10878_General Permit_19920917

CAMA AND DREDGE AND FILL.
GENERAL
r
PERMIT T 08
as authorized by the State of North Carolina c 4r
Department of Environment, Health, and Natural Resources and the Qoast Resources Commission
in an area of environmental concern pursuant to 15 NCAC '% /7 - 11oC)
Applicant Name D' R Phone Number
Address ) �% r h L, r
City, l %'�(/�n /( �.:� State A/ C Zip z;
Project Location (County, tate Road, Water Body, etc.
Type of Project Activity /T/ A / " rw i r D
/-J, 41 '1, r'OIV /P iirf
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
�J
permit officer's signature
7 /� (7 �.
issuing date expiration date
attachments - ^� ' - ! �"( ' io
In issuing this permit the State of North Carolina certifies that
this project is consistent with the North Carolina Coastal
Management Program.
application fee

ADJACENT RIPARIAN PROPERTY Cyrd R STATEMENT
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I hereby certify that I own property adjacent to
P444 ,-� Is property located at
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(Name of Property Owner)
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(Lot, Block, Road, etc.
on _���rC ' C_l1A� - in ��L�l.(T�C �6�e� N.C.
(Water (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 DEVELOPMEINT:
(To be filled in by individual proposing development)
i 1 AI TeAl A 6 ��e
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Print or Type Name
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Te'.pphone Number

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to
Is property located at
(Name of Property Owner
';_�W �< S'f � L (D�(067
��v r S oU�6YJ ( Lot, Block, Road,. etc. )
on L%eC5i��s in N.C.
(Waterbody) (Town and/or County)
He has described to ine, 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 DEVELOPMENT:
(To be filled in by individual proposing development)
9141 h` T,��7K/4 j elf-
11111111111111
Cxis{-r,.rq 7o+ems
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o c /Z04'F SL r(o.
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Signature
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,.:t or Type Name
Telephone Number