28058_HERRON, MARK_20010613

CAMA and DREDGE AND FILL (s
G E N E R A L
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 Phone Number
Address 3C ��•�-�
city_���(C -- - -- e zip — --4:
Project Location (County, State Road, Water Body, etc.)
Type of Project Activity
PROJECT DESCRIPTION SKETCH
(SCALE:
)
z
Pier (dock) Length
( }
4
Groin Length
number
Bulkhead Length
1
max. distance offshore
Basin, channel dimensions
cubic yards' €
','
_
Boat ramp dimensions �n
Other
Z
...
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 become null and void.
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 Carolina certifies that this project
is consistent with the North Carolina Coastal Management Program.
applicant's signature
permit officer's signature
issuing date expiration date
attachments
application fee

2615
DOBKINS AND KRIEGERS MARINE fa'4'�
66-30/531
O ' AND GENERAL CONSTRUCTION Date �``� 342
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Pay to the
Order of C Dollars
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nLvJ K J 1 H 1 t dUr-1V 1
(FOR A PIERIMOORING PILINGS/BOATLIFT/BOAMOUSE)
I hereby certify that I own property adjacent to 172a 'k Ye "'-a h is
(Name of Property Owner)
property located at 7 0 % 2 5o vti d
(Lot, Block, Road, etc.)
on d , in � -T , N.C.
'TWaterbodv) (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/mooring
pilingslboatlift/boathouse 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 the setback requirement. /
I to wish to waive that setback requirement.
DESCRIPTION AND/OR DRA WM OF PROPOSED DEVELOPMENT:
(To be felled in by individual proposing development)
1 ZX < v'
o /h-A v
Signarure
Print or Type Name
Telephone Number
Date:

FROfl1 1,.10MEN'S HEALTHCARE PHONE N0. it -in. 01 FJOI 10:5SAfri PI
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(FOR A NEifAWOORTnir'., NUNGSIBOA rLiF-118UA -IW OVSE)
I herby =dfy !hat 16VM property 42c= W
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at— 70/ 1- -
iLOL,
VwMrbody! town andior C.atinty)
He has de=d W W mot, as 3h w baiow, dte drm' W mcit he is proposing at *= kxadon,
and, I have no cgecdans to ids proposal 1 rmdnd thu a pierlmoo in8
prTi p(bloadir m%&oM mug be wt bwl a minimum disz= of fifoaan fm (15') ftm -,y area
of ApuiAn k cess unlew waived by ,mac.
tirw+�rrw+tir
vy saiG
/ I g wish w waive ftl whack mquirement
DECC?'PTION A_�!Oa MAWN9 OF PROPOSED DEVTI nnNMN'r.
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Print or Tyke Naas
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Yclephc r Number

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MONITORING & COMPLETION REPORT
[CAMA Major Development & State Dredge & Fill Permits]
PERMITTEE' S NAME: PERMIT #
LOCATION: - FIELD REP.
PHONE: DATE REPORTEDLY COMPLETE:
1) Do th ' cured dimensions of the development differ from those indicated in the permit and workplat?
Y circle one].
COMMENT:
2) SEDIMENTATION ROSION CONTROL: Has Permittee seeded, grassed, or otherwise stabilized
all disturbed areas? /NO [circle one]
COMMENT:
3)
action needed?
COMMENT:
O )[circle one].
Is further investigation or enforcement