24570_HENDERSON, RUDOLPH_20000613

CAMA and DREDGE AND FILL
G E N E R A L 24570
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
Address
City
Project Location (County, State Road, Water Body, etc.)
Type of Project Activity
State
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. I
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 Caroiina certifies that this project
is consistent with the North Carolina Coastal Management Program.
Phone Number
Zip
issuing date
applicant's signature
permit officer's signature
expiration date
attachments
application fee

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DIVMSION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION
-------------------------------------------------
Applicant's Name: RJ
Address Of Property: %ASS _D; >�'
Street #,
Applicant's Telephone Number
rs&.
Street Name, City & County
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I hereby certify that I own waterfront property adjacent to the above -referenced property. The
applicant has provided mp a drawing of the the proposed development. Please 'ni W the
statement below if you have no objections to the applicant's proposed development. Initialling
this block does not constitute a waiver of the required I5' setback from the riparian corridor
lines
this proposal.
v
Pint Name and Mailing Address
C,5�/a) 3.z G -- 70 9 .?
Telephone Number With Area Code
If you have objections to the applicant's proposal, do not initial or sign this form. You should
contact the Local CAMA Permit Officer listed below as soon as possible to register your
concerns:
Telephone:

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DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION
-----------------------------------------------
Applicant's Name: tie
Address Of Property: _ / 3 � _D
Street #,
Applicant's Telephone Number j' —
Street Name, City & County
CA
I hereby certify that I own waterfront property adjacent to the above -referenced property. The
applicant has provided me a draiNriniz of the the proposed development. Please inju the
statement below if you have no objections to the applicant's proposed development. Initialling
this block d e not
lines constitute a waiver of the required 1 S' setback from the riparian corridor
I have no objections to this proposal.
Signature c' Date
Print Name and Mailing Address j 3 p L Si_1 4 DR
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2� - loot
Telephone Number With Area Code
If you have objections to the applicant's proposal, do not initial or sign this form. You should
contact the Local CAMA Permit Officer listed below as soon as possible to register your
concerns:
Telephone:

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