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CAMA AND DREDGE AND FILL
GENERAL :v 018077 _D
PERMIT
as authorized by the State of North Carolina
0 Department of Environment, Health, and Natural Resources and the Coastal Resources Commission
in an area of environmental concern pursuant to 15A NCAC 7 N 1 I 0 0
Applicant Nam
,.)Or yr. PQrrJPhone Number e)04J )3Q. s 2 6
Address —2 1 4
City (-1 +Jcco,.�. -„- , State 13 C. Zip 2 �
Project Location (County tate R ad Water Body, etc.) IJ J 0 -- � >1 a�'E TD r= L � ?�
luta_111/4.3 LAD
Type of Project Activity
�► L1 LacC l y4krs OG -
PRO JECT DESCRIPTION ) SKETCH (SCALE: 1 if; "3 Q I )
Pier(dock) length MT w
Groin length
number
Bulkhead llleentgtth
7. L E
.z.
max.distanc offshore _ I
-Re
Basin,chan I dimensions v �,, rALe. S,,<
. Jf.Jo ESL . 1..Nv
cubic yards
7b — 2 x8
____ --_ ..._ ,___,5 . — 7 - 6X6-14-
Boat ramp dimensions 'fj/ ,
Other __., , so/
I '/
S
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This permit is subject to compliance with this application, site
drawing and attached general and specific conditions. Any „../.....- ---'s---,'
violation of these terms may subject the permittee to a fine, ^
`/ icant's signature
imprisonment or civil action; and may cause the permit to be-
come null and void. �` /��
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. I`Z� _ ��
The applicant certifies by signing this permit that 1) this pro-
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 i4 ' I 0 C
objections to the proposed work. attachments
1� .'
The American Fish Company
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���,;. ttu, P.O. Box 11046
iiiiisioatt)st
� �,
Southport, North Carolina 28461 (910) 457-5488
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•Complete items 1 ardor 2 for ddltiOfel services. I also wish to receive the
4 •Print naem.me and eddy 4b.
L �on the reverse of this form so that we can return this extra leg services(for an
card to you. extra fee):
o permit
di■Alla this form to the from of the mailpiece,or on the back if space does not
� •W 'Return �
Receipt Requested'on the ;l t• ❑ Addressee's Address
piece below the article number.
S ■The Return Receipt wit show to whom the article was delivered and the date 2 CI Restricted Delivery c delivered.
° Consult postmaster for fee.
3.Article Addressed to:
f 7h 1
ff7 / 4a.Article Number
//� Z r 1 ■ :.st: :. ❑ Certified a
'1- sLItiki0 . C..fI ��' CIExpr::- ❑ Insured 9
, 1
a �65 -I•.. j v lima •or Merchandise 0 COD
• 7.D: : Y livery $
al.1 i\
5.Received By (Print Name) • as
���° '••rasa(Only if requested -It Rif'
Z.. endoaid) 1
re. A.. -
Agent ...
PS Form 3811, 1994 . • .. 1o2ss5,sz:a-ays Domestic Return Receipt
iti 1
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to
\iO e-,11/tit fJ d 's property located at
(name)
1410 2. yA614-1 on
(lot, block, road, etc. )
1 C in
Lm6
(waternbody)
p W 1\1 C `
N.C.
(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. I understand that a pier must be set back a minimum
distance of 15 feet from my area of riparian access unless waived
by me. I do / do not wish to waive that setback requirement.
Description and/or drawing of proposed development:
(To be filled in by individual propo 'ng development. )
60 /
e (signature)
27-
(print name)
(phone number)