20291D - Black

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\ CAMA AND DREDGE AND FILL
\ GENERAL N9 929291 -=�
...... ..) PERMIT , ,N.
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 15A NCAC 1 H. .ZO 00 /
Applicant Name ���N4=U a IL• e- 1_,A - r Phone Number (76 b,E3(n"O SS. ,
Address ( t.S Yr : Lq. L. 3 .
City \/�) t t1 State K1 I Zip 2-814 I
Project Location (County,State oad, Water Body,etc.) Cf�-r►�� 7 b'O1 A'C__•e- � ..?A,-... --S I C *&r
1;.1 mot,t I'-4-4 a i e vp r a . kJ
Type of Project Activity AM c ':L L cry ``b oa-1-I i 1-1-7 i 1 x 1 tv €<i—" r t,t.._if7 .
PROJECT DESCRIPTION SKETCH (SCALE: PJ T S )
. t.;-„_-. --- ?A"....-:,---t. -_--- .. CoPi--r--- ---- -"e"---
Pier(dock) length
Groin length t
number •"-1'
Bulkhead length , —.�
.-- q
/
max.distance offshore � • (
,:11 Kr4e 12I -
Basin,channel dimensions
-rterAOCV--
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cubic yards I {
;__ )
.. 1
Boat ramp dimensions "' a1 7; ;1,
I I j
Other n 1 ,
/ + t
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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- applicant's signature
---) rv.-- L.4a----..-
come null and void. 21---
This permit must be on the project site and accessible to the permit officer's signature
permit officer when the project is inspected for compliance. G
The applicant certifies by signing this permit that 1) this pro- l I ` I S` I Q _ 2"- I E " �
ject is consistent with the local land use plan and all local issuing date expiration date
ordinances, and 2) a written statement has been obtained from
adjacent riparian landowners certifying that they have no attachments /) -21,-)ov
objections to the proposed work.
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Name Of Individual Applying For Permit: / Z Z6? /e
f//�
Address Of Property: "LE
/,7 c-7 ,f ///
(Lot or Street #, Sreet or Road, City & County)
I hereby certify that I own property adjacent to the above-referenced property.
applying for this permit has described tome as shown on the attached p w n The individuallpt
they are proposing. A description or drawing, drawing the development
letter. with dimensions, should be provided with
this
I have no objections to this proposal.
v P P
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Ifv�L hay h"Pp nniinAri b y C P
rtrr,on nfiai _
lAn i
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I understand that a pier, dock, mooring pilings, breakwater, boat house
rer� , lift or sandbags must be
set back a
minimum distance of 1� from my area of riparian ancess unless waived by me. (If you
wish to waive the setback, you mast initial the appropriate blank below.)
I do wish to waive the 15' setback requirement.
I do nr t wish to waive the 15' setback requirement.
y.
J Allrilitiirli
S-grature
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Pr- Tam
cc: .\ 72 - <------Thn <)- n NcDENR_
TeIe) ne umber With Area Code Nay CAROUNA DF_"
LN AURAL
VIRONMENrr AND NATURAL
T OF
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Name Of Individual Applying For Permit: l F//,y
Address Of Property:
(Lot or Street #, Street or oad, City & County)
I hereby certify that I own property adjacent to the above-referenced property.
applying for this permit has described to me as shownP p"m The individual
they are proposing. A drawing, on the attached drawing the development
P P A description or with dimensions, should be provided with this
letter.
= I have no objections
eons to this proposal.
C '• g A o
Fa A
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I�ycTu have h�Pn nntifl by t PT TTt1Pn rtn 1
W A T1PR SFrnp T
I unde:s'and that a pier, dock, mooring
set back a r , � pilings, breakwater boat house, lift or sandbags must be
minimum distance of 1 j from my area oIan arr_-
ss unless wish to waive the setback, you mast initial the appropriate blankbelow.)waived by me. (If you
I do wish to waive the 15' setback requirement.
I domor wish to waive the 15' setback requirement.
//- ?.97 AlCoirilirA
SAig�gnature Date
l-NAwleS p,,,, l� 2E�92r6ss '~��`AsimminmendIfi
int NamP
q/0 6n - 03 NCDENR
Telephone Number With Area Code Nam, C-oRD J�
AL FM NT OF
LNVIRONM='NT AND NQLIRLCSDUR c

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