17845_SMITH, THOMAS M_19970623

CAMA AND DREDGE AND FILL '
GENERAL
PERMIT 0"r CC/
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
Applicant Name Phone Number
Address
City— r;. � ! �ir�7 State A/ C zip
Project Location (County, State Road, Water Body, etc.)
tj 7i r
7 �;� , s.. r', r%.r ! i L... i. l� f_:.�i..� /� / i'" i - �.�
Type of Project Activity"r =/.,! r - Pr ' f : i `,"r,, ,%%✓ u
u
PROJECT DESCRIPTION SKETCH (SCALE:
P14­(do'ck')'teAgth
Groin length
number
Bulkhead length
max. distance offshore
Basin, channel dimensions 1 1
j� -.
cubic yards :::.: =�'• �1� �7 - - /.G!'
Boat ramp dimensions /V
Other — — - ` 1 i _ - --- _.
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
f permit officer's signature
� 3 27 ri.
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
Management Program.
application fee

PATRICIA M. SMITH 66-25/531
THOMAS M. SMITH 29 4225
NCDL 2350255 2274757
119 BOWEN ST. 919-726-7668 n
ATLANTIC BEACI-11 NC(_ -
Pay Order of fhe %�
O-er of_ S[/ TTT�JJn��/,���///_^ $ 5-6,ari
j NamonsBank
Nations Bank, N.A.
Carolinas M
For eayyl&1 0/79
1:0 5 3 L ApC�
00 2 58'. 28 308 38 j,8n' 4 2 2 5

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT (FOR A PIER)
I hereby certify //thatt I own property
/
property located at !1 Y 5
001— J , L -k
A
) j (lot, block, road, etc.)
on int(.� , 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 set back a
minimum distance of 15 feet from my area of riparian access unless waived by me.
I do do not wish to waive that setback requirement.
(circle one)
Description and/or drawing of proposed development: (to be filled in by individual
proposing development)
%u
d
�y
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v
13A
F Sig at re
z
Name /
Phone Num er

�ry II,,
04/'25r 1995 04: 23
'9199672917
CHAPEL HILL TIRE
PAGE 01
ADJACENT RIPARIAN PROPERTY d[acent
ER STA"19MENT (FORA
I hereby certify that 1 own property a to 1 ti�7�1�5 lrl, (Y►�2.(�t, _a
property located at _
(lot, blo k, road, etc.)
on _4j In . OA A fU , N.C.
(water body) (town and/or county)
He has described to me as shown below the d velopmenl he Is proposing at that location
and I have no objections to his proposal. 1 nderstanC that a pier must be set pack a
minimum distance of 16 feet from my area ofI 1parian ai cess unless waived by me.
I do / do n2t wish to waive that setback rd uirement
(circle one)
.'i
Description and/or drawing of proposed deb elopment (to be filled in by- lAdldidual
proposing development) `
I
7nature
iaame l
Phone Number
1^U
Y n r P.�,