17098_THOMPSON, NORWOOD_19970522

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CAN
CAMA AND DREDGE AND FILL �17,0$-�,
GENERAL N
PERMIT
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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
Address
City -4i
Project Location (County, State Road, Water Body, etc.) _
Type of Project Activity
Phone Number SS y _/G l&
State `r zip ?7 S 2 G'
7
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PROJECT DESCRIPTION I SKETCH (SCALE: +C ", )
Pier (dock) length
Groin length
number
Bulkhead length 1�'Q C 6
max. distance offshore
-
Basin, channel dimensions
c%
cubic yards
Boat ram dimensions
p 18 i
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Other
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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.
In issuing this permit the State of North Carolina certifies that
this project is consistent with the North Carolina Coastal
Management Program.
applicant's signature
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permit officer's signature
7
issuing date expiration date
attachments G7/�. #Go
application fee /''' 2s�i2-

EROSION CONTROL SPECIALISTS 66-30/31
133 2592
ATLANTIC BEACH CAUSEWAY NCOL 8039839
P O BOX 3355 PH 919-726-2191 p
ATLANTIC BEACH, NC 28512 Aatps- 19
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ADJACENT PIPARIAN PROPERTY OWNER STATEMENT
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I herd hyp certify ,-hat I own p operty adjacent to
VV� NW goJ� 1 ih SD Is property
7_ocated ;.-t Me S) ti� , -� on
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AC�C�-Cg C� ,44NC-lL in i o�e; , N.C.
Flater Body) -Town and/or County
He has described -.o me as indicated cIelow the development
he is proposing at that location and I gave no objections
to his proposal. I understand that a pier, pilings and
dredging must be set back a minimum distance of fifteen feet
(15') freer my area cr riparian access u.11ess waived by me.
I do not wish to waive that set.--)ack requirement.
:10 wish tc. waive that setback requirement.
::escription and/or drawing of prop_.:,_.ed development:
(To be fi_.led in by individual proposin__ development)
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ADJACENT RIPARIAN PROPERTY O6iNER STATEMENT
I hereby certify r:hat I own property adjacent to
c o_� _ 's property
located at � � �' �l v � on
!900kiot, 1310C
er A tin �( - N.C.
- baater Body) ( Town an or County)
He hAs described to me as indicated below the development
he is proposing at t:.:at location and I have no objections
to his proposal. I understand that a ;,ier, pilings and
dredging must be set back a minimum distance of fifteen feet
(15') from my area of riparian access unless waived by me.
do not wiEr, to waive that set-.'.,)ack requirement.
R/ 1 do wish tc waive that setback requirement.
Desc_r•il-)tion and/or drawing of proposed development:
`64 is c lcrE�'i' o G !o s ' L« 644.. ►��Er o F , P&T-Cga
(T6C-1*,;)4tY.r).lQ4rian dayJykndk l 5� '3 development)
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Print NaTe
Date Phone Number

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