13080_FORDHAM, J.M._19940524

CAMA AND DREDGE AND FILL ^� r , -';
GENERAL `''7 13 "M
PERMIT
as authorized by the State of North Carolina
Department of Environment, Health, and Natural Resources and the Coastal �esources Commission
in an area of environmental concern pursuant to 15A NCAC
Applicant Name 'Ar Phone Number
Address 4 -�'✓ `
City 1. / State r Zip
Project Location (County, State Road, Water Body, etc.)
Type of Project Activity .� �� ° i t'"' �- L- X
PROJECT DESCRIPTION SKETCH 1,4, /"'r s,
Pier (dock) length
a _
Groin. length
f-
av 4a r -
number
° ..
Bulkhead length, k
� i I
ax. distance offshore
Basin, channel dimensions _
Y .k
cubic yardsX4
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.
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 -
qRis consistent with the local land use plan and all local
nances, and 2) a written statement has been obtained from
adjacent riparian landowners certifying that they have no
objections to the proposed work.
' applicant's signature
permit officer's signature
issuing date expiration date
attachments I ` 214 1 4 1)
In issuing this permit the State of North Carolina certifies that
this project is consistent with the North Carolina Coastal
Management Program.
application fee

LARRY G. ARNOLD 66-152/531
P 0 BOX 2277 0777
MOREHEAD CITY, NC 28557
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Wachovia Bank of North Carolina, N.A.
Morehead City, NC 28557
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ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER)
I hereby certify that -I own property adjacent to
Name
located at
's property
, on
(Lot, Block, Road, dtc.)
in ` r/ N.C.
(Water Body) (Town and/or County)
He has described to me as shown below the developmeii- e is
proposing at that location and I have no objections to his
proposal. I understand that a pier must be set back a minimum
distance of fifteen feet (151) from my area of riparian access
unless waived by me.
I do not wish to waive that setback requirement.
I do wish to waive that setback requirement.
Description and/or drawing of proposed development: (TO BE
FILLED IN By INDIVIDUAL PROPOSING DEVELOPMENT')
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gnature
n/ G V D .T
Name
Phone Number t

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER)
I hereby certify that -I own property adjacent to
F
J ' N
located at
"s property
on
�Q (Lot, Block, fRoa�, etc.)
n i_ . N . C .
(Water Body) 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. I understand that a pier must be set back a minimum
distance of fifteen feet (15' ) from my area of riparian access
unless waived by me.
I do not wish to waive that setback requirement.
I do wish to waive that setback requirement.
Description and/or drawing of proposed development: (TO BE
FILLS IN By INDIVIDUAL PROPOSING DEVELOPMENT)
Gam:
gnature
Name
(qi?)-- )3fool
Phone Number
Nr
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