HomeMy WebLinkAbout13098_CHANCE, KEN_19940629Applicant Name i
Address , i '`1'"
CAMA AND DREDGE AND FILL
GENERAL
PERMIT
as authorized by the State of North Carolina
Department of Environment, Health, and Natural Resources and the Coastal I�s?yrces Commission
in an area of environmental concern pursuant to 15A NCAC / G
t r Phone Number
City, f !' (r /3— "! a State /4f <' Zip } �" �!
Project Location (CoLnty, State Road, Water Body�tc.) � � r? �' � C r
Type of ProJ'ect Activity
PROJECT DESCRIPTION SKETCH PI A
Pier (dock) lengthC/ 1,
number
Bulkhead length
—_
�1 a
+�
'— distance offshore
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Basin, channel dimensions
cubic yards
Boat ramp dimensions
i
er
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y
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.
applicant certifies by signing this permit that 1) this pro -
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.
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issuing date
s
0
f ,
applicant's signature
permit orticer-s signature
attachments /� (
expiration date
In issuing this permit the State of North Carolina certifies that J
this project is consistent with the North Carolina Coastal application o 0,-
Management Program.
60481260�02 940629 288601
U. S. DOLLARS AND CE
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_��____ _ JACENT i2IPARIAN-PitOpEitTX �OWNBR''SfiATEMgi�T . �, _._. .
I hereby certify that* •I owri - property adjacent-. to, r< .... _
F'' C IAki.4� r ' a roperry .r 1
• Name p
located at S e� 1,1 - on
(Lot, Block, , Rbad, etc .)
jEiA in I ' 9cJ`
N.C.
(Water Body) (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
r
proposal., ,7 understand that a pier must be set back a,minimum
distance of fifteen feet (151) from my area of riparian access
unless waived by me.
I do not wish to waive that setbach requirement.
I do wish to waive that set bac}: requirement.
Description and/or drawing of proposed development: (TO 13B
FILLED IN BY IRDIVIDUAL PROPOSING DEVELOPMENT)
Si ature -
21 ame
Phone Number
Date .
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