11891_WATERS, GENEVA_19930630

CAMA AND DREDGE AND FILL
GENERAL
C a �
PERMIT
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 // r //" C
Applicant Name (� r r✓ f,! el V /(✓ S Phone Number
L/ 17
Address 4; �` i� (r'—lc wN IQ f)
City State n/C Zip
Project Location (County, State Road, Water Body, etc.) ,% t ' V7,`/1i tJ % c: f111 L
Type of Project Activity
PROJECT DESCRIPTION I SKETCH
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.
(SCALE:
rl
_ �,o-vim,: y� �-►_ ,�j! G✓�
applicant's signature
permit officer's signature
issuing date expiration date
attachments
In issuing this permit the State of North Carolina certifies that
this project is consistent with the North Carolina Coastal
Management Program.
application fee 4e- ) ' (£)

PAY TO THE /1 a �� (� yC
ORDER OF f ,lr✓
wacnovia
Wachouia Bank & Trust Com any, N.A.
Ihncebore. NC//28586 040/6� 7C 18 9/
FOR-2
1:05310L529�: 7.9-5 5 -0
U O 19 66-152/531
t
I $ ,dam
4

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to
's property located at
( Name of Property OQhdr )
�° 1 0 7x oV 14 G� L
(Lot, Block, Road, etc.)
onin 0 C-a - 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.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
v �
c ( c a (D� has C � Q,l�
0 4o t c.
ZLL--L
Signature
1��✓r N&L
Print or Type Name
�?— Z�5 /7:''7
Telephone Number

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I ownproperty adjacent to
� ;.14 q4 �,�; es ' s property located at
(Name of Property Owner)
(Lot, Block, Road, etc.)
on ,/ SC �D�' Cr�C� k in IIJ 4 40 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.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
Signature 6/
i f'llf a /-�o14es
Print or Type Name
636���yy
Telephone Numb r