HomeMy WebLinkAbout16079_PALMER, COLBERT_19960417CAMA AND DREDGE AND FILL 016079-C.;
GENERAL I � ro
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 6)!1,7. //[,o 1
Applicant NaPhone Number
m.e.., i °'�• C�� � Pt i ����'��
Address
City ' j''���%�`{' State N C zip
Project Location (County, State Road, Water Body, etc.)
Type of Project Activity �" -28
PROJECT DESCRIPTION I SKETCH
Pier (dock) length
Groin length
number
Bulkhead length
max. distance offshore
Basin, channel dimensions
cubic yards
Boat ramp dimensions
Other
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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.
applicant's signature
permit officer's signature
issuing date expiration date
attachments O)// //C) y
In issuing this permit the State of North Carolina certifies that
this project is consistent with the North Carolina Coastal application fee !� V
Management Program.
3."151
AQUA DESIGNS
216 DELLINGER DRIVE ® 364
P O BOX 524 PH 704-733-4309
CROSSNORE, NC 28616 66-5381531
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VERY COUNTY BANK
NE -LAND, NORTH CAROLI NA 28657
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5 69. 50211180L11i91Io 0364
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ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify
A
(Name of Property
t I own property adjacent to
's property located at
11
(Lot', Block, Road, etc.)
on =o !� c 34�' , in c�w� �c��t �� _ N.C.
1
(Waterbody) (Town aid/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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MAR 15 10
56117-0 c'-1W
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Si ture
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Print or Type Name
Telephone Number