7671_ROGERS, TOM_19900619

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CAMA AND DREDGE AND FILL 7671
GENERAL 9ti
PERMIT
as authorized by the State of North Carolina,
Department of Natural Resources and Community Development�V the5Coatstal Resources Commission
in an area of environmental concern pursuant to 15 NCAC '/ �r// �W
Applicant Name ( C—)M Phone Number
Address U - G Xa�
City to f, S to Zip
Project Location (Countydn, t
State RoadWater Body, etc/) T �� < < r/ ro S
Type of Project Activity 15 0 7 -I- l
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:
1__�i / '`J
4N/?o
issuing date
attachments �/
applicant's signature
p rmit of - cer's signature
9 �9 , )
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.

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ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to
tb g 'N S,Q YS __ Is property
Name
`�- ��located at , on
i(Lot,Block, Road, etc.)Q
CkNA-in "] 1-Nwb(- c�. �%'L, , N. C.
(Water Body) (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. I understand that a pier must be set back a minimum
distance of fifteen feet (151) from my area of riparian access
unless waived by me.
I do not wish to waive that setback requirement.
V*'*' I do wish to waive that setback requirement.
Description and/or drawing of proposed development: (TO BE
FILLED IN BY INDIVIDUAL PROPOSING DEVELOPMENT)
sirgnature
sue' N
Name
Phone Number

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ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A� -1111_j,,CS)- 'DDC4, �-I�
II h1e�reby certifypthat.I own property adjacent to
1 1rV C) M cv5 `iJ r PD SZ .rS ' s t
located at
proper y,
on
(Lot, Block, Road, etc.)
�
9 in �.�a�► � P_Gz e, , N.C.
(Water Body) (Town and/or County)
Name
31�ki2
ik-Q ".:> -'10
He has described to me as shown below the development he is
proposing at that location and I have no objections to his
proposal. I understand that a pier must be set back a minimum
distance of fifteen feet (151) 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)
- � 0� 1&34 V
Signature
F�NrJkLteJ �� R
Name
10 - sae v 37 �6
Phone Number
-2-3 21

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