13997_FREEMAN, RALPH_19950405

CAMA AND DREDGE AND FILL
GENERAL 1997
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 Name, `
Phone Number
Address
City State Zip
Project Location (County, State Road, Water Body, etc.) -
Type of Project Activity
PROJECT DESCRIPTION SKETCH
Pier (dock) length `I IF —VT
(SCALE: 4s
Groin length
number
Bulkhead length
max. distance offshore 4
�
I
Basin, channel dimensions
s
cubic yards
Boat ramp dimensions
i, Other
y
f
_ _ ! 1 e.
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-
i
applicant's signature
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-
ject is consistent with the local land use plan and all local
issuing date
ordinances, and 2) a written statement has been obtained from
expiration date
adjacent riparian landowners certifying that they have no
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
," Management Program.
application tee

t
HAZEL MAE FREEMAN NC 2457864
RALPH H. FREEMAN 5771
2122 RIVER DRIVE PH 910-326-5250
STELLA, NC 28582 66- 152/531 CC
Pay To The /� �9---�-
OrderOf �✓ ,
Dollars
Wachovia Bank of North Carolina, N.A.
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1
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property
adjacent to Alle ''K MxS hle �i4s
property located/described as %
adjacent to t�sfFrT� GAIN' t� 2 North Carolina.
He has described to me as shown on (attached) the development he is proposing at
that location and I have no objections to his proposal. I understand that a pier,
boat ramp, or dock must be set back a :ninimnum distance of 15' from my area of
riparian access unless waived by me. I o I do not ( circle one) wish to waive that
setback requirement. I do Cdo not '(circle one) have objections to locate a boat
4C�Q-r
ramp, pier or dock within feet from our property line.
Description and/or drawing of proposed development: (to be filled in by
individual proposing development)
name
phone number

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to N/2l Ae-S '7�'e-n! r:ty 9,L/
property located/described as
adjacent to C A-S1-l--r-72--- c AZ-' 11?td North Carolina.
He has described to me as shown on (attached) the development he is proposing at
that location and I have no objections to his proposal. I understand that a pier,
boat ramp, or dock must be set back a minimum distance of 15' from my area of
riparian access unless waived by me. I do/do not (circle one) wish to waive that
setback requirement. I do/do not (circle one) have objections to locate a boat
ramp, pier or dock within //(J feet from our property line.
Description and/or drawing of proposed development: (to be filled in by
individual proposing development)
s Ggnat �r`�%�-fl-�"
/o L -a rs N)
name
phone number
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