25633_COULTER, JACK_20000614

CAMA and DREDGE AND FILL
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 Phone Number =
Address
City State Zip "' -7 i
Project Location (County, State Road, Water Body, etc.) �.
1!11111111111113M
Type of Project Activity
PROJECT DESCRIPTION SKETCH
Pier (dock) Length - k i',
Groin Length
number
Bulkhead Length
max. distance offshore
Basin, channel dimensions
cubic yards
Boat ramp dimensions
Other
(SCALE: N' -i-4c )
This permit is subject to compliance with this application, site arawing
and attached general and specific conditions. Any violation of these terms applicant's signature
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- permit officer's signature
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 issuing date expiration date
land use plan and all local ordinances, and 2) a written statement has
been obtained from adjacent riparian landowners certifying that they l 'jr.'
have no objections to the proposed work. attachments
In issuing this permit the State of North Carolina certifies that this project
is consistent with the North Carolina Coastal Management Program. application fee

V, Jun 12 00 08:31a John Greene
1-919-870-0331 p.l
ADJACENT RIPARIAN PROPERTY OWNER STOEMLNT
1 Q1�Owner)
I hereby certify that I own property adjacent to t (Name or Pr•ol�
Property located at�,
(Lot, Bloch, Rond, etc.
on Ifl 1 1jt_r , in VC"i� N.C.
(Watet-body) (Town and/or Coutsty}
He ilas described to me as shown below, the development he is proposing at that location,
and, I have no objections to his proposal.
f
DRSCMP`rION AND/OR DRAWING OF PROPOSED DIVE-LOPmgNT
(To be filler! M by individual proposing developmeit4 j
�rpr r� (T I �rb r
Y' ^r-. l f 6 �� i l.• E�
n
Sig c
Print or Type Name
Tcicp!ione Number
Datc: 2 0
-29- i

jK
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to
(Name of Property Owner)
property located at
(Lot, Block, Itoad, etc.
-)
�
on �Ue , in r t ►LLJO-- 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.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(To be in by individual proposing development) 11
I CUU CtU _
Signature
Nancy ,D, Wel (fS -
Print or Type Name
Telephone Number
Date: 6 —`U — D0 _
—29—