10817_AC Monk Jr & R T Monk_19920608

CAMA AND DREDGE AND FILL
GENERAL
PERMIT coP:
as authorized by the State of North Carolina
Department of Environment, Health, and Natural Resources and he Coastal Resources Commission
in an area of environmental concern pursuant to 15 NCAC —1 � .j i f x,�
Applicant NameL'
Address
City
Project Location (County, S
S• l
Road, Water Body, etc.)
State
Phone Number ]
zip A g.5 S -7
Type of Project Activityv
PROJECT DESCRIPTION
SKETCH
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V"
(SCALE: )
�Ta•t;
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Pier (dock) length Ls�
(.
•�/{—�
`n`'
kP
f, A
Groin length
l
40'
number
-
Bulkhead length
4
max. distance offshore
Basin, channel dimensions
cubic yards
b'
.z
Boat ramp dimensions
`
f
�.i
Other
T_
A.&III
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.
The applicant certifies by signing this permit that 1) this pro-
ject 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.
/ applicant's signature
permit officer's signature
s, g dateto expiration date
attachments ISA�cAc_ 14I1A-e*,)
In issuing this permit the State of North Carolina certifies that tj
this project is consistent with the North Carolina Coastal application fee
Management Program.

T D EURE CONSTRUCTION TEL=9197284192 Jun 04,92 6:36 No.001 P.01
ADJACENT RIPhRIAN PROPERTY OWNER STATEMENT
(FOR A PIER)
I hereby certify that.. 7 own property adjacent to
's property
ame
located at � O e��
(Lot, Block, Road, etc.) nn nn
� inJif:_)�C7��
(Wat $ody ('town and r County)�
, on
N.C.
He has described to me as shown below the development he is
px0p09ih9 at that location and I have ho objections to his
proposal. I understand that a pier must be set back a minimum
distance of fifteen feet (151) from my area of riparian access
unless waived by me.'
I do not wish to waive that setback requirement.
I do wish to waive that setback requirement.
Description and/or drawing of proposed development: (TO BE
]FILLED IN By INDIVIDUAL )PROPOSING DEVELOPMENT)
signature
Name
Phone Number _T