21571_EVANS, PETER F_19990428

O
CAMA AND DREDGE AND FILL
GENERAL,,,/71"'(....
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
Applicant Name Phone Number
Address I
City State Zip
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
Ll
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.
(SCALE:
7)
applicant's signature
permit officer's signature
Li 1
issuing date expiration date
attachments
(S�iiK t ,L V
application fee

Name i/! rG It
Date / ^ Z o / g
68-783/531
to
the Orr N
the der o1:
� ollars
30239-NC (9/97)C/ ACCOUNT NUMBER AMOUNT
* 5461 113214$ 50.00
TACHoyu
Wachuvia Bank, N.A.
Raleigh, NC P EO A4-15
II' �0444871(1 1:053 107633-1i: L
P,e 1,���-

MIN
I hereby certify that I own property adjacent to �� "c"-?� �V�►�(
s
(Name of Property Owner)
property located at 3704 Emercic1 DrIVb Ernerekld j.-le . MC.
(Lot, Block, Road, etc.)
on U Q So tin a , in Co- r--+ , N. C.
(W aterbody) (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 DRAWI'Vi �G OF PROPOSED DEVELOPMENT
(To be filled in by individual proposing development)
JJ
N.
Sigrl�:ture
Print or Type Name
Telephone Number
Date:/

. .1 . ADJACENT Rr-PARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to
property located at 3 V D L-- Fm e.I-mil
(Name of Property Owner)
Dr P'vy-� ercfl d 5) e. k1 r
(Lot, Block, Road, etc.)
on 350 U 2- SO u n C in CCC' —+- C"re+ , 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 DEVELOP M
rp e C,
1�7
Signature
Print or Type Name
Telephone Number
Date:
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