13091_LEE, ALBERT_19940623

F
CAMA AND DREDGE AND FILL
GENERAL
PERMIT C 9rc;
as authorized by the State of North Carolina
Department of Environment, Health, and Natural Resources and the Coastal Resources Pommission
in an area of environmental concern pursuant to 15A NCAC 1�' r?r
Applicant.Name L •0--r Phone Number �� f
Address
City n;_^ State t Zip i7
Project Location (County, State Road, Water Boy, etc.
J dOn
Ty Q of Project Activity <, r C. 4r ^ ,
PROJECT DESCRiPTION
Pier (dock) length
Groin length
number
Bulkhead length
ax. distance offshore
Basin, channel dimensions
cubicyards
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 -
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.
(j,
applicant's signature
permit officer's signature
i.
issuing date expiration date
attachments / �/ !
In issuing this permit the State of North Carolina certifies that
this project is consistent with the North Carolina Coastal application feel
Management Program.

Personal Account Information Redacted
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT (FOR A-PI444
oi4 l c,i T:m 7-
I hereby certify that I own property adjacent to TT L Li56- Vs
property located at a a a ?bt-4D —OR-
(lot, block, road, etc.)
on 1'Ylnl'j ffiA725 POND in / I1 L14-7PrfN.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 15 feet from my area of riparian access unless waived by me.
I do do not ish to waive that setback requirement.
64�9
(circle one)
Description and/or drawing of proposed development: (to be filled in by individual
proposing development) v
D'e oS�
L� r °64
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-D 0 c t<
Signatu
Name
Phone Number