13053_WOOD, RAY_19940421

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 Resources Commission
in an area of environmental concern pursuant to 15A NCAC
Applicant NarrLe I ! `F � `�� Phone Number
Address '
City 'e State _
Project,Location (County, State Road, Water Body, etc.) J ..,-r .' r
Type of Project Activity < '
Zip
PROJECT DESCRIPTION
SKETCH
Pier (dock) length
top
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Groin length-
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i
number
Bulkhead length
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ax. distance offshore
Basin, channel dimensions_
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cubic yards
Boat ramp dimensions
Other,
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This permit is subject to compliance with this application, site
drawing and attached general and specific conditions. Any
fV
violation of these terms may subject the permittee to a fine,
ll..
applicant's signature
jimprisonment or civil action; and may cause the permit to be
void.
come null and
This permit must be on the project site and accessible to the
permit officer's signature
!: permit officer when the project is inspected for compliance.
certifies by signing this permit that 1) this pro
4applicant
is. consistent with the local land use plan and all local
issuing date expiration date
o nances, and 2) a written statement has been obtained from
adjacent riparian landowners certifying that they have noj'(-�
objections to the proposed work.
attachments
In issuing this permit the State of North Carolina certifies that,
1
!'
this project is consistent with the North Carolina Coastal
application fee
1
Management Program.

Personal Account Information Redacted
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT (FOR A•V4F*)
OJT L �*-z,
I hereby certify that I own property adjacent to �� l.! ��� is
property located at 1 U �I o r-T t+ S 11 � (z-e I P-L ell F- 1�
(lot, block, road, etc.)
on J r]70 .' in .l- (-J3 H -) C 1 C 1 , 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 proposal. I understand that a pier must be set back a
minimum distance of 15 feet from my area of riparian access unless waived by me.
I d 7 do not wish to waive that setback requirement.
(circle one)
Description and/or drawing of proposed development
proposing development)
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+(57/Nb +'
CJC J1
L 36
(to be filled in by individual
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Sigonature " .%
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Name
Phone Number