25687_BYRD, CLARENCE_20000614

CAMA and DREDGE AND FILL
25 6 87
,.t G E N E R A L
PERMIT
as authorized by the State of North Carolina
Department of Environment and Natural Resources and the Coastal Resources Commission
in an area of environmental concern pursuant to 15 NCAC
Applicant Name
Address
City
Project Location (County, State Road, Water Body, etc.)
Type of Project Activity
IPROJECT DESCRIPTION SKETCH
Pier (dock) Length 1-77
Groin Length
number
Bulkhead Length
max. distance offshore
Basin, channel dimensions
cubic yards
Boat ramp dimensions
Other
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State
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 become null and void.
This permit must be on the project site and accessible to the permit of-
ficer when the project is inspected for compliance. The applicant certi-
fies by signing this permit that 1) this project 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.
Phone Number
Zip
(SCALE:
applicant's signature
permit officer's signature
issuing date expiration date
attachments
application fee

IMPORTANT MESSAGE
FOR
DATE
TIME P.M.
//l)�O
M iCc r C � 'Bc/ r
OF
PHONE
AREA CODE
Cl FAX
NUMBER EXTENSION
O MOBILE
AREA CODE
NUMBER TIME TO CALL
TELEPHONED
PLEASE CALL
E
CAME TO SEE YOU _
WILL CALL AGAIN
WANTS TO SEE YOU
RUSH
RETURNED YOUR CALL
i SPECIAL ATTENTION
MESSAGE
ex ' 3 �FML�(.� 4 le
SIGNED
FORM 3002S
MADE IN U:S.A.

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;11MAC EN'I RIPARIAN PRO I'll" WI N' OWNER S'1'ATF11NIFNT
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f hert•hc cartifilit;jt. 1 �rtt•n pr�if7c��ty rirljar•��nf tc� _ —
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O alcu1`►r►dy)
anif/m. ( •c►lmty)
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f le. has derwribed to rue, is szho�vn helow. the development he is ploposinu at that location, and, i
have no objections to his prol os,1l. l understand that a pierhrnr;over-ed boat lift rnrrst he sM hack a
rninirrium c115tance. offifteen feet (f ;) fiOm rtty area c►friparian access imless waived by me
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�' 1 S�i�.1Y.lxlr ter ��•�ti�.e Ihat st�lf7ack iccltrirerrterrt
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AD-11M.'i N 1 RIPARIAN 1'it()1'i R t i� ()ti��[VEM I i1 � ��,MU"N ll
(.l OR ,4 P//,'Ril./'N('0I'l wj) BO ,17,1,llq)
! hertht ce+tifv Iit:�t. l moil i)Tcrpci(y sadjar("nf It)
rtmc �at� Pr�Fu�rt}' rtFt-}
mt
(«'satei'F►c►dy} I Ta anJ/oI. ( 'ract111N )
Ile has dc.Neribcd it) mc, as shop vtt lmmv. (lie develohnaenl he is hloposinu al that location, and, i
hay e no obiections to his proposal 1 ttn(et:Stand th<•tt a hies/uncovered boat lih tnnst he sM hack a
minimuttt distance of fiffeen feet (15) fiom n)y area of riparian access !)nles-, %va.lved by me
1 dl)-091 Nvldt to the wtllack mluiremcnt
vl�vvi,it. to rvaivc ih:al s;,tback Tccluirement
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