18426_BRINN, LINDON_19970917

CAMA AND DREDGE AND FILL '
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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
Address
City
Project Location (County, State Road, Water Body, etc.)
Type of Project Activity - -
State
Phone Number c � ,/
PROJECT DESCRIPTION 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.
issuing date
attachments
_ Zip
(SCALE:
applicant's signature
permit officer's signature
expiration date
In issuing this permit the State of North Carolina certifies that
this project is consistent with the North Carolina Coastal
Management Program.
application fee

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ST. AUGUSTINI?, FI, 32086 2560
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ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to )—iNDoh..) D. 9)?m K) s
(Name of Property Owner)
property located at Al 3u)e-r6 A) PL AC d
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(Lot, Block, Road, etc.)
on i Ve- 1?_, in --J)+ C, k5 oAJ L) JL L e 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)
W)Ql Ve- The /s FooT Se-T FO'Z
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Signature
C_'1' y R, goo
Print or Type Name
Offi) 947 -00�
Telepfione Number
Date: )97

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ADJACENT RIPARIAN PROPERTY OWNER STA
I hereby certify that I own property adjacent t� /1V )ph� Q�IIV V 's
(Name of Property Owner)
property located at d-f dogTow PL Ac e
(Lot, Block, Road, etc.)
on AVL"_C.0 �) IJe , in J4C /C 30 AV f// LLe 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)
Signature
Print or T Name
Telephone Number
Date:

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