10786_General Permit_19920603

CAMA AND DREDGE AND FILL �` v
GENERAL
PERMIT C, N76 10786
as authorized by the State of North Carolina
Department of Environment, Health, and Natural Resources and the Coastal Resources Commission
in an area of environmental concern pursuant to 15 NCAC 7 / R r l`
Applicant Name , -"`"'` uy-� Phone Number
Address s i H E
City ��t /� State ✓c zip k 5,6
Project Location (County, Sta^te Poad, Water Body, etc.)��
(lit ){ - t ,�'lc+¢t/�
Typ of Pr ct ct'vit �� �'��� t/ L i� rl
PROJECT DESCRIPTION
SKETCH f��jy
/ ii`
►r) 1;(�
1 I
(SCALE: { )
y
Pier (dock) length � � K �
Groin length.
r
I v 5
�
p
number
Bulkhead le�th
max. distance offshore
Yo
Jl-
3 a
Basin, chapnel dimensions
cubic yards
l
Boat ramp dimensions
I
Other
y�
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 fin;
imprisonment or civih 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
issuing date expiration date
attachments Ii C /i C �,// / �
c
In issuing this permit the State of North Carolina certifies that
this project is consistent with the North Carolina Coastal
Management Program.
application fee �� Q
d & y v _? §2

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ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to
V C C k Q,4 Is property located at
(Name of Property Orrdner)
i (Lot, Block, Road., etc
on -Tip►'-.� i � ,'� F�,, �r�y � in A/ I=,,J 13 EPO ., t N . C .
(Waterbody) (Tcrdn 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 DEVELOPMENT:
(To be filled in by individual proposing development)
County of
State of
J
Notary Pt;blic .
My Commission Expires:
k1i r'y PH �O ra °eta➢
Print 6r Type Name
Telephone Number

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to
V E C E Q 14 Is property located at
(Name of Property Owner)
c�ro�Gi Lye e k, -rJY .
Lot, Black, Road, etc.
on —7 1?i; i 2-a'o F-, , w7)?) (f2G�LJ in /(/ k'i 13IZ.). (2j?V,,r�.y , N . C .
(Waterbody) (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 DEVELOPMENT:
(To be filled in by individual proposing development)
County of �� �,✓
State of
Notary Public
My Commission Exaires: ,,- 9- 9?
Signature
Gf,l'4E I`I21 Lo �J
Print or Type Name
(6 3 9-- g 3 -7 -;L
Telephone Number

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