13058_DUNN, PHILLIP_19940428

CAMA AND DREDGE AND FILL
GENERAL
PERMIT
13058
CV9 Of
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 15A NCAC
11 A r 1
Applicant Name 1 n! �0 (d­k,�Y ' Phone Number 1/ '/---'/---!r f, - /;f /
Address /' 7 d
City,°t' !�- -, State r
Project Location (County,, State Road, Water Body, etc.
Type of Project Activity �� l r t.',S.s :r =7 r,"Z
PROJECT DESCRIPTION I SKETCH
Pier (dock) length
Groin length
numberBulkhead length
Oax.
distance offshore
Basin, channel dimensions
cubic yards
Boat ramp dimensions
Ofther
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 -
is consistent with the local land use plan and all local
fiances, 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.
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applicant's signature
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permit officer's signature
/ issuing date expiration date
attachments £ I r ;1 /_% / 2 n ��
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application few"

' DAVID V. HODGES NCDL 01999167
EXPENSE ACCOUNT 0430
t
P O BOX 87 66-30/531
MERRITT, NC 28556 L
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PAY TO
ORDEROFE Y..�-��/L/ /\ f ' `✓ (�/1 ���
-DOLLARS
FY CITIZENS -
fusi{laws 6onr s Luu Company EMKOnenloi, NC 78571
FOR 01
.°i:0531003001:L,717022616u' 01,30
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I hereby certify that I own property adjacent to Try'
)roperty located at - 1,, T .
(lot, block, road etc y�
)nCie, _1 V��'{%- in -
(body of water) )
forth Carolina in Pamlico County. The proposal has been described to me as shown below;
he development, a pier/bulkhead/structure, and the proposed location, and I have no
(circle one)
,bjections to the proposal. I understand that if the development is a pier, it must
,e set back a minimum distance of 15 feet fran my area of riparian access unless waived
)y me. I do/do not wish to waive that setback requirement.
(circle one)
;ascription and/or drawing of proposed development: (to be filled in by individual
)roposing development.) INDICATE THE SIZE AND LOCATION OF THE STRUCTURE AND THE
[STITCE BMWEEN EACH PROPERTY LINE AND THE WATER.
(Original must be retained in the Inspection Department)
Signature
— date — ---
----- Name (Please pri

s✓
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to a A
>roperty located at
(lot, block, road etc.
y
)n��' in —
(body of water) ( )
forth Carolina in Pamlico County. The proposal has been described to me as shown below;
-he development, a pier/bulkhead/structure, and the proposed location, and I have no
(circle one)
,bjections to the proposal. I understand that if the development is a pier, it must
,e set back a minimum distance of 15 feet from my area of riparian access unless waived
)y me. I do/do not wish to waive that setback requirement.
(circle one)
o- t**,t***+t**ir*********ft**********tk**i1**1r�**,k****ittt�tt*A*!k*�!r*****,t*!r*+►****R***,k*,t****,t*,r* r ** -
,escription and/or drawing of proposed development: (to be filled in by individual
I)roposing development.) INDICATE THE SIZE AND LOCATION OF THE STRUCTURE AND THE
' [ S`I ITCE BUIWEEN EACH PROPERTY LINE AND THE WATER.
�O
11 ('av
(Original must be retained in the Inspecti"par t)I
T ure
raTel_�--
- -- -----Name-

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