10919_General Permit_19930202

CAMA AND DREDGE AND FILL -
GENERAL�x„'=�
PERMIT -0919
as authorized by the State of North Carolina
Department of Environment, Health, and Natural Resources and the Coastal Resources C fission
in an area of environmental concern pursuant to 15 NCAC _?�t /— ; �r_')J
Applicant Name __J ' r t:>cc) J I fr--
Address I
_�; ire, 11W) fZ�
City. 84 & St te.
Project Location (C9unty, State Road, Water Body, etc.
r(s r e,ti t1 i ll vi p -- Ae v e P, .,-f
Type of Project Activity
Phone Number
Zip D 7__—) cU %
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PROJECT DESCRIPTION SKETCH �, ,� (SCALE: )
Pier (dock) length
Groin length•
number ( I
Bulkhead length
I ! I tl
max. distance offshore +
Basin, channel dimensions
cubic yards
Boat ramp dimensions
Other � �1 _
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r
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.
Z
F applicant's signature
permit officer's signature
issuing date ; expiration date
attachments —7//r / /Uy
In issuing this permit the State of North Carolina certifies that
this project is consistent with the North Carolina Coastal application fee `� •
Management Program. :A '

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to
ta' 4z 's property located at
(Name of Propert Owner)
ski F ,, o e.� /� ,�g p { SS
(Lot, Block, Roa , etc.)
i 1�f i
on , . in�l�'�r Oe) t!�.� N.C.
(Waterbody) (Town and/or County4
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:

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