13920_CHAPMAN, RICHARD_19950308

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LAMA AND DREDGE AND FILL �3 Q
GENERAL �, I �� �
PERMIT C-0-71 -P -7_�eY p
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 Name` { tin j -" (f �,��r �iy. Phone Number Tj!
Address
City, 1 State/(' Zip
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Project Location (County, State Road, Water Body, etc.)
Type of Project Activity
PROJECT DESCRIPTION
Pier (dock) length
Groin length
number
Bulkhead length
max. distance offshore
Basin, channel dimensions
cubic yards
SKETCH �,7U / ?A
Boat ramp dimensions
Other 4
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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 fink,
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.
applicant's signature
I
permit officer's signature
issuing date expiration date
attachmentsf C >>?�� 1'
In issuing this permit the State of North Carolina certifies that
this project is consistent with the North Carolina Coastal application fee J ��
Management Program.

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RICHARD C. CHAPMAN, INC. §Li 2 1172
DBA CAS INVESTMENTS 531
12332 WHARTONS WAY
RALEIGH, NC 27613
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ORTH CARUI.5A 27611 Y
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ADJACENT RIPARIAN PROPERTY OWNER
I hereby certify that I own property adjacent to _(&"s
located at (Lot/Block/Road,etc) 5 / ;_5— L /'V , Qdr -� on
;m4 in N.C.
(Water Body) (Town and/or County)
Property owner has dS�cribed to me the proposed development as shown in drawing.
I (DO), / (DO NOT) object to proposed project.
I understand that a pier must be set back a minimum distance of fifteen (15) feet from my
area of r' arian access unless waived by me.
I / (DO), (DO NOT) wish to waive that setback requirement.
DESCRIPTION OF DRAWING (MUST BE FILLED IN)
PIER
BOAT LIFT
BULKHEAD
LIFT /DECK OVERHEAD
LIFT/ROOF OVERHEAD
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Signature
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Print Name
(FOR PROPERTY OWNER USE)
Rr_kt Ac-
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(Name)
31S �iViz O.4IC
(Mailing Address)
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(City, State, Zip Code)
(Life- 3,T3-2 �q �
(Home Phone)

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