HomeMy WebLinkAbout11769_ASHWORTH, LENZY_19930423CAMA AND DREDGE AND FILL
GENERAL
1- r 6 9
PERMIT "w
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 15 NCAC
Applicant Name / (-ti-7 ' I f (� Phone Number 71,/
Address
City 416 ri! n, ? ('r d State /1,/ Zip
Project Location (County, State Road, Water Body, etc.) If—,,
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Type of Project Activity I r /
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PROJECT DESCRIPTION SKETCH T �V
Pier (dock) length
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Groin length
number
Bulkhead length - - - —
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max. distance offshore
Basin, channel dimensions
cubic yards
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Boat ramp dimensions V!
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Other
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.
attachments _
application fee
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��-- applicant's signature
permit officer's signature
issuing date expiration date
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LENZY L. ASHWORTH, SR.
BARBARA 0. ASHWORTH 0390
P.O. BOX 285 919-728-3596 y, ? C�3 66-763/531 32
HARKERS ISLAND, NC 28531 %f J 19_�
008
Pay To The Q
War6ovia Itank of North Carolina, N.A.
Harkcrs kIn,id. NC 2M31
1:0531076331: SL.94 550279ul T3g0
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
/ rr+n � a•r flr, �
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I here c 'fy thatI own
RJ
perty AdjAcent to
s property
ocated 'i � 'i?�� on
Gl/ KIAIZA Lot, Block, Roadf tc.j %%
in ' //
( er Body)-, N.C.
(Town and or Cou y)
He has described to me as shown below the development he is
proposing at that location and I have no objections to his
proposal.
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Description and/or drawing of proposed development: (TO BB
FILLED IN BY INDIVIDUAL PROPOSING DEVELOPmwT)
Ck'
'gigihature
Name I
Phone Number
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
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I hereby certify that -I own property adjacent to
Name
's property
located at , on
(Lot, Block, Road, etc.)
in N.C.
Water Body) (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. mum
dis ^f f i -ty& fee* (15' ) from mar—a�e.a—•,� , ; : an—a�eess ,
v��trat se�t)sa�3c -requirement.
Description and/or drawing of proposed development: (TO BE
FILLED IN BY INDIVIDUAL PROPOSING DEVELOPMENT)
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Signature
0 IVA-:N
Name
Phone Number