22233_OXLEY, BILL_19990505

CAMA AND DREDGE AND FILL ��►
GENERAL 1' 0 2"21233 -c
c .
PERMIT
as authorized by the State of North Carolina j
Department of Environment, Health, and Natural Resources and the Coastal Resources Commission d
in an area of environmental concern pursuant to 15A NCAC j
Applicant Name '�L' ��� Phone Number
Address i 1U Ir
City ` y''' fey- State aJ zip
Project Location (County, State Road, Water Body, etc.)' Z�b
Type of Project Activity i' % ell,;
7-
PROJECT DESCRIPTION SKETCH (SCALE: )
Pier (dock) length �►.!' G i '
Groin length C Lk,. i
number )
Bulkhead length I
max. distance offshore 0
Basin, channel dimensions 1J
cubic yards V
�r \ll.Ic�vfs
Boat ramp dimensions !
Other
"
i • 1.
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.
applicant's signature
permit officer's signature
r• �
issuing date expiration date
attachments 3/
In issuing this permit the State of North Carolina certifies that
this project is consistent with the North Carolina Coastal application fee
Management Program.

ADJACENT RIPARIAN PROPERTY OWNFR STATEIVIFNT
I hereby certify that I own property adjacent to _�.c�' z�;
s
(Name of Property Ow er)
property located at / � 9 O 1) 10 r '
. -Q= _.
(Lot, Block, Road, etc.)
011—&eti.1cr .m CkAv6►�
(Waterhody) , N.C.
('own and/or County)
He has described to me as shown below, fN- de aelopment he is proposing at that location,
viijelons to ius proposal.
DESCRIPTION AND/OR DRAWL : O' PROPOSED DEVELOPYMNV-T
(To be filled in by indivuk;••%>: G Hosing development)
w
Signature
S-"LC—v&)
Print or Type Name
Telephone Numbe:
Date: 9

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to _ ice; �S
(Name of Property Own •)
property Iocated
(Lot, BIock, Road, etk")
on---N'-g-Se )'J ,in n—(RAJ--E t2
(Waterbodv) , N.C.
Ro" &ad/or County)
He has described to me as shown below, the deve.70pme-it he is proposing at that location,
znd, I have no objections to his proposal.
DESCREMON AND/OR "f OPOSED DEVELOP MW,
Print or Type Name
Telephone Number
Date: q T