gpnom| and specific conditions. Any
violation of these terms may subject the pcnni000 to a fine,
imprisonment or civil action; and may cause the permit to be-
come null and void.
This ponnir 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 pcnnh that l) 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 nothe proposed work.
In issuing this permit the State of North Carolina certifies that
this poiuc/ i, consistent with the North Carolina Coastal
Management Program.
alllic,��
applicant's signature
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permit officer's signature
issuing date
expiration date

11W11CI.N1' RIPARIAN 1`110111•]t'i'Y U1rn11al �M1'L71h:l11'
1 hereby cerL-ify prat I owls property adjacent Lo
is prolx-,rty located at v C
! i slot, dock, road, etc.)
err �i( in `-,�,,�/ ..•�' , N.C.
(water body) (town and/or county)
Ile 1►as described to me as slrown below the develolxnent Ire is proposing at
Lhat location and I have no objections to his proposal. I wrderstand that
this /bulkhead/structure must be set back a minimum distance of 15 feet
(circle one)
frun rny area of riparian access carless waived by rue. I do do not wish to
waive that setback requirement. (cicala one)
AAAAAAARRAAAAAAA#AAAAAAAAAAAAA*AAA*A*AA*A*AAA***A*A*A****AAA*AA*AA*AAAAA#*
Dnecriptlon and/or drnwing of proponed developments (to be filled
In by individual propoeing development) ve
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ARRAA4RAAAAA##AARAARAAAAAARR#AAAAAAAR#RAA AAAAAAA#ARAAAA*R#R*AA*AAAAAARAAA
Signature
Name
Phone Nuidier

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ALUACf.Nr RIPARIAN 1'ROVI•3iTY U1�nl1:It 0lY�'1'L711:ir1'
1 hereby certify tlwt I own property adjacent to
c
is property located at v�
on c(lot, block, road, etc.)
�t� in , N.C.
(Water body) (town and/or county)
Ile has described to me as spawn below the development Ile is proposing at
that location and I have no objections to his proposal. I understand that
this/bulkhead/structure must be set back a minimum distance of 15 feet
(circle on")
fruniny area of riparian access wiless waived by me. I do do not wish to
waive that setback requirement.(circle one)
#AAAAA#R#A##RAA#AAARRRARAAAAAAAAAAAAAAAAARAA#AA#A#RAAAA##AAAA##AARARA##AAA
Uoncrlption and/or drnWing or proposed developments (to he filled
In by Individual proposing development)
AAAAAAAAAA#A#AAARAAAAAAAAARAAAAAARAAAAAAAAA#AAAARA#RAAAAAAAAA#RAAA#AAAAAAA
Signature
Naane
Pl�a�e Nu�i��er

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