10739_Charles Roming_19920423

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Applicant ar
Address 6
City
04CAMA AND DREDGE AND FILL
GENERAL
F 4 +'
PERMIT Of Ni101"39
as authorized by the State of North Carolina
Department of Environment, Health, and Natural Resources a�dAhe Coastal F39sources Commission
in an area of environmental concern pursuant to 15 NCAC C// ! 2
Phone Number l0
0
State
Pro' ocation (County, State Road, Water Body, etc.) E
Type of Project Activity X
PROJECT DESCRIPTION
Pier (dock) length 2 X
Groin length,
number
BulkFied�length
max distance offshore
Basin, channel dimensions
cubic yards
Boat ramp dimensions
Other
SKETCH
Zi
(Y
J7 _11�7d
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------ — .. _ 70 Tom^
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
�i issuing date expiration date
attachments C C f �/ 4)
In issuing this permit the State of North Carolina certifies that) OQr� L,I
this project is consistent with the North Carolina Coastal application fee i Ir
Management Program.

APPLICANT'S fViME:
GENERAL PERMIT APPLICATION INFORMATION
e4igre.1,FS
Hrr...ING ADDRESS:
(First) //
(Middle)
(I.:St)
(PERMANENT)
`V
STATE Al C
ZIPo?� ZS
TELEPHONE:WORK (
)
HOME
CONTRACTOR'S NAME:
F d' � � F
,
TELEPHONE NUMBER asps
_
PROJECT LOCATION: N.C.
Hwy. # SR # Road/Street Name
C%^
Waterway Name Sl-7Ctl e Ce r
County
UFO
Town
Subdivision Figirz9'"a4c0
PROJECT ACTIVITIES
PIER: Total dimensions of pier from MHW to platform
(Length) (Width)
IT' or, 'L'-head platform tiO /,.) h
(Length) (Width) (Number of Mooring Piles)
Water depth at end of pier A Number of Mooring piles IV 6,*J F
r T HOUSE/BO:�T LIFT: Length Width
Number of Piles Water Depth
BULKHEAD: i/1 Total length
Average distance waterward MHW f (0
Maximum distance waterward MHW
#2
Total length
Average distance waterward MHW
Maximum distance waterward MHW
RIPRAP: Total length
EXCAVATION: [MAINTENANCE 'ONLY']
Length Width
Base width from MHW
Depth of Cut
Adjusted water depth on MLW Existing water depth(s)
Estimated Cubic Yards (length x width x depth/27)
Type of spoil: Sand Mud
Dragline Backhoe Hydraulic
U: 'il 1R STRUCi U j "m

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ADJACENT RIPARIAN PROPERTY owNER STATEMENT
(FOR A PIER)
I hereby certify that I own property.adjacent to
(Name of Property er) s property located at
ko?'alo
S' C S
Lot, Block, Road, etc.
on �Zi Crtxra , in ti6,0 9,%w CR a/iiJ , 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. 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.
li
I
do
not wish to waive
that setback requirement.Decic_
'. ✓
I
do
wish to waive that
setback. requirement.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
- 8-
County of
State of
Notary Public
My Cominission Expires �- �z
S gnature
Print or Type Name
_WJ- lyyg
Telephone Number

ADJACENT RIPARIAN PROPERTY OWNER STATEmzNT
(FOR A PIER)
I hereby certify that I own property.adjacent to
C ho2� Is property located at
(Name of Property Owner)
SAS
(Lot, Block, Road, etc.)
on SP crfi L in tiF� 5)?V4' N.C.
(Wa erbody) (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 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.ao�-/c
I do wish to waive that setback requirement. !3o//C4
DESCRIPTION AIM/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled Jr_ by ind3 i 'vidual proposing development)
0
County
of
State
of
f >
l
Notary; Public
My Commission Expires: 6' % y
/ Si97nature��.
1zeO zz
_.Print or Type Name
'elephone Number

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