10974_General Permit_19931006

O
CAMA AND DREDGE AND FILL
GENEkAL
PERMIT '' - 10974
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 71 ' 1
Applicant Name I I • L, 1
Address
City,
Project Location (County, State Road, Wiate Body, etc
Type of Project Activity
Phone Number , a' %- % 7/ s
State G' C Zip 9 ut Sh
PROJECT DESCRIPTION SKETCH f£ 1
Pier (dock) length
Groin length _
number
Bulkhead length
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 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.
In issuing this permit the State of North Carolina certifies that
this project is consistent with the North Carolina Coastal
Management Program.
9
! oe
issuing date
(SCALE: �f )
attachments L -(
application fee ��� 0
if -
applicant's signature
permit officer's signature
expiration date

GRAFTON MARINE CONSTRUCTION
105 SEA HORSE DRIVE
SWANSBORO, NORTH CAROLINA 28584
919-393-6137
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to
L111 N.J s r-� Is property located at
(Lot, Block, Road, Etc.)
on
(Water Body)
in
(Town and/or County)
, North Carolina.
Property owner has described to me the proposed development
as shown in drawing.
I object to propooed project.
(Do) (Do Not)
I understand that a pier must be set back a minimum distance
of fifteen (15) feet from my area of riparian access unless waiv<:d
by me.
I - wish to waive the setback requirement.
(Do) (Do Not)
DESCRIPTION OF DRAWING (Must be filled in) o'K aw "'�) 'os
ht-,Cv-, 1 • ON
Deck over
Lift
Roof over
Lift
Boat Lift
Pier
Pole Replacement
_a�
Signature
4(J'415
4'a
Name (Print)
3073 -
"�S_y/Y
Phone Number

GRAFTON MARINE CONSTRUCTION
105 SEA HORSE DRIVE
SWANSBORO, NORTH CAROLINA 28584
919-393-6137
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to
P,u c��s��ti _ Is property located at
�,Ftr��crL Slr��r�.5
(Lot, Block, Road, Etc.)
on (_ ��.���, 0�'uL'0 r�
(Water Body)
in
(Town and/or Cou
y)
, North Carolina.
Property owner has described to me the proposed development
as shown in drawing.
I object to proposed project.
(Do) (Do Not)
I understand that a pier must be set back a minimum distance
of fifteen (15) feet from my area of riparian access unless waived
by me.
wish to waive the setback requirement.
(Do Not)
DESCRIPTION OF DRAWING (Must be filled in).
Deck over Lift
Roof over Lift
Boat Lift
Pier
Pole Replacement
Signature.
I Lo i> um i�l
Name (Print)
Phone Number
I"J' '(')(4t N;
fps Q ouEfL

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