11980_ALLEN, DAN_19930622

CAMA AND DREDGE AND FILL
GENERAL':a
PERMIT
as authorized by the State of North Carolina
Department of Environment, Health, and Natural Resources and the Coastal Resources VCmmission
in an area of
environmental concern pursuant to 15 NCAC
Applicant Name r�r s^ mow. Phone Number
Address
City ��"t-� State _
1�
Project Location (County, State. Road, Water Body, etc.)
Type of Project Activity << X C2
PROJECT DESCRIPTION
Pier (dock) length
Groin length
number
Bulkhead length
max. distance offshore
Basin, channel dimensions
cubic yards
Boat ramp dimensions
Other
i
SKETCH , U j' %1 A (SCALE:
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.
I,
applicant's signature
permit officer's signature
d d /
issuing date expiration date
attachments
In issuing this permit the State of North Carolina certifies that
this project is consistent with the North Carolina Coastal
Management Program.
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application fee f/1

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UNITED STATES POSTAL SERVICE
Official Business 'PO PENALTY FOR PRIVATE
N USE TO AVOID PAYMENT
OF POSTAGE, $300
Print your name, address and ZIP Code here

^' SENDER:
O • Complete items 1 and/or 2 for additional services.
I also wish to receive the
Complete items 3, and 4a & b.
following services (for an extra
00
y Print your name and address on the reverse of this form so that we can
fee):
CDreturn this card to you.
> • Attach this form to the front of the mailpiece, or on the back if space
1. ❑ Addressee's Address
fn
o does not permit.
a
m • Write "Return Receipt Requested" on the mailpiece below the article number.
2. ❑ Restricted Delivery
• The Return Receipt will show to whom the article was delivered and the date
Consult postmaster for fee.
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delivered.
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3. Article Addressed to:
4a. Article Number
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4b. Service Typeq
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7. Date o� eliv�{y�
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8. ddressee's Address (Only if requested c
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6. Signature (Agent)
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gPS Form 3811, December 1991 s7 U.S.G.P.O.:1992-307-530 DOMESTIC RETURN RECEIPT

105 SF.A HORSE
S`-,\- ST39Rn, NC -"SSF--'.-
(919 ).391-01.0
'✓er eelqel� l�,Q. tof
OR K e1 ✓ e-e AAAt IV1) O C _ P.TI I CARC NI -.A
Property ov tt r ha decrib�xl to me the proposed L elopinetit as shumi in drawing.
I object to proposed project.
(DC)) (DO NOT)
I understand that a Icier must he scat haQk a minimum distance of fifteen (I -) feet 11,0111 mT
area of tipar1a11 a xccsS IMICss �t,nicd 1)N roc.
I I to waive that setback reyuircinait.
(DO) (DO NOT)
DESC RTPTIC)?' OF IMAWINOT I I'l) Vy11)
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