10990_General Permit_19930302

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CAMA AND DREDGE AND FILL C�
GENERAL I C)
PERMIT '!�T� 10990
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 7 N f !O f
Applicant Name f1-1A n
Address 1 U SyS—cy
City,
Pro4ect Location (County, State
Type of Project Activity
Water Body, etc.)
3
O
State /" --
PROJECT DESCRIPTION SKETCHW, f T /Y
Pier (dock) length
Groin length
number �) ,1,� -� O 0 �j 0
Bulkhead length-��
max. distance o wre.
Basin, channel dimensions, ,
i
Phone Number `' •�'r� l
cubic yards. C9 Lt�Ef
Boat ramp dimensions
Other
zip ,�, Sg /)
(SCALE: L )
0
This permit is subject to compliance with this application, site
drawing and attached general and specific conditions. Any f ! j
violation of these terms may subject the permittee to a fine, l �"
imprisonment or civil action; and may cause the permit to be- ` applicant's signature
come null and void. �� V
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.
permit otticer's signature
-r
issuing date expiration date
attachments / ` 4 / // // r
In issuing this permit the State of North Carolina certifies that
this project is consistent with the North Carolina Coastal application fee h o. o
Management Program.

T
ADJACENT i2IPARxAN PROPERTY dWNER STATEI►lENT
I'hereby certify that I own property adjacent to
's property.:.:located' at
,..(Name Hof, .Property. Owner)
(Lot, Block, Road,.etc.)
on ,� -�J ii +y in ssZ,"/j inn l2Fa 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)
1

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6
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ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to
' s property . located at
(Name of Property. Owner)
(Lot, Block, Road,.etc.)
on ( 1,y , in Vv Qlj ;an, C1,Vur•J, 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.
--------- ------------------------------------------------------
DESCRIPTION AND/OR'DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
94
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Signatur
PrintorType Name
Telephone Number

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