13037_BOWEN, H.M_19940411

CAMA AND DREDGE AND FILL1���i
GENERAL 130 17
PERMIT roll
as authorized by the State of North Carolina
Department of Environment, Health, and Natural Resources and the,Coastal Rgso.urces Commission
in an area of environmental concern pursuant to 15A NCAC / 5 i ,
-�1W3c�
Applicant Name IT lj Gr'_.3 -I,—
Address ! {'
City
Project Location (County, State Road, Water Body, etc.
Type of Project Activity
c ✓ %' P cry _O,� - / ! .
Phone Number ( /
State99��y� ! fZip
.O
L.
POj C& DESCRIPTION
Pier (dock) length
SKETCH �y
(
, (SCALE:
a r.
�, , 7
e_,b
Groin length
ff
number
Bulkhead length
ax. distance offshore
Basin, channel dimensions
i�
cubic yards
Boat ramp dimensions
Other-.
This permit 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.
0in
applicant certifies by signing this permit that 1) this pro-
fs consistent with the local land use plan and all local
ances, and 2) a written statement has been obtained from
adjacent riparian landowners certifying that they have no
objections to the proposed work.
! applicant's signature
i permit officer's signature
issuing date expiration date
attachments 1l , o/ C -71 r ��
In issuing this permit the State of North Carolina certifies that
this project is consistent with the North Carolina Coastal
Management Program.
application fee

N. M. BOWEN, JR. TOBACCO MADE
RT" 1 BOX 510 THIS CHECK
AYDEN, NC 28513 POSSIBLE ♦ 19
' Pay to the
Order of��
1855
66-25/531
608
oOU
ivationaBank of North Carolina, N.A.
F—ville, NC 27828 Deluxe Banking Custo er
For
1:0 5 3 100 2 561: 608 20 24B rmum L8 5 5 i'"

io x/ V
n J C PARIAN PROPERTY OWNER STATEMENT
C;�I hereby certify that I own property adjacent to
's property located at
off\14
( ame of Property Owner)
i
(Lot, Block, Road,
�!l'J€ S'oral✓O
.. ,/a�CS'-f' �-'�4���1��� in A�, rc �54�1� N.C.
on
(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.
0 osal.
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DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled. in by individual gt:oposing development)
S nature
Print or Type Name
Tel.phone Number
f, '

(
ADJACENT � [PARIAN PROPERTY CwdNER STATEMENT
' F
hereby certify that I own proper�y adjacent to
Y, n% O W e n ��y. .--Is property located at
j Name of Property owner)
//�� (Lot, Block, Road, etc.)
on /JU �Jlr� in ,����`t f-�c' /J��C f1 N.C.
Waterbody) (Tourn and/or County)
He has described to !ne, as shown below, the development he is
proposing at that location, and, I hav,- no objections to his
proposal.
DESCRIPTION 2�'`(D/OR DRAWING OF PI,OPOSED DEVELOPMENT:
(To be filled in by individual p%:oposing development)
AL-,v vC i ' x r S' x 2. S 0CPT4 i t
kP'w-<<
sigr,.awre
b
Pri t o Type Name
Te_'_. phone Number