7904_SMITH, WILLIAM E_19910328

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� CAMA AND DREDGE AND FILL 7904
GENERAL
PERMIT rig-
as authorized by the State of North Carolina,
Department of Natural Resources and Community Development d:4,astaYta�mmission
in an area of environmental concern pursuant to 15 NCAC tt �'
Applicant Name �''%�` f����1� L' 3 /</ o✓J Phone Number
Address
City, ��- �'.'
y State : 'G l Zip ��
Projects Location =(County, State Road,, Wate Body, etc. �'W I' f'•' N( t ' r � .%�
Type of Project Activity""
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PROJECT DESCRIPTION SKETCH (SCALE: )
Pier (dock) length
Groin length M1 t
number- ! (�
s Bulkhead length
Cf
ax. distance offshore ...:F P
Basin, channel dimensions
cubic yards SLA `
J g
Boat ramp dimensions
AI)er
Other
This permit i >'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-
726 —l25
2Z 7 —$ 30
'icer's signatures
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is consistent with the local land use plan and all local issuing date — expiration date
inances, and 2) a written statement has been obtained from r /
adjacent riparian IandoWners certifying that t ei y ave noy
objections to the proposed work. attachments
i 1 /
In issuing this permit the State of North Carolina certifies that
this project is consistent with the North Carolina Coastal application fee
,i Management Program. t,t,%�.;, z

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ADJACENT RIPARIAN PROPERTY OWNER STATEMENT (FOR A -PIE )
I hereby certify that I own property adjacen to J. C �l / l 1 7-4 - s
property located at C EEL,L SPfo rE12
(lot, block, road, etc.)
on 7) KED C..- CC-- in N.C.
(water body) (town and/or county)
He has described to me as shown below the development he is proposing
that at that location and I have no objections to his proposal. I
understand that a pier must be set back a minimum distance of 15 feet
from my of riparian access unless waived by me.
I do do no wish to waive that setback requirement.
(circle one)
Description and/or drawing of proposed development: ( to be filled in
by individual proposing development)
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I
S�gnature --j
Name
Phone Number

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ADJACENT RIPARIAN PROPERTY OWNER STATEMENT (FOR A
I hereby certify that I own property adjacent to �J'67- s m / 17r + - s
property located at
(lot, block, road, etc.)
one _� in N . C .
(water body) (town and/or county)
He has described to me as shown below the development he is proposing
that at that location and I have no objections to his proposal. I
understand that a pier must be set back a minimum distance of 15 feet
from my of riparian access unless waived by me.
I do do no )wish to waive that setback requirement.
(circle one)
Description and/or drawing of proposed development: ( to be filled in
by individual proposing development)
�5ep Cpc�
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9 T- S
Signature
Name
( Phone Number