10978_General Permit_19930113

CAMA AND DREDGE AND FILL
GENERAL
PERMIT N9 ® �0 78
as authorized by the State of North Carolina
Department of Environment, Health, and Natural Resources and the Coastal Resources Commission
in an area of environmental concern pursuant to 15 NCAC .1 n
Applicant Name hj'P Phone Number- 9 69 �"k
Address - C 9 d 9
City._ 11'�q-,, e� 9- State "__k Zip
Projec Location (County, State Road, ater Body, etc.)
Ty �'�-� ��+--*•� �0 5 T `i��4- -s
T pe of roj�ct Activity a(.� -t -&44
PROJECT DESCRIPTION SKETCH (SCALE: )
_ tom'
.Pier (dock) length ? 3 y� l ' �' s^✓ �✓in�; p , rt
-irei�.J,p�ngth. �^�-z ''�t� — �� 1` •-- ''��%%
number
Bulkhead length,
max. distance offshore
Basin, channel dimensions `` 4_1
_ r �
cubic yards
I '
Boat ramp dimensions v
Otll er
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- applicant's signature
come null and void. i
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.
i - %? !2:�
issuing date
permit officer's signature
expiration date
attachments ///" /q r % �� l� Ci V n t
In issuing this permit the State of North Carolina certifies that r/�
this project is consistent with the North Carolina Coastal application fe ; � � � � 7
Management Program.

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ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to
J Is property located at
(Name of Property Owner)
7-1,e;WA
(Lot, Block, AR'oad, etc.)
on F0-F R 0 ,�1? , in Ab! ,j 0"/—j (210 u&) , 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.
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DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
SC �7T" �R, N y
Print or Type Name
Telephone Number
bATF

ADJACENT RIPARIAN PROPERTY OWNER STATEt►DWT
I hereby certify that I own property adjacent to
Is property located at
(Name of.Property.Owner)
(Lot, Block, Road,.etc.)
on I f?F�T 1<iy ��� in /V &, J 099N CDI-34urz N. C.
(Waterbody) (Town and/or County)
He has described tome., as shown below, the development he is
proposing at that location, and, - I have no objections to his
proposal.
DESCRIPTI
(To be fil
SCF
ING OF PROPOSED DEVEL
vidual proposing deve
y
Signature .
R, R N 35AF,
Print or Type Name
• it9-�37-q-��8 •
Telephone Number
DATE, /
t)

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