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CAMA and DREDGE AND FILL
G E N E R A L W ���tis -
; /111 <. ,.. -17
PERM I T 41
as authorized by the State of North Carolina '`' i c.y I i,iA
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 1 :.�,� • f 1/1 714
Address
CityState Zip
Project Location (County,
State Road, Water Body, etc.)
Type of Project Activity
PROJECT DESCRIPTION SKETCH
Pier (dock) Length
tlf(
{ i
(, !
i C , Ire
4'
TT
(SCALE:
Nine
)
C,
e
LAI,
Groin Length
number
Bulkhead Length
max, distance offshore
(
/
i Z,
F.
} .
`C, _
j 3( F Ik
5t
1
r
Basin, channel dimensions
a•
cubic yards
(
- 4
Boat ramp dimensions
LL
other
=+
1+
'_
k ,t14
LM
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.
issuing date
applicant's signature
permit officer's signature
3 ?- _1
expiration date
attachments
application fee
MONITORING & COMPLETION REPORT
[CAMA Major Development & State Dredge & Fill Permits]
PERMITTEE' S NAME: S lr vcr T xr c PERMIT #2 7 90/ _
LOCATION: 93 y Spa W fc Dr: ve _ FIELD REP. SAa vex
Ne , Pn,4- w c PHONE: g3 $ —Dl6 3 <�J) DATE REPORTEDLY COMPLETE: 6, 7Oo/
1) Do the sured dimensions of the development differ from those indicated in the permit and workplat?
YES/W[circle one].
COMMENT:
2) SEDIMENTATION &XAOSION CONTROL: Has Permittee seeded, grassed, or otherwise stabilized
all disturbed areas? NO [circle one]
COMMENT:
3) FUTURE MONITORQJQ & ENFORCEMENT ACTION: Is further investigation or enforcement
action needed? YES/ O [circle one].
COMMENT:
E6540294092 010 416
SERIAL NUM
PAY TO
ADDRESS
Y
.. �
285521 *100*D0
Y POST. OFFICE>--
"�"U S 00 LIARS AND CENTS
C HECKWRITER Al 13
0 1
IMPRINT AREA d
FROM
\.�
A DDRESS/.-7) . _..
'-0BED FOR (—
NEGOTIABLE ON
I:Q0000800 21:
86 S 4 0 29409 21I'
ONS
JAB R iP ik+4 *0PpFXRTy SrATLjVi',Wj,
(AX-R A 21MUNCOVERM B0,Aj- - In)
1 hefty cerdfY t1kit I own propm ry Adj t °.. /'`_ ._ ,S
(N41n4�rtv '
Pam' Ioc W V a2 _,- *ai •• ..� �!
(may IM ' etc.)
an
frown an&
He tug des ite-A �o jr a, as .sho" below, the davelopffa.; et he ;.s prvWsing at that
location, uid, 11uvv :wrs vb ns to his proposal. I undue avt a po�lt��re� bws li�t't
must be set bark st �����,1,,. ,un dUwce of fifteen feat (151) f om my arm > u--;p►axfaun acd°rss emless
waived by me,
r- l do ;u�#j ti a,ikive the setback requirement,
I a: tc vidve flux shack requireamt.
]�F�t" IRb L m: < fOR �`sR�4►i�VM OF PROPOSED; z ",�_t :! T:
'o he ,WUd in by usdi'vid&&d pmp using davvI60,; ;, -.0)
s1pature
Print or Type ic
%6
Telephone Number
ADJACENT
IherebycerdfytkatIoT°.+Mp 'y'pdjt
• ihlame �� ' �-ry �n��
property loaded at _
sGIA4Doted, ems.) .�..� .�...s.�
onin
yi Wn aasd/or Cotwly)
He has dect fiV4 ►o AT,^ #s shown below, the dcvrlopti;t:,t he :s s aNsing at that
toatiOn, 1,41d, I hart M 0 ons to his proposal. I underswW L4t a ppecfuricovered kw lift
must be set bark a,-44'1i.ua n dszrce of ilftcen feet (151 from my WOR 41' -'-jparian a cr=s )MIMS
warred by me.
..., I do M4 wish ri ws;ve the se d ark requirement.
I itu wr,Fh: to W*Ive that srmck require neat.
?IRA WING OF PROPOSE �;, �� ♦' �" �-➢x�'1'�;k T:
.f'o bs ,WUd in by in&vi ud proposing develcop,.a -P)
1ZY pro "SG�
g4.2�
G�
l �oc-f= �rcb os►�i 7 -� �� G r
l y'..4 J_� NO ,Doc w A 4
S9
i (Y
lPrint or 'Ij►pe Name Q�
Telephone hlumbe
Imo:
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