7919_WALL, AARON_19901218

O
CAMA AND DREDGE AND FILL
GENERAL
r" ?919
I ERMIT r_1�,
as authorized by the State of North Carolina,
Department of Natural Resources and Community Development and the Coastal Resources Commission
in an area of environmental concern pursuant to 15 NCAC - /
Applicant Name f `'��G� Phnna NumhPr 7 it " 5 k:
Address , N iw r2,,
City, _/� t /•,:. "��' ��r�r.r
Project Location (County, State Road, Water Body, etc.)
• A
Type of Project Activity
PROJECT DESCRIPTION I SKETCH
_ State Zips ` __Q
-40
�1
Pier (dock) length
Groin length
I number
Bulkhead length,
m ax. d istan ce offsh ore
Basin, channel dimensions
���. �•
cubic yards
Boat ramp dimensions
Other 1
jf
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:
y ,rr--,rI, t-
applicant's signature
permit officer's signature
1
issuing date expiration date
attachments _ / !, /
In issuing this permit the State of North Carolina certifies that
this project is consistent with the North Carolina Coastal application fee ';Ic
Management Program.

ADJACENT RIPARIAN PROPERTY O�,7NER STATEMENT
(FOR A PIER)
I hereby certify that I own property adjacent to
i C �12 `� S� 's property
Name
located at J 24 1 L on
(Lot, Block, Road,` etc.) rr
C� wilU�� in tt� ��-4�c �P�Ch flPe�e-4-, 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 understandha--a-
ee riparian ces
V 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)
k. N' K
Signature
TA I GLEE"
Name
Phone Number

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER)
I hereby certify t I own property adjacent to
th
X?Ajov 's property
/ Name
f
located at o1S �S��li IV7&ojve,�1 XJ- on
(Lot, Block,
l Road, etc.) ,
in /`i/ok9 ,1�G ICJ-�fiuy . �i �� 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- Asz hack a m;ninum
distance of fifteen foot ( i _)_from my area -of-riparian--aecess%
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)
Si ture
Name
Phone Number

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