10741_General Permit_19920424

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Address 7
City
Project LWcation
CAMA AND DREDGE AND FILL -
GENERAL N V
PERMIT
k' 1 ; 41
as authorized by the State of North Carolina
Department of Environment, Health, and Natural Resources and th Coastal Resources Commission
in an area of environmental concern pursuant to 15 NCAC 7 c�
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ty,State Road, Water Bo y, etc.)
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PROJECT DESCRIPTION SKETCH (SCALE: A/ )
Pier (dock) length T-0
Groin length- a � ,a,,,r)U
number
Bulkhead length
max. distance offshore - Q
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Basin, channel dimensions
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cubic yards M
Boat ramp dimensions Alp
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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
permit officer's signature
issuing date expiration date
attachments _,9� < "rho C
In issuing this permit the State of North Carolina certifies that }�j
this project is consistent with the North Carolina Coastal application f �f �' �� -- 0,92o
Management Program.

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ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to
Name of
)v
roperty Owner
's property located at
T •y J 1
(Lot, Block, Road, etc. )
on in / " IQ Cr Q �i l , N . C .
(W terbody) (Town and/or C ty)
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)
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Print or Type Name
Telephone Number
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I
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to
c,l i f o f p / J 1 � Is property located at
(Name of Property Owner)
(Lot, Block, Road, etc.)
on !�-_�r�+�.�., , in i��rr�._p 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)
'I n IVA
Print or Type Name
0� �/- 1-3//i
ne Number

3069�

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