21570_KELLY, SCOTT AND DERRIK SMITH_19990428

CAMA AND DREDGE AND FILL r
GENERAL
PERMIT f'
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
Phone Number
State Zip
PROJECT DESCRIPTION
SKETCH _j, ,_ ��_P�zft _�>
(SCALE:
Pier (dock) length
Groin length
rr
number
Al! "% _ . • r _':
v I i (., i L'.{ I -? : t
Bulkhead lengthe,
1
'� ,� tom, 1
� t 1 3. 'l ,
max. distance offshore
{ • .... i (.1 L: �-�1.� l � �' 1` � i a t: f �—�. � .. - ` _
.�ii� . L. � l `� — i l'. ''�z r, I ; . .
[ yy
Basin, channel dimensions
cubic yards
r
'.{ T
1
c­
Boat ramp dimensions
f I
'
K,
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.
attachments
applicant's signature
permit officer's signature
issuing date expiration date
In issuing this permit the State of North Carolina certifies that
this project is consistent with the North Carolina Coastal application fee
Management Program.

Name Oe r,Gl�
Date Y — Z F, — 7 /
Fay to /
/ 1 / l._. /'� ^ l 66-763/531
' v
the Order of: V
f �UM��(9
302 ' -N(/97) ACCOUNTBER AMOUNT Dollars
* 5461. 11 3214 $ so va
TACHOVIA
ales li. Ban
k. N.A.
B
_��' 104448811' 1:0531076331:

I hereby certify that I own property adjacent to �2C L,Je j 's
(Name of Property caner)
property located at J 7 C' ( G i14 e i &e .1 L - e I
(Lot, Block, Road, etc.) i
on D ��
in `� , N.C.
aterbody) (Town and/or County)
He has described to me as�own below, the development he is proposing at that location,
and, I have no objection his proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(To be filled in by individual prQpo�ing develo ment)
,JxnS
Signature
Print or Type Name
R-04-- - 'S 7-? o
Telephone Number
Date:
--)-� f�

I hereby certify that I own property adjacent to !!!1' Cp
s
(Name of Property 0 er)
property located at 7
(Lot, Block, Road, etc.)
on -�-t � in � � r �
, N.C.
aterbo y)
(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 DEVELOPIYIENT
(To be filled in by individual proposing development)
X k� f( `�, I C- r-
�.J
1
�l,C
Signature
nu z an ne-, Evans
Print or Type Name
-11`-1) 062-III
Telephone Number
Date: 3 2D —�G]
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