11757_PARISI, TED & DONA_19930301

CAMA AND DREDGE AND FILL _
GENERAL p 1.1 � 5- 7
PERMIT /
as authorized by the State of North Carolina
Department of Environment, Health, and Natural Resources and the Coastal Resourvs Commission
in an area of environmental concern pursuant to 15 NCAC
Applicant Name Phone Number
Address—
• C.
City _ ��'/ r , I'� State fV Zip S� 6
Project Location (County, State Road, 1 ater Body, etc.)
Type of Project Activity
Kln ,,-
PROJECT DESCRIPTION SKETCH L w, ( (SCALE:
Pier (dock) length j (_
' U
Groin length. �
number
�
Bulkhead length y
max. distance offshore
Basin, channel dimensions
cubic yards
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"prbject 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.
j 1 -, 3
issuing date
attachments
o
applicant's signature
permit officer's signature
expiration date
In issuing this permit the State of North Carolina certifies that
this project is consistent with the North Carolina Coastal application fee
Management Program.

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to
..
n�� ��rr;S ► is property located at
(Name of Propertk/Owner
(Lot, Block, Road, etc.)
on in _ 2u WA �c`� C) N.C.
'(Waterbody) 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)
1
Si 1natuie
I �t Z 11 ," U
Print or'Type Name
v Y - �6
Telephone Number

__ . 01 1 .
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to
17
Name of Property Owner)
's property located at
(Lot, Block, Road, etc.)
on 40_ in ` /IIM���c� N.C.
( a erbody) ��� 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)
C4 ' C L 4cf
gnature
,-7, G, S ,�;e, 7�r,n F
Print or Type Name
tl y- /o/ 7
Telephone Number

LAW TRUCKING SERVICE
P O BOX 241 919-745-3785
MERRITT, NC 28556
1172
66-30/531
--3
�- wrens oanK aL uust Company 471
Bayporo, N.C. 28515
For PC- 11/7 5
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