21102_BEDFORD_19981112

1� `
CAMA AND DREDGE AND FILL°�
GENERAL ' 0M112 C
PERMIT t*>1 I
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
r
Applicant Name Phone Number
Address
City State Zip %'
Project Location (County, State Road, Water Body, etc.)
Type of Project Activity ! �► .�� -nJ' //'i
p1 yy �'Y? v-elljj
PROJECT DESCRIPTION SKETCH L 10 /4 (SCALE: f )
Pier (dock) length
t
Groin length
number
Bulkhead length
max. distance offshore
Basin, channel dimensions
cubic yards
Boat ramp dimensions �.,
,l
Other
i
}
9
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.
In issuing this permit the State of North Carolina certifies that
this project is consistent with the North Carolina Coastal
Management Program.
p
s
permit otticer's signature
issuing date expiration date
attachments ✓� C
i
application fee A r�'

I hereby certify that I own property adjacent to f�j r�-<, '1_� ( .� 's
(Name of Pro
.::. party 0��:?-
property located at
GlAt, Bock, Road, etc.)
_ s 171
OPt- CQi2�pQ
(Waterbodv) -- —� =ia N.C.
(Town and/or Count)
(., (r•Q,'L-r'z;�ot� /SOIn.,"� Rive Q.- -
He has described ±e' „ _G:.
_ L, �� a< s�i ��vn below, the development he is piopa„tl,�,
and, I have no ob j rctiou
DESCR t. ➢R DRA NWG OF PROPOSED T�� ::, •, ' -
• &x by dividual proposing developmi;--dA
Signature
Print or Type Name
Telephone Number
Date:

A-'
I hereby certify that I own property adjacent to F� eA,�o s
�c
(Name of Property Owner)
property located at
(Lot, Block, Road, etc.)
on C,C-h \ e. N.C. in , J'Ut�-��2-� CG..�2�� ��� C�
(R'aterbody) (Town an or County) " f
C�V,2 V
He has described to me. -as _shown below, the development he is proposing at flap 1 : cbny
and, I have no objections to his propr,3aj.
DESCRI MoN- /OR DP.;A YVDTG OF PROPOSID DEVEI;OP;�IFA�
T ,' • ti
(To be filled Tat by individual proposing development) t= r
L c.,n �q "� � o v� n,
-11
I,
ID
�14 I I5' 1
pc,j ri
Print or Type Name
Telephone Number
Date: - � - r 9,