18433_SCOTT, GEORGE_19970820

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Applicant Name
Address
Citv
CAMA AND DREDGE AND FILL
GENERAL. 6 cop
PERMIT
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 15A NCAC
Project Location (County, State Road, Water Body, etc.)
Type of Project Activity
PROJECT DESCRIPTION I SKETCH
Pier (dock) length
Groin length
number
Bulkhead length
max. distance offshore
Basin, channel dimensions
cubic yards
Boat ramp dimensions
Other
State
A-(
Phone Number
Zip
(SCALE:
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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.
attachments
applicant's signature
permit otticer's signature
issuing date expiration date
In issuing this permit the State of North Carolina certifies that��
this project is consistent with the North Carolina Coastal application fee w
Management Program.

I
I
hereby certify
that I own property adjacent to
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Is property
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located at o r- ��Ay�-on/ %,q y ,
r2A ia�E
, ice/
block, road, etc.)
on
Alm ✓5f
��► ✓�2
Alot,
in MLICJ �,> ✓�f7� , 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 this pier, bu-l�e-ad, xFE-o..in structure
(circle one)
must be set back a minimum distance of 15 feet from my area of
riparian access unless waived by me. I do t.wish to
circle one)
waive that setback requirement.
* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *
Description and/or drawing of proposed development: (to be
filled in by individual proposing development) ir1
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( ignature)
(Name)
6 3 741,3
(Phone Number)

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I hereby certify that I own property adjacent to
is property located at f o r /, �,�>,:�7�jT✓ �'��?�
J C ) lot, block, road, etc � on �� I'� �'�`� in f� M�iGo N.C.
(water body) (town and/or county)
He has described to me as shown below the development he is
I%07
proposing at that location and I have no objections to his
, Vic- " 1 V
proposal. I understand that this pier, bulkhead,.grein structure
(circle one)
must be set back a minimum distance of 15 feet from my area of
riparian access unless waived by me. I do 4e--r�et. wish to
(circle one)
wa i i..A +h? t setback rerTu i- ramant-..
Description and/or drawing of proposed development: (to be t��pPeE
filled in by individual proposing development)
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************