13111_FENNER, SUSAN_19940701

Applicant N4T
Address
City'
CAMA AND DREDGE AND FILL '
GENERAL � . I Jt CJ -'C 1 111
PERMIT
as authorized by the State of North Carolina
Department of Environment, Health, and Natural Resources and the. Coastal Resop,rces Commission
in an area of environmental concern pursuant to 15A NCAC % f -0 % !6 !'
Phone Number �!/
Project Location (County, State Road, Water Body, etc.)
Type of Project Activity fh r, h t� i .k A 4 G
State Zip
PROJECT DESCRIPTION
Pier (dock) length
SKETCH.C5
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-1
(SCALE:
Groin length
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numberT.
Bulkhead length
r
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ax. distance offshore
1—
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IX J
�.� t., A✓'� �� _
Basin, channel dimensions
cubic yards
i
1•
Boat ramp dimensions
Other
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. r.
This permit must be on the project site and accessible to the
permit officer when the project is inspected for compliance.
applicant certifies by signing this permit that 1) this pro -
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.
issuing date
applicant's signature
permit officer's signature
expiration date
attachments/ _ f /4 r 7 .7 /I t! 6
application fee q r� / eq 4! / / e/ 2 r,

Now
SUSAN FENNER 66 12 1442
P. O. BOX 12 9yr-J��q 53'
MERRITT, NC 28556
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AWACEW2 RXPAUXAN PROPERTY MHM STATEMENT ­-
• I *hereby. certify that •X, own property. idj Ucdnt.-._to:_­..
_Mopgr tY
-si (Name ..ofPXoparty. Owner)
(Lotj, Blc)bkj, Road r etc.
on in
aterway) (Town j3d (or.,County):,-
ge:-his- -described to 'me,, as shown below,,.'.the ddvoIopm'e­n­t'-h0'
a and;'I have no, objections. to his proposing.,�t 'that location,
1.
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DESCUPTrOM ANDADR.-DRAWING OF PROPOSED DEVELOPMENT:'
(To be filled y individual, proposing development)
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Print or Type Name
Telephone Number
Date
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• ADJACENT RIPARIAN PROPERTY C*NM STATEMENT --- �
I 'hereby . certify that I own property adj scent' -to-
Is
pr
• :y',�' f -,z�operty-Socated at
•• _•
(Name ..of,,-. Property. Owner)
(Lot, Bl , Road, .etc.)
on . its• .. infit/d►J;GLc,
7. ( aterbody) (Town and/or.County)
"Ho'has' to as shown below, the devalopment he is.
proposing , at :that' location, .and; .1, have no. objections' to his
proposal. , .. ,
--------------- -
DESCRIPTION AND OR.'DRAWING OF PROPOSED DEVELOPMENT;
�• (To be filledYindiv
idual. proposi
ng development)
opmen t
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Signature
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Print or Type Name
Teldphohd Number
• Date
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