10765_General Permit_19920717

Applicant Name:
Address
City
CAMA AND DREDGE AND FILL
GENERAL ? J
oil
PERM I TN© 107635
as autS-����, .���r / horized by the State of North Carolina i
Department of Environment, Health, and Natural Land o ResoZr7
' sion
in an area
ofof^environmental cc ern pursuant to 15 NCAC
P 4: �eZmm b e r c- U
(CpGnty, State IjZad,aa;er BQdy,
Type of Project Activit
Zip
l �rA.
PROJECT DESCRIPTION SKETCH r (SCALE:
Pier (dock) length
Groin length•
number /�C �r ( "� /l/ ,1
Bulkhead length
distance offshore
Basin, channel dimensions
cubic yards
Boat ramp dimensions
Other
% �Ii
AV,.
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, • it r applicant's signature
imprisonment or civil action; and may cause the pebe---
come null and void.
This permit must be on the project site and accessible —to — he
permit officer when the project is inspected for compliance.
The applicant certifies by signing this permit that 1) this pro-
is consistent with the local land use plan and all local
antes, and 2) a written statement has been obtained from
cent riparian landowners certifying that they have n•
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.
%J �permit ffice
atu re
/ issuing da expiration date
attachments Ila,
application fee o ���

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GENERAL PER?4IT APPLICATION INFORMATION
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APPLICANT'S NAME: SAhu.�L /y � /A-
/t (First) (Middle) (Last)
ING ADDRESS: 3 9 R � ✓e-Rs, a� P Rj ,
(PERMANENT)
X e w �eiN STATE A, ZIP :2 ffi
TELEPHONE: WORK ( ) HOME (_qJ7)
CONTRACTOR'S NAME: TELEPHONE NUMBER
PROJECT LOCATION: N.C. Hwy. # SR # Road/Street Name >?lPIP.
WaterwayMe-0
.�l1e0S /i-f t V� County Q_dA AA/
Town Me-0 Subdivision
C D PROJECT A
=.-:
PIER: Total dimensions of pier from MHW to platform
(Length) (Width)
'T' or 'L'-head platform
(Length) (Width) (Number of Mooring Piles)
Water depth at end of pier Number of Mooring piles
SHOUSE/BOAT LIFT: Length Width
Number of Piles Water Depth
BULKHEAD: #1 Total length wi
FT
Average distance waterward MHW
Maximum distance waterward MHW
#2 Total length
Average distance waterward MHW
Maximum distance waterward MHW
RIPRAP: Total length Base width from MHW
EXCAVATION: [MAINTENANCE 'ONLY']
Length Width 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
OTHER STRUCTURES:

ADJACEENT RIPARIAN PROPERTY OWNER STATIMMENT
I hereby certify that I own property adjacent to
': ), 1,1 Kl,,re Is property located at
(Name of Property Owner)
T, vc/i S�iJ� DIV.
(Lot, Block, Road, etc.)
on �,' 3 in r,PA"N , N.C.
(Waterbody) (Town and/or County)
He has described to me, as shown below, the development he is
proposing at that- t l oc t i cn , and, i have nc objections to his
proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
wA l Q �sc
r
Signature
oP� c.y19.e.v f Nouz Ic f/
Print or iype Name

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to
,S,A)1 rArlo1? 's property located at
(Name of Property Owner)
(Lot, Block, Road, etc.)
on in nflA'AN , N.C.
( a 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.
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DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
106N J
Signature
Print or Type Name
/. /
Telephone Number

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