25659_DAVISON, TOM_20000720

CAMA and DREDGE AND FILL
G E N E R A L P E R M I T
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
PROJECT DESCRIPTION
Pier (dock) Length
Groin Length
number
Bulkhead Length
max. distance offshore
Basin, channel dimensions
cubic yards
Boat ramp dimensions
Other
State
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 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.
i
Phone Number
zip
applicant's signature
f permit officer's signature
issuing date expiration date
attachments
application fee

TOM DAVISON
SUE DAVISON
PH. 707-255-4760
1730 MILTON RD.
NAPA CA 94559
rf1 /o f/r• �w
iv or
Na
>i
SONOM VALLEY BANK
u SONOMA CA 95475
1:12LL4L6LSGS26411100L4456
5264"
Affle Oci
90.416111211
MP
CHECKS'- 1-800-224-7621 -CHERUB

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
JUAA
I hereby certify that Xownsproperty adjacent to is
(Name of Property Owner)
property located at bsA g 3 246 QC1 a
(Lot, Block, Road, etc.)
\\Ve-
on r E , in u Or��re , N.C.
(W erbody) (Town andlor ounty)
He has described to .� as shown below, the development 'he is proposing at that location,
W�
and, -r have no objections to his proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOP-MY.NT
(To be filled in by individual proposing development)
-A)ov
AV-
Sig�ture
Print or Type Name
.267 ;jf�
Telephone Number
Date: LI 4- moo

ADJACENT RIPARIAN PROPERTY OWNER STATENIEN'T
I hereby certify that I own property adjacent to %p�tf l ,t�lv� Sam 's
(Name of Property Owner)
property located at
(Lo , Block, Road, etc.)
in`;t-- , N.C.
(Waterbody) (Town andlor ounty)
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 jUled in by individual proposing development)
/© L14 c c l90 c.� 14t-,,) A/G wccFi E� FAc),-Z o
So fig CEv c e-'S -9 -4- - TO ✓j Xc T` '0/ .
Signature
Print or Type Name
Telephone Number
Date: