18795_BACORCE, MILDRCO W_19971027

T
CAMA AND DREDGE AND FILL
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
Applicant Name >� " (i t =4. Phone Number
Address f'
City State Zip
Project Location (County, State Road, Water Body, etc.) f.'.
Type of Project Activity
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PROJECT DESCRIPTION I SKETCH
Pier (dock) length
Groin length
number
Bulkhead length
max. distance offshore
Basin, channel dimensions
cubic yards
Boat ramp dimensions
Other
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.
(SCALE:
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t applicant's signature
permit officer's signature
le- 27- y7 / 274*7
issuing date expiration date
attachments 07/A ba �'
In issuing this permit the State of North Carolina certifies that
this project is consistent with the North Carolina Coastal
Management Program.
application feer.3 t
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PAY TO POST OFFICE
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ADJACENT RIPARIAN PROPERTY OWNER STAB
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I hereby certify that I own property adjacent to 1119, 's
(Name of Property Owner)
property located at +//�
(Lot, Block, Road, etc.)
on A(4 &gam -*� • in , �. , 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)
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Iv Signature
twiwLm'
r r Print or ype Name
O C T 2 0 1997 Telephone Number
I
PAL MANAGEMENT Date;
MOREHEAD

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to Z - is
(Name of Property Owner)
property located at_1 f P",ev4:�, j1510rA-f a&
(Lot, Block, Road, etc.)
on atj::±� , m aay7v, , 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 fzlled in by individual proposing development)
OCT 2 0 1997
COASTAL MANAGEMENT
San
Print or Type Name
q1P ��V[11 iL��
Telephone Number
Date: d