14508_ENGSTROM, LINCOLN & LILLIAN_19950306

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Applicant Name
Address—r
City C '14
Project Location
CAMA AND DREDGE AND FILL
GENERAL �-- ---. % ",p 14508
PERM I T.
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 f R
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.ounty, S
Type of Project Activity
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State
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PROJECT DESCRIPTION•
'(dock) length
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r
..fir
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max. distance offshore
moms,.
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Basin, channel dimensions
cubic yards
moms
Boat ramp dimensions
NNOMM
Not
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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 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.
t
applicant's signature
( permit officer's signature
issuing date expiration date
attachments � tZIA i3 C A C—
In issuing this permit the State of North Carolina certifies that
this project is consistent with the North Carolina Coastal
Management Program.
application fee.

LINCOLN L. ENGSTROM, MD 6666 85 LILLIAN T. ENGSTROM , NC6338
P. O. BOX 7665 P 53�
ROCKY MOUNT,
27804
PAY TO TFiEy��/
ORDER OF
DOLLARSC 2 Bank
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ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent tol/��/!/iL,,/.�i%'!�� f�'s
(Name of PropertFOwner)
property located at A r DE iy
(tot, Block, Road, etc.)
on SbUtnllJ _,in P)I\IP- ' )NDLi_ SHORE , N.C.
(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)
► I �{' r 55' 1:.�" — 97' 89
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Signature
Print or Type Name
V Telephone Number
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Date: �-- a—
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ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent s
(Name of PropertvOwner)
property located at f-- q 3 FDW 6 0t" k-LC— A F -DQ i \! G
(tot, Block, Road, etc.)
on Z�� �. Sb(�tN D , in P J NP— K) MOLL S N D R E S , N.C.
(Waterbody) (Town and/or County)
He has described to me as shown below, the development he is proposing at that location,
Ind, I have no objections to his proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(To be filled in by individual proposing development)
I ' 155, I:��' 97/ gg'
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13vu{NUA v
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NOT I TO 5C LSE
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Print or Type Name
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Telephone Number
Date: �/-�-z / �1�% �� K