HomeMy WebLinkAbout13144_MILLER, HOWARD_19940825CAMA AND DREDGE AND FILL
GENERAL
() 144
PERMIT 621
as authorized by the State of North Carolina
Department of Environment, Health, and Natural Resources and th Coastal. Resources Commission
in an area of environmental concern pursuant to 15A NCAC
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Applicant Name "�" '� �% ��-" Phone Number
Address 572 17 F o
City f`
Project Location (County, State Road, Water Body, etc.)
Type of Project Activity'
PROJECT DESCRIPTION
Pier (dock) length ® t/ f
Groin length
number
Bulkhead length
ax. distance offshore
Basin, channel dimensions_
cubic yards
Boat ramp dimensions
Other
State Zip 5
SKETCH'S / `/�� L. S (SCALE: )
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- n
come null and void. � �
applicant's signature
This permit must be on the project site and accessible to the permit officer's signature
permit officer when the project is inspected for compliance. ,
1 !r
The applicant certifies by signing this permit that 1) this pro-
is consistent with the local land use plan and all local issuing date expiration date
riances, and 2) a written statement has been obtained from
adjacent riparian landowners certifying that they have no [ C
objections to the proposed work. attachments
In issuing this permit the State of North Carolina certifies that ? ,
this project is consistent with the North Carolina Coastal application fee.7�7
Management Program.
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6048131.5265 940825 2856 00
YEAR MONTH, DAV POST OFFICE U. S. DOLLARS AND CENTS
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SERIAL NUMHER 1"I
' CHECK WRITER
PAY TO IMPRINT AREA
gQQ00Q800 21• 6048 13 6 5 26 Sil'
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ACENT RIPA.RIAH PROPERTY OWMER STATEMENT -
_ 'hereby certify that I� own property �adj acen` .to
f r:r 1,41
y 's-property-located -at ---
'; (Name : of ; Property., Owner) = -
(Lot, Bloc ,Road, .etc.)
J16-0/3c : C.
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(Waterbody) '(Town d/or.,Couaty) -
:-:• •. .. ,.: ... • " ., •o the dev 10 ment he is • . !' '' : .
ie`'has' described to 'me, as shown bel w, s p
proposing , at 'that ' location, and; I have no. objections ' to his
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DESCRIPTION AND/OR 'DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individualproposing development)
P'J I L '
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Print or Type Name
�relephone Number
Date
�'i•j lfS^��fY'tl` �'��tP ,....sv .:.� K.t.,,,.�,i�r5. .,,. �. �Y�... �, �.. f: �,...}.. 4,r. �.,.s r: •i'-A'a •. r�, t: 9+y�!�,�:.�•���•oh r>>. ..
aa.. Rn � m •t ._ l.:a �: �+�-. _ .. S .;� ' . � d ' :enw_ .:.:.1,,.. w. . a• i,: -F a .e .¢ ... .... .....� w ... ..n.... ra.• • ti.;r.�r .�
ACEkT nIPARXAV PPOPMTY aMM STATEMiM
I'hereby certify that 1, ovin property adjacent'
-located' at.'
.60s.1, (Name ..of-,
r2 4kr7 I Aj I pn
(Lot, Block, Road, etC.)
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in
(WatenFRY) (Town and/or, coun .Pe., has, *d scr bed-to*me, as shown below, the ddval
opme n t he
proposing lat:that 'location, and; .1 have no. objections' to his
prpPosA.1..
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DESCRIPTION AND/OR*DRAWING OF PROPOSED -DEVELOPMENT:
(To be filled in by individual. proposing development)
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S ature
C.) a I L- F-
Print or Type Name
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Telephone Number
Date
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