HomeMy WebLinkAbout28054_LEWIS, LEA_20010606CAMA and DREDGE AND FILL'
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
Address
City
Project Location (County, State Road, Water Body, etc.)
Type of Project Activity
PROJECT DESCRIPTION SKETCH
Pier (dock) Length
Groin Length i
number i m
Bulkhead Length
max. distance offshore
Basin, channel dimensions
cubic yards r
Boat ramp dimensions
x ..
Other
Phone Number
State zip
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.
i'
issuing date
(SCALE:
applicant's signature
permit officer's signature
expiration date
attachments
application fee
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ADJACENT RIPARIAN PRO W OWNER STATEMENT2 8
(POR A FIERIMOOR06 PIUNGSJ)047i1PTIBOA1''ifOUSE)
I hereby certify that I wwn property adjacent to � � 1 o L C w ` <
(Nam of Property Owner)
ply located at 5 Ci EJ c1� : s!�L %-�1�,
(Lot, Bloch., Road, etc.)
I
on _ , in f 0 ( e N.C.
(W y) (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
pilingyb�'"oa�tziwsc must be at back a minimum distance of fifteen feet (151 from my area
Of ripar9an ac zu unless waived by me. -
I do wish to waive the setback requirement.
MAl�2y2bui I
ooi
I fg wish to waive that setback raquires=t.
COASTAL MAN�AGEM N
---------------------- -__ --- --- -- ---_- ------ MORENE,
DESCRIPTION AND/OR DRAG OF PROPOSED DEVELOPWM;
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Signature -
or
Tr.Iephone Number
Date: ymwZ iI�
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MONITORING & COMPLETION REPORT
[CAMA Major Development & State Dredge & Fill Permits]
PERMITTEE' S NAME: �Luo'
G 5 PERMIT # ,)�<5� —(f/
LOCATION: �c� ���; '�1 FIELD REP.
I —
PHONE:
DATE OF INSPECTION � I ,
I
DATE REPORTEDLY COMPLETE:
1) Do the measured dimensions of the development differ from those indicated in the permit and workplat?
YES& [circle one].
2)
3)
COMMENT:
: Has Permittee seeded, grassed, or otherwise stabilized all
disturbed areas? 3(/NO [circle
COMMENT: k
FUTURE MOMTORING & ENFORCEMENT ACTION: Is further investigation or enforcement action
needed? YES O [circle one].
COMMENT: