14582_DAVIS, CORBET_19960626

CAMA AND DREDGE AND FILL
GENERAL
PERMIT
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
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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-
come null and void.
This permit must be on the project site and accessible to the
permit officer when the project is inspected for compliance.
The applicant certifies by signing this permit that 1) this pro-
ject 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.
applicant's signature
permit officer's signature
issuing date expiration date
attachments
0eq
application fe��

ss=>>2 849
C. H. DAVIS, JR. 531
P. O. BOX 90
DAVIS, NC 28524
� / Y `11011ll/41'
BUT
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BEAV FORT. NORTH C�AR"OjLI�NA 28518
l/n« � l�i� liyna�nn �l A
i:053LOL120:1223OG379Sum 0849

ADJACENT RIPARIAN PROPERTY O`N NER STATEMENT
I hereby certify that I own property adjacent to ��46 L se-1
(Name o(f Property Owner)
property located at ,
(Lot, Block, Road, etc.)
on a _12, in - " b /` � , N. C.
(Waterbody) (Town and/or County)
He has described to me as shown below, the development heis proposing at that location,
and, I have no objections to his proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(To be filled in by indiiidual proposing development)
44ggnature
P int or Type Name
Telephone Number
Date:

t
ADJACENT RIPARIAN PROPERTY ONINNER STATEMENT
I hereby certify that I own property adjacent to )0,4 -? ':�-p 's
(Name of Property Owner)
property located at ,
(Lot, Block, Road, etc.)
/�
on ( 6eC S6(iI'1%, , in 61��/S, , 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 filled in by individual proposing development)
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P,-N , " a,, � - � e
Signa ure
RAC—/-S AIL .S,
Print or Type Name
Telephone Number
Date: " 7 ' / car- 1Jr