12129_EDWARDS, JAMES_19970127

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CAMA AND DREDGE AND FILL
GENERAL NQ 3 9,9
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 15 NCAG
ApplicantNameCYr l Phone Number
Address -
City - f State Zip
Project Location (County, State Road, Water Body, etc.)
Type of Project Activity E
PROJECT DESCRIPTION
Pier (dock) length
Groin length
number
Bulkhead length
max. distance offshore
Basin, channel dimensions
3 rr
cubic yards
Boat ramp dimensions
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
t officer's signature
1 7 Ll
issuing date expiration date
attachments `� {
application fee

EROSION CONTROL SPECIALISTS 5/91
ATLANTIC BEACH CAUSEWAY
P O BOX 3355 [phone]
ATLANTIC BEACH, NC 28512
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AllFirsi-Cilzens Bank & Trust anllcl Beach, NC 28512C
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ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to
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's property
located at _ /ZZ �QO.eU �T��2t Vb'-' on
'304 Ve 5;0V'g0 (Lot, Block, Road, etc.)
�2�CS's (214,44AIC`4 in N.C.
(Water Body) (Town and/or County)
He has described to me as indicated below the development
he is proposing at that location and I have no objections
to his proposal. I understand that a pier, pilings and
dredging must be set back a minumum distance of fifteen feet
(15') from my area of riparian access unless waived by me.
I do not wish to waive that setback requirement.
I do wish to waive that setback requirement.
Description and/or drawing of proposed development:
(To be filled in by individual proposing development.)
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Print Name
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Phone Number

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to
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t>igGyt �s ���i%� ids Is property
located at _ �22 �Q�50,,O- U 17-46 �2t Vim"' on
�JDC(UC 5�00/-10 (Lot, Block, Road, etc.)
�C'C'CS'S (2A44AI6-C in _ F�/�(�� ��d GL �(.���5', N.C.
(Water Body) (Town and/or County)
He has described to me as indicated below the development
he is proposing at that location and I have no objections
to his proposal. I understand that a pier, pilings and
dredging must be set back a minumum distance of fifteen feet
(15') from my area of riparian access unless waived by me.
I do not wish to waive that setback requirement.
I do wish to waive that setback requirement.
Description and/or drawing of proposed development:
(To be filled in by individual proposing development.)
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Signature
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Print Name
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Date Phone Number