10920_General Permit_19930203

CAMA AND DREDGE AND FILL
GENERAL `
PERMIT N9 10920
as authorized by the State of North Carolina
Department of Environment, Health, and Natural Resources and the Coastal Resources Co ion
in an area of environmental concern pursuant to 15 NCAC
Applicant Name � f�> f J I m iTp
Address
r
City .
Project Location (County, State Road, Water Body, etc.)
Type of Project Activity
PROJECT DESCRIPTION I SKETCH
Pier (dock) length
Groin length
number
Bulkhead length
max. distance offshore
Basin, channel dimensions
cubic yards
Boat ramp dimensions
Other
Phone Number '
State /y {
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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.
attachments
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(SCALE:
applicant's signature
permit officer's signature
issuing date expiration date
/ i t ",
In issuing this permit the State of North Carolina certifies that T
this project is consistent with the North Carolina Coastal application fee =
Management Program.

ADJACENT RIPARIAN PROPERTY OWNER STATEMITTT
I hereby certify that I own property adjacent to CHRI S
property located at 1EE ' 5KAF—A ico SUB DI\ls)Dhi� — -- - - --
(lot, block, road etc.
c,n_61 i MRN C.Rc-EIC _ W NiEAA VI ROkION Sv )ULE
(body of water) (town) '
forth Carolina in Pamlico County. The proposal has been described to me as shcf.m hel..:;
the dc-ve:opr,'ent, a ier/ lkhea /structure, and the proposed location, and I halve no
(ci )
obj-ctions to the proposal. I understand that if the development is a pier, it a,-t
! set Lack a minimum distance of 15 feet from my area of ripari<zn access unlc,--;,: a."M :
!� r. Rio do not wish to waive that setback requirement.
ircle one)
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--srription and/or drawing of proposed development: (to be filled in by individual
Dros i'IQ development.) INDICATE THE SIZE AND I=TION OF THE STRUCTURE AND 'i';1E
!''t` -r: EjE:I'.:T-,EN EACH PROPERTY LINE AND THE WATER.
PLAFS C 51 C I Rt- KEvcRS6 FOP, SETA �L-5,
(Original must be retained in the Inspection Department)
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igna ure
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Name (Please Print)

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