13952_BURNS, RILEY_19940109

R C, u t► T `(
_Y-
CAMA AND DREDGE AND FILL
GENERAL
PERMIT
C�;7* ,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 111'- '
Applicant Name' �`''� t'-�"' Phone Number h'
Address ' 0, /Ve;
City :f/ P,;,'Y State ✓VC_ Zip
Project Location (County, State Road, Water Body, etc.)r'
Type of Project Activity 49.9
PROJECT DESCRIPTION
Pier (dock) length
SKETCH
W
(SCALE:
a
Groin lengthT7_
1 1
-
g�
i f•,` ` ^
r
ri—
I
number
Bulkhead length
!
max. distance offshore
Basin, channel dimensions
S
cubic yards
Boat ramp dimensions
Othert
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-
ject 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.
r / applicant's signature
i
permit officer's signature
{iqy
issuing date expiration date
attachments 09 // f?-,-
In issuing this permit the State of North Carolina certifies that
this project is consistent with the North Carolina Coastal application fee
Management Program.

RILEY W. BURNS 10-89 1374
JANICE L. BURNS 60-1356
3009 GLOUCESTER STREET 19 j � 313
PAY TO A
LANCASTER, PA 17601 ORDEROFE / V c y / J v I� I $
C�
DOLLARS
Bai* of
® I.ixaster County, KA.
/� ,� IJ,NCnSTER,.PA1//803 q (`a{� /
MEMO G1+/ �'l I /y
i:03 i13 1356 21: 0 0 11396-0Ills 3?4

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to R d ey W Q to rn T
property located at t p rt '� % 4/ Creek 8 0 a e/
(lot, block, road, etc)
on _ all C)-ee k in _ -I0 L on C c
(body of wat r) (town)
North Carolina in Pg n,ilCO County. The proposal has been described to
me as shown below; the development, a pier/bulkhead/structure, and the
(circle one)
proposed location, and I have not objection to the proposal. I under-
stand that if the development is a pier, it must be set back a minimum
distance of 15 feet from my area of riparian access unless waived by me.
I do/do not wish_to_ waive that setback requirement.
(circle one)
Description and/or drawing of proposed development: (to be filled in by
individual proposing development). INDICATE THE SIZE AND LOCATION OF THE
STRUCTURE AND THE DISTANCE BETWEEN EACH PROPERTY LINE ANP TUF wa,F
'335.00' l ,
ux
•
o ti:
7S 64' 39 24 (5� ��
Pa5EME 50
,
2.065 AC. /' 2 o P 5 oP F� E �
36' E
� . 22 �gec0° .. E• �' h c
Oro / \ -' ' 69 \� \
1•
`�s. Ya �r�J e9 3 0
.4 �•
5 0
6s 3- t�i'� ,p 90 6.. N --SECTION WETLANDS
404
2
50
vIN
N 67' 50'56" W
turiginal must be retained in the Inspection Department)
r I Stgnature
- Da
0i,LgFZ &F-1 % • 1 \ r f.�flT�Z
Name (Please Print) (J

c.

ADJACENT RIPARIAN PROPERTY OWN R STATEM_MENT
I hereby certify that I own property adjacent to
rn
property located at G
on Ci, (lot, block, road, etc)
(body of water) in r Q h c r
North Carolina in (town)
Pa4i . County. The proposal has been described to
me as shown below; the development, a pier/bulkhead/structure, and the
proposed location, and I have not objection(torcle the proposal. I under-
stand that if the development is a pier, it must be set back a minimum
distance of 15 feet from my area of riparian access unless waived by me.
I dodo not wish_to waive that setback requirement.
(circle one)
Description and/or drawing of proposed development: (to be filled in by
individual proposing development). INDICATE THE SIZE AND LOCATION OF THE
STRUCTURE AND THE DISTANCE BETWEEN EACH PROPERTY LINE AN� TUF wad
v
.1 • --,- • -- 33 0
.�
l 64 39' ,
2.065 A C. 2? P q F FF % 5 "� °"� • U
\ 36 �� a�� m �?ft
�
A: /E�.
5 �l
22 ,�- �{L.Gan
d ,•. e 2
11090 26. Y1 SECTION 404
C 0 ` V
�o \arn WETLANDS
15
\ N 67 50'S6" W (original must be retained in the Inspection Department);
Signat e-
Dat�e/�,
Name (Please Print)