16359_BALLAW, SUNNIE GAIL_19960719

CAMA AND DREDGE AND FILL 01639-C
GENERAL
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 Y, '�• ! ` -`
Applicant Name
Address /��G'/ ��n�/ `rare/IA
City
Project Lo�ation (County, State Road, Water Body, etc.)
41
Type of Project Activity
PROJECT DESCRIPTION I SKETCH
Pier (dock) length
Groin length
number
Bulkhead length
max. distance offshore
Basin, channel dimensions
cubic yards
Boat ramp dimensions
Other
M
114
Phone Number
State Zip
_ C Zip
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(SCALE
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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.
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applicant's signature
permit officer's signature
�-� 0- 96 /a / -9- Q Z
issuing date expiration date
attachments ry-1e
In issuing this permit the State of North Carolina certifies that ,3
this project is consistent with the North Carolina Coastal application fee S� ! � �' V� If �Z
Management Program.

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ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
6
W
CA
I hereby certify that I own property adjacent to 's
(Name of Property Owner)
property located at
(Lot, Block, Road, etc`.)
on , in L` , N. C.
terbody) (Town and/or C nty)
He has described to me as shown below, the development he is proposing at that location,
and, I have
to his
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT,
(To be filled in by individual proposing development)
d
Signature
Print or Type Name
Telephone Number
Date:
or
v

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
ro
I hereby certify that I own property adjacent to i A's
(Name of Property Owner)
property located at /';� Q
(Lot, Block, Road, etc.)
on t , in �� C�<<�,� , N.C.
aterbody) (Town and/or ounty)
He has described to me as shown below, the development he is proposing at that location,
and, I have no objections to his
er
DESCRIPTION AND/OR DRAWING OF PROPOSED D LOpi �
(To be filled in by individual proposing development)
NV
Signature
Print or Type e CfDj►'
Telephone Number
Date: