11894_DISHER, HAGEL_19930712

r-y -y _ .. ._. .-T ., _..v-was--.,i.r.. ,:. ,,,, .. --t -:�*^'.�„ ,.r. •mac-�.�'Ypt.v--r-= _ , •—r-�--•-
1;
CAMA AND DREDGE AND FILL ,�
GENERAL 1
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 15 NCAC ' / , "
Applicant Name
Address
City
Project Location (County, State Road, Water Body, etc.) -
0) 7 S .' 9 4 /'_1 ,
Type of Project Activity % I '
_ State
Phone Number // /-
Zip_
i
PROJECT DESCRIPTION
Pier (dock) lengthTT
SKETCH
(� /� �i (SCALE: { )
A. __J
I I ,
i
I i r
_._.. .—d
i
I I I +
I I I I
Groin length
number
Bulkhead length
max. distance offshore
Basin, channel dimensions
cubic yards
Boat ramp dimensions
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.
applicant's signature
permit officer's signature
issuing date expiration date
attachments ' f
application fee ` ��

11fj �' MRS. HAZEL S. DISHER 0433
NCDL 877143
334 WESTVIEW DR. PH. [phone] 66-52/591
WINSTON-SALEM, NC 27104 9 19
Pay the $ �O �
Order
of 1J r ,[j/
NationsBank of North CarAinn N.A. Deluxe Banking Customer
Winston-Salem, NC 2710
For
CO 5 3 L00 5 204 L 0�7olle 0 t. 3q

• ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to
o ' ( i'D 1 's property located at
(Name of Property owner)
(Lot, Block, Road, etc.)
on T� 0 UE- Vou'/ , in A ► LA1,1T/C S&:Ae 1-4 N.C.
(W terbody) (Town and/or County)
He has described to :i,e, 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)
o4:7 (Dert e' r o""'4; �.0
1 kj s"'i Ai z-00 04c-'CT1-� I k(
!�DAe0U*!�O 01u��
At C kl 6d'4L L ' To
Signatu >� i C )ef)or
Print o Type Name
Tei,,phone Number

ADJACENT c.IPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to
L , o , ' s property located at
(Name of Property Owner)
(Lot, Block, Road, etc.)
on 041i U8 V00 in [ ,4gT/C N.C.
(W terbody) (T�,wn and/or County)
He has described to 1,e, 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)
�C 6 T
A,3 GCS' i os' 64 il / T VI
I y.l STALL-6-0 o`
9e4 (-d.4 LL.
Sic,:uture
Pri ,it or Type Name
Telephone Number

IL 0.. zv-
'D614 t4 R

r
• .. � a _
- ...'#� i

w"A

-� ���
� Lj
� ,�%�
��

1-
P

7-� a- 9 3
/-) 4z" -4