13169_YOCHIM, RICHARD_19940901

C'AMA AND f1RFIlC:F AND FII
GENERAL � '"'� �, ''O 13169
PERMIT
as authorized by the State of North Carolina f.
Department of Environment, Health, and Natural Resources and the,Co I Res�ii•; omm/ts
in an area of environmental concern pursuant to 15A NCAC /�✓ �` • ffp
('� '• t^1
Applicant Name �/����rt�' ' " `'�l; + Phone"Number ���
Address
City
Project Location (County, State Road, Water Body, etc.)
i
Type of Project //Activity ✓� =? ' '�%
q t<zi
PROJECT DESCRIPTION I SKETCH
Pier (dock) length
Groin length.
number.
Bulkhead length
ax. distance offshore nl
°-xl�fY c. ,
Basin, channel dimensions_i}t�`{
cubic yards
Boat ramp dimensions
r
Other
LLMA
E
State
FAr
(SCALE:
55 l
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,
— t _ .• -
� � applicant's signature
i 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.
•/ / permit officer's signature
The applicant certifies by signing this permit that 1) this pro -
_
consistent with the local land use plan and all local
% issuing date expiration date
P*is
Inlances, and 2) a written statement has been obtained from
r' cerifyi,ng have
adjacent riparian landowners _ ti6t ,they no
d -- _ _._
t
;''
objections_to the proposed work.
attachments -
In issuing this permit the State of North Carolina certifies that
this project is consistent with the North Carolina Coastal
application fee
Management Program.

J
� lT\TITED s,1�1rrils l�l�r.'7�iAL .'��1NE 1� ORDER15-8
ow
�kt, ..,,�,.......u,,y�" ,.
6000004\3371 940851 085570 5
CHECKWRITER t .
SAY 70
4
IMPRINT AR A}fit"/,/���
'ADDRESS
FROM "L al_ -
ADORES a
CPD NO. OR
FOR
1
tiJ
USED
t..
t:Q70Q$QO 2�: 6000 3 24 3 3 7 111'

C
s.[pz drnc� �l
PA,

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to
Prope tk-y Owner
(Lot, Blc
on ✓1"�;
(Waterbo y)
's property located at
X, Road, etc.)
in �� � N.C.
(Town an /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.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by in ividual proposing development)
Pa
G LAI -�
j ' 1 Signalfure
Print or Type Name
15 9-1- ':�z 9 -7
1 Telephone Number
U
I
l

a
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
hereby certify that I own property adjacent to
is property located at
Name of Prdperty Owner
(Lot, Block,/Road, etc.)
f /2
on "4, 40
(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.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
N
j�'/Q; fibM�vGra7�
l
9
Signature
tint or Type Name
_5��-
Tele hone Number
I
I
I

(si
v
prop��scc!
M�Lkf- r

h
r
�t'Y

MONITORING & COMPLETION REPORT
[CAMA Major Development & State Dredge & Fill Permits]
PERMITTEE' S NAME:
LOCATION:
PHONE:
PERMIT #i
FIELD REP.
DATE REPORTEDLY COMPLETE:
1) Do the measured dimensions of the development differ from those indicated in the permit and workplat?
YES/NO [circle one].
COMMENT:
2) SEDIMENTATION & EROSION CONTROL: Has Permittee seeded, grassed, or otherwise stabilized
all disturbed areas? YES/NO [circle one]
COMMENT:
3) FUTURE MONITORING & ENFORCEMENT ACTION: Is further investigation or enforcement
action needed? YES/NO [circle one].
COMMENT:
r