27368D - Jones

CAMA and DREDGE AND FILL k��PR F ; l ,P 27368
G E N E R A L sU --) 110 -1-2)
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 , f I • t )U ' .
Applicant Name RoN Song % 7U L- ( ��� vtS( Phone Number J -30 '- yo -27
Address L) U 9 q t n" S t
City S'tn R i C i+` State NC Zip 2 (- w VS
Project Location (County, State Road, Water Body, etc.) .) 1 v�-A , ‘.Lici pet iMA, N - WA r) 4 (AAA I
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Type of Project Activity vPaP 1� 0 C-tL A gQA� L ; i--I ( v„Co v' izrci ,
PROJECT DESCRIPTION SKETCH (SCALE: I "7- 0 C.) r )
Pier(dock)Length . d _. ... __.... - - w•_. 4
Groin Length ' €
numberIII A
Bulkhead Length
max.distance offshore
Basin,channel dimensions ^_~ 0 __ `
cubic yardsc�t t r" 4
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Boat rampdimensions / I
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This permit is subject to compliance with this application, site drawing .
and attached general and specific conditions.Anyviolation of these terms
p 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- Q 7 - t3- CU 1 / J - I - I
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 .) _/ • J. v
have no objections to the proposed work. attachments
/l In issuing this permit the State of North Carolina certifies that this project x 0c) . U`J �-C (- 1ft) 1
is consistent with the North Carolina Coastal Management Program. �7 application fee

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CODES FOR AEC DESIGNATIONS
"OH" - Ocean Hazard "PT" - Public Trust
"EW" - Estuarine Waters "CW"- Coastal Wetlands
"ES"- Estuarine Shoreline "FC" - Fragile Coastal Natural/Cultural
"PW"- Public Water Supply "OR" Outstanding Resource Water --
CODES FOR PROJECT
"P"- Private-usually an individual "F" - Federal
"C" - Commercial "L" - Local Government
"U" - Utility "H" - Housing Development
"S" - State : "0" - Other
# CODES FOR PROJ DESCRIFTION
"11" - Bulkheads,Riprap "16" - Utility Lines
"12" - Piers, Docks Boathouses "17" - Emergency Repairs
"13" - Boat Ramps "18" - Beach Bulldozing
"14"- Wooden Groins "19" - Temporary Structures
"15" Maintenance of Basins, Channels,Ditches. ---- — —
GENERAL PERMIT COMPUTER FORM
APPLICANT NAME: d , 'S N e
ADDITIONAL NAMES: L; 4 v - vW v
AEC DESIG: 6-W L Qr DEVELOP AREA:_0_.� PROJ DESC: 1 11—
(W�only take 6) (Will only ta a 1)
WORK: ,=S 1 , (b -
(will only take 4) 8 L 11 � 1 Y - -
MAI T:
(will only take a)
IMP: 0 I✓ .24 o .
(will only take 6)
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ACTION EXPIRATION
DREDGE&FILL REQUIRED:
CAMA MAJOR DEVEL REQUIRED: 0 -7--)3-4 I 10'0 3"U (

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illZISION_ OF CO4ST4L M4\4G N,rE,.•
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Name Of Individual Applying For Pe:mir_
�C S
Address Of Property:
Q. U
(Lot or Srreet#, Stree Road, CityJ S
& County)
I hereby certify that I own property adjacent to the above-referenced
applying for this permit has described to'Me as shown on the attached per ' The individual
the development
they are proposing. A description or drawing, with dimensions, should be wiprovided with this
letter.
I have ao objections to this proposal.
if yo havr l2=r acdrmi
-!f7'hTAti wen 1
WAIYER S CT'1oN
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set back pier,that a dock, mooring pik; breakwater, boat house, lift or s
distance of 15' from my area of must be
wish to waive the setback, �a� unless waived by me. (I f you
you mist initial the appropriate blank below.)
I do wish to waive the 15' setback requirement.
7)4 I do wish to waive the 15' setback requirement.
Si Irate ATA
Peat Name `G ' �7'
-1oi� NCDENR
Telephone Number With Area Cade
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