10986_General Permit_19930202

CAMA AND DREDGE AND FILL
GENERAL
PERMIT NA 10986
as authorized by the State of North Carolina
Department of Environment, Health, and Natural Resources and the Coastal Resource mission
in an area of environmental concern pursuant to 15 NCAC 2 LI
r
Applicant Name TIQ" �-r' �� Phone Number
Address �� 17
City State
Project Location (County State Road, Water Body, etc.) c nti
Type of Project Activity
Zip 7l^ /
-1 ,=
PROJECT DESCRIPTION SKETCH f 1f' F S i -�''~- (SCA^ L_E
Pier (dock) length
11 i
Groin length
number
Bulkhead length —
max. distance offshore /
Basin, channel dimensions
cubic yards 't'
I
Boat ramp dimensions
Other `, f r. ,� `£.,✓
Y)�tcell
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.
i
issuing date
attachments - /y C// 11 ; / / /
application fert
applicant's signature
permit officer's
expiration date

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to
M&me of Property Owner
c
's property located at
n (Lot, Block, Road, etc.)
cc,
on N /` c , in J , N.C.
(Waterbody) (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.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
Signature
.� Print or Type Name
Telephone Number
op

Y
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to
is property located at
Name of Property Owner)
I
(Lot, Block, Road, etc.)
onN.C.
(Waterbody) (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.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
'e�' -2e—�Z
Ale Q
� v
E..
Signature
0
Print or Type Name
Telephone Number

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