21165_BLANDFORD, JAY_19990127

CAMA AND DREDGE AND FILL N° 021165
GENERAL
PERMIT CRA r✓t, Co
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 0-7fi • I ZC
Applicant Name —Yet' Phone Number 25?•
Address kooGtQ!& G2. 1D•
City Aoty--" State r.1 G Zip 7-85t.a
Project Location (County, State Road, Water Body, etc.) ADSAteN-r TD :ZZtL41i C_ �V. OF * ►CAS C �►��fi�
t l (A n-tv) 01-N 5,�D^Jb C'TY c , —
Type of Project Activity�o E`i lSTit� �t�-ts- IrtAw Z� }��i ►��S vas �� .
PROJECT DESCRIPTION
Pier (dock) length
Groin length
number
Bulkhead length
max. distance offshore
Basin, channel dimensions
cubic yards
Boat ramp dimensions
OtherZ-
SKETCH AEC- - ?—A l e'J
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,hull 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' W 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.
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applicant's signatt
permit officer's signatu
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issuing date expiration d:
attachments
MR. t�oD
In issuing this permit the State of North Carolina certifies that (�
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this project is consistent with the North Carolina Coastal application fee ' tD-DZ>
Management Program.

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER)
I hereby certify that I own property adjacent to
�Ati i3 k,4- QJso' J ' s property
Name
located at
0le, co, �Y'
(Lot, Block, Road, etc.)
on
13Q.6n c2aEk- in ALEd 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 fifteen feet (151) from my area of riparian access
unless waived by me.
I do not wish to waive that setback requirement.
I do wish to waive that setback requirement.
Description and/or drawing of proposed development: (TO BE
FILLED IN BY INDMDUAL PROPOSING DEVELOPMENT)
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S gnat e
Name
Phone Number

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