10791_General Permit_19920615

O
Applicant N
Address
City
CAMA AND DREDGE AND FILL -
GENERAL
PERMIT �T�i 10 791.
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 7 t! ' -<- 0
Project Location (County, State Road, Water Body, etc.)
c_
Phone Number 7 9 3 " 2
Type of Project Activity �y �� 141 4 7 �P S I— �e 07 Q
Zip
d W S7�
PROJECT DESCRIPTION SKETCH , %�} )A� 4, I (SCALE: )
Sa
30
Pier (dock) length
Groin length;
number
Bulkhead length i
I5v
max. distance offshore
!�
Basin, channel dimensions 1 f
cubic yards �0) r
Boat ramp dimensions 9
Other _✓' Li
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
_ Y —/ 7'
issuing date
attachments /y C A C ? p f? 0"-
In issuing this permit the State of North Carolina certifies that � �_e, (r r�
this project is consistent with the North Carolina Coastal application fee yt I"i P jJ
Management Program.
expiration date

Official Business
PENALTY FOR PRIVATE
USE, $300
Print your name, address and ZIP Code here
�l �L 1,4Al �S
NE ADI�% /V.�.��Y�✓�
i
JGIVIJr-n;
• Complete items 1 and/or 2 for additional services. I also wish to receive the
• Complete items 3, and 4a & b. following services (for an extra
• Print your name and address on the reverse of this form so that we can
return this card to you. fee):
• Attach this form to the front of the mailpiece, or on the back if space 1. ❑ Addressee's Address
does not permit.
• Write "Return Receipt Requested" on the mailpiece below the article number.
• The Return Receipt Fee will provide you the signature of the person delivere 2' El Restricted Delivery
to and the date of delivery. Consult postmaster f f
3. Article Addressed to:
5 EI/ 57kC00
PS5d
�A/ e 9 y, N. 6, �)'76 a
5. Signature (Addressee)
6.
PS
or ee.
4 Article Number ,
1�
4b. Service Type
❑ Registered ❑ Insured
L—Certified ❑ COD
❑ Express Mail �7 eturn Receipt for
Marrhanrfiso
7. Date of Delivery ..
8. Addressee's Address (Only if requested
and fee is paid)
, November 1990 *U.S.GPO: 1991-287-0ss DOMESTIC RETURN RECEIPT

CERTIFIED MAIL
RET;.1RN RECEIPT REQUESTED
L TT/1� �a (Date)
Dear Sir/Madam:
This letter is to notify you, as an adjacent riparian landowner, that the intent of
Mr/Mrs is to construct �X
it - \ J 1 A
on their property located at [clock # , Lot # V /Q(r'c�
(street address)
N.C. The sketch attached accurately depicts the proposed construction.
Should you have no objections to this proposal, please check the statement below, sign,
and date the blanks below the statement and return the entire letter to:
` n
I
, as soon as possible.
***** A self-addressed, stamped envelope is enclosed for your convenience *****
Should you have objections to this proposal, please send your written comments to:
N.C. Division of Coastal Management, P.O. Box 769, Morehead City, N.C. 28557.
Written comments must be received within: 10 days of receipt of this notice. Failure
to respond in either method within 10 days will be interpreted as being No objection.
---------------------------------------------------------------------------------------
(Response)
I have been advised by my adjacent riparian property owner, . �,�� _QA ,
(name)
of the intent to develop (-5�, ��� ra;m���zu� zs=. , ;�:-C.
I have no objection to the proposed development described to me, as it is presented.
If applicable, I understand that a pier must be set back a minimum of 15' from my
riparian access unless waived by me. In order for the pier to be constructed, I
DU DONOI one) wish to allot, construction to be within the 15' setback.
(Name)
� I ;UA—A' --_1 )J% (Street address)
I'sa (City, state, zip)
NA�,
\j (5ibnatt' c)

kc3y,y

_ ��
1 a'

I
r
L6