18635_JOHNSON, LARRY_19980512

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CAMA AND DREDGE AND FILL
GENERAL
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 -
ou. yam. q�i1�
Address
City State
Project Location (County, State Road, Water Body, etc.) —
zip 7S V
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
(SCALE:
Other t �'
�G'',! 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 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
1
J w %
applicant's signature
f permit officer'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
Management Program.

TIM
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First -Citizens Bank & Trust Compaciy
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Raleigh; North Carolina
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THE ORIGI{J� L DO•'�I• EN HEATS 7E
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APR-03-58 FRI 01 :01 PM COOPER 213 876 8611P. 0 1
ADJACFI,%rT ��-C�✓i � � C� t �:s�4 ��
AR%A,�v ,
(1'6R A PIEh'IUNCOVER D WAT LIFE
I certify that I own rr� �
oww
hercby ce
� �rh' a�jaccnt to
('w`anie 4f ProperEy O�vrtEr�^
Property located at / o —� n! .
�jt�
(Lot, $tack, -Road, etc.)
I
on in : c_ , N.C.
�o
(Waterbody) wn and/or,Cduuty)
14e has described to me, .as shown below, the development he is proposing .It that
loradon', and, I have no objections to his proposal- I understand that a pier/uncovered, boat lift
must be set back a minimum distance of fifteen feet (15') from my area of riparian access unless
waived by,.me.
T gavot wish to wave the Schack requirarnem.
I t r wish to waivy that setback requirement.
S------------------------
I'
ESCioN AND/OR DRAWLdG of pROPUF�D��y�
(70 lied in by Wtyid'Ua proposing development)
--------------------------------------------- --- ----------Signature
--------------
?nr.t or Tye Name
Te':ephc,ne Number
r,
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