7827_KOLLER, JOE_19901031

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CAMA AND DREDGE AND FILL (- 7827
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
Applicant Name LG Phone Number 4
Address
Cityr'/, c. /s^f /
. State _w ! + Zip
Project Location (County, State Road, Water Body, etc.)
/t
Type of Project Activity
PROJECT DESCRIPTION I SKETCH
Pier (dock) length
Groin length-
number
Bulkhead length e
max. distance offshore
Basin, channel dimensions
cubic yards t
Boat ramp dimensions
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.
F
(SCALE:
applicant's signature
permit officer's signature
7
issuing date expiration date
attachments i r-
In issuing this permit the State of North Carolina certifies that
j"
this project is consistent with the North Carolina Coastal application fee `
Management Program.

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT (FOR :)
I hereby certify that I own property adjacent to -YC)G C 's
property located at 3 (o --3D Lj C s--r.
(lot, block, road, etc.)
on lfliAl" fflaj� CANAL in A'&P1HTIL 13CH. 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
from myATeWriparian access unless waived by me.
I do 4dLn�otwito waive that setback requirement.
(circle one)
Description and/or drawing of proposed development: ( to be filled in
by individual proposing development)
oC-
Jz
ignature
Name
%�
L�6 / / - � �h
Phone Number

ftT ' l T
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT (FOR)
I hereby certify that I own property adjacent to 's
property located at 0 (0 Ft)Uiet—)S%
(lot, block, road, etc.)
on ►_1litN MAT),F CPI -JAL in /-9T(,ft/T T /C- &'f% , 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
from rdo
riparian access unless waived by me.
I donot wisho waive that setback requirement.
(circle one)
Description and/or drawing of proposed development: ( to be filled in
by individual proposing development)
�c'�C75�I
v
i'gnature
Name
Phone Number