10778_General Permit_19920519

Applicant
Address
City —L
PrQ�ect l.c
e
CAMA AND DREDGE AND FILL
GENERAL
s, i<
MEM
MINE
PERMIT � s M 10778
as authorized by the State of North Carolina
Department of Environment, Health, and Natural Resources and the Coastal Resources Commission
in an area of environmental concern pursuant to 15 NCAC �/� f/D� CJ Pei e�7
Phone Number
PROJECT DESCRIPTION
Pier (dock) length L
SKETCH f'J7-
/�
/r
b1
Groin length �'—
number
Bulkhead length
max. distance offshore
� a - -s-
Basin, channel dimensions
cubic yards
Boat ramp dimensions
Other
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- tQ
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.
In issuing this permit the State of North Carolina certifies that
this project is consistent with the North Carolina Coastal
Management Program.
(SCALE:
SCALLE:
iv
applicant's signature
permit officer's signature
�- -/ 7 '?g �) - / 9- F;
�J�rX issuing date! `/ expiration date
attachments /' c 711 /� w r/— / � (' �-)
application fee 0 D,O,J `mil ^ / l O
-9c4..,

ADJACENT RIPARIAN PROPERTY OWNER STATnnMT
I hereby certify that I own property adjacent to
_/ir ^% i xd 's property located at
(Name of.
4, r, MV
(Lot, Block, Road, etc.)
on in PJI: (29,9,i, N.C.
(Waterbody) (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.
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DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
�JFt'� tZa.��I �A1UL2 •
' 1
c 2H
J is'o4
�12 r-
County of'
State of 1
r3atary Public
my Commission Expires:
Signature
Print or Type Name
Telephone Number

i
ADJACENT RIPARIAN PROPERTY CANER STATEMENT
I hereby certify that I own property adjacent to
i 1 b 1, V d -A 's property located at
(Name of Property Owner)
�o� 1 (- uLL
(Lot, Block, Road, etc.)
onL , in I Ew f3f:'2fJ N.C.
(Waterbody) (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.
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DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
I
ki
r2
County of
State of
// ✓6La u��
ATotary Publie
icy Commission Expires:,
Signature-"
Print or Type Name
Telephone Number
z

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