10875_General Permit_19920916

CAMA AND DREDGE AND FILL
GENERAL�v
PERMIT
N! 1075
as authorized by the State of North Carolina 6 P
Department of Environment, Health, and Natural Resources and the Cpast I esources Commission
in an area of environmental concern pursuant to 15 NCAC � 1`/ - ( )a
Applicant Name Pr AK VxrV �,A&AIL > Phone Number LA)
Address F3d7( O �O
City State N C zip r� _7 -7
Project Location (County, State Roa , Water Body, etc.) 14-/oS2 FP 0,4 1;
Type of Project Activity
PROJECT DESCRIPTION
Pier (dock) length
Groin length
number
Bulkhead length
max. distance offshore
Basin, channel dimensions
cubic yards
Boat ramp dimensions
Other h 1711J 0#
f,
SKETCH
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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.
(SCALE:
Capplicant's signature
f
permit officer's signature
issuing date —� expiration date
attachments (/wf ` lPo U
In issuing this permit the State of North Carolina certifies that
this project is consistent with the North Carolina Coastal
Management Program.
application fee -,570,6

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M. L. BARNES 1526
SPECIAL ACCT.
63
P. O. BOX 1090 66 1
DURHAM, NC 27702 L
19
PAY TO THE y $
S ORDER OF
DOLLARS
Wachovia
Wachovia Bank & Trust Company, N.A.
Durham, NC 27702-2252
FOR------------------------------------ - - -- -- - ---
115000015 2611•® 1:053 L076331: 2378 00605 •

TOWN OF BEAUFORT
INSPECTION DEPARTMENT
P. O. DRAWER 390
BEAUFORT, N. C. 28516
SEPTEMBER 10,1992
TO WHOM IT MAY CONCERN:
THE TOWN OF BEAUFORT HAS NO OBJECTION TO THE PLANS
SUBMITTED BY MR. BARNES AND WAVE THE 15' REPARIAN
SETBACK FOR THE THREE PILES.
GORDON DAVIS
lay
TOWN ADMINISTRATOR

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER)
I hereby certify that I own pr
� K J k ►-� 4, Cel ru 4h 't A
Name
erty adjacent
)ARR Jes
to
is property
located at �4SOtO 0 7-
(Lot, Block, Road, etc.)
a 1%bb S ��ECIZ in �je-Au R
(W ter Body) (Town a d/or County)
. on
N.C.
He has described to me as shown below the development he is
proposing at that location and I have no objections to his
proposal. I understand that a pier must be set back a minimum
distance of fifteen feet (151) from my area of riparian access
unless waived by me.
'1$ �Ido not wish to waive that setback requirement.
I do wish to waive that setback requirement.
Description and/or drawing of proposed development: (TO BE
FILLED IN BY INDIVIDUAL PROPOSING DEVELOPMENT)
ignature
Name
7zk a-�7-z,,7
Phone Number

ADJI�CENT R1Pl�RIJ4N PROPERTY M'ER STATNT
UDR A PIER)
I hereby certify that I own property adjacent to
Name s property
located at
Block, Road , onIn etc. )
(a►'ater Body) T,.) t'yl,t ;r, N.C.
(Town and/or County]
Re has described to me as shown below the development he
P is
proposing at that location and I have no objections, to his
proposal. I understand that a pier must be set back a minimum
distance of fifteen feet (15') from my area of riparian access
unless waived by me.
I do not wisb to waive that setback requirement.
do wish to waive that setback requirement. .
Description and/or drawing of proposed development: (To BE
PILLED IN BY DWMDUAL PROPOSING DEVELOPmENT)
Signature
r
Name
,
Phone Number