HomeMy WebLinkAbout26902_GOODWIN, RODNEY_20000913CAMA and DREDGE AND FILL -
G E N E R A L
PERMIT
as authorized by the State of North Carolina
Department of Environment and Natural Resources and the Coastal Resources Commission
in an area of environmental concern pursuant to 15 NCAC
Applicant Name �C�('��tl Phone Number
Address
City
Project Location (County, State Road, Water Body, etc.)
Type of Project Activity
PROJECT DESCRIPTION SKETCH
Pier (dock) Length
Groin Length
number
Bulkhead Length
max. distance offshore
Basin, channel dimensions
cubic yards
n
Boat ramp dimensions
other
State
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 become null and void.
This permit must be on the project site and accessible to the permit of-
ficer when the project is inspected for compliance. The applicant certi-
fies by signing this permit that 1) this project 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.
0
Zip
(SCALE:
applicant's signature
permit officer's signature
issuing date expiration date
attachments
application fee
�o
NJ0NEY OnvL1Z
\Y.W.n,n,�uwV\\m\1TM\\lam\NNyi1\\plUt111 �pnutWj',ty�iry.�\l\itWttlt �,�+ xn�: .itt,\`,qT
;854821,72722 000914 28557 �
� L00*gyp
SERIAL NUMBER YEAR MONTH DAY
POST OFFICE" U DO
I
PAY TO S LLARS AND CENTS
C HECKWRITER. I- P I{ { II I `x3 I„I
IMPRIN
E
T ARA t
�f.'i �1. 1111
ADDRESS
FROM a ��• ,�
OR
EGOTCABLE ONLY-IN..7 L>r:'AND POSSES IONS
�:00000800 2�: 8 51 8 3 l? 2? 2 20
1�N - M1aNitY.\N�NO;N11\I„ttmt, UUI,vM\\WN\NY.\ \ \ .l•:iM1\X �,�1„`.v ��t„�„\\\\,r�\mtim.....��
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
,,��jj 7Z�!
I hereby certify that I own property adjacent to?/ ,(s
s
(Name of Property Owner)
property located at Z- 0 Z
on C4 '1 4
(Waterbody)
l /,? 6. e r/
Block, Road, etc.)
in 0&2 0 r -/' ,- <!�4 � �r - e % , N. C.
(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 DEVELOPMENT
(To be filled in by individual proposing development)
LA,
ignature
Pnn r ype Name
elephone Number
Date: !�- -3l 'D'
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
7Z- — Z?z?
I hereby certify that I own property ,.djacent tolnz'!' -: is
(Name of Property Owner)
property located at Z U Z // c-, ( D2/
(Lot, BV;—A, Road,
etc.)
on IF /
(K'aterbody) (Town and/or County)
He has described to me as shown be!(,, v, the development he is proposing at that locat;r:11
and, I have no objections to his pruljosa1.
DESCRIPTION AND/OR Iy ' ; 1ING OF PROPOSED DEVELOP ILN-T
(To be filled it r fnd7v dual proposing development)
Sig ature -
Print or Type Name
Telephone Number
Date: Pj-
40-
PERMITTEE
LOCATION:
-;�Cj //W1
MONITORING & COMPLETION REPORT 4/
[CAMA Major Development & State Dredge & Fill Permits]
l
' S NAME: PERMIT # -�)ip q0 D �C
- FIELD REP. L
PHONE: �O� DATE REPORTEDLY COMPLETE: icO-
--T
DATE OF INSPECTION a
1) Dot sured dimensions of the development differ from those indicated in the permit and workplat?
Y /NO circle one].
COMMENT:
2) SEDIMENTA EROSION CONTROL:
disturbed areas YFS NO [circle one]
COMMENT:
Has Permittee seeded, grassed, or otherwise stabilized all
3) FUTURE MONITORING & ENFORCEMENT ACTION: Is further investigation or enforcement action
needed? YES O [circle one].
COMMENT: