10775_General Permit_19920914

CAMA AND DREDGE AND FILL
GENERAL -�
PERMIT,- N9. 10775
as authorized by the State of North Carolina j
Department of Environment, Health, and Natural Resources and e;4ta/11c ommiY(�:
/0'
in an area of environmental concern pursuant to 15 NCAC / / , _ /
Applicant Name �� rl ® Phgne Nu ber -6 - �>
Address �t c� �L nr /� rP it e. Z
City C� / State Zip
Project Loca �/' (Coun Sta�te/�o}�I Water B dy�+e�.) � � �'� ��Y�1' �i�
"Y ��ir� e C�' e % �lll
Type of Project Activity
-�'I � stir �%G►;
PROJECT DESCRIPTION
Pier (dock) length
Groi length
57
number
Bulkhead length ,
1
Max. distance offshore
Basin, channel dimensions
cubic yards
Boat ramp dimensions
Other
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SKETCH E
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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-�
permit officer when the project is inspected for compliance.
The applicant certifies by signing this permit that 1) this pro -
is consistent with the local land use plan and all local
nos, and 2) a written statement has been obtained from
a scent riparian landowners cer_ti ..., _that_ thin, have no
objections to the roposed work.
In issuing this permit the State of North Carolina certifies that
this project is consistent with the North Carolina Coastal
Management Program.
(SCALE:
applicant's signature
f l j / p rmit otticer's signature
issuing date expiration date
attachments f-2,4!Z,` 1XVI)
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application fee 7'✓ �/��

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ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to
1-- Il _
's property located at
(Nadle of Property Owner
(Lot, Block, Road, etc.)
r
on , in` �&ey , N.C.
(Waterbod ) (Town and/i6r County)
If
He has described to me, as shown below, the development he is
proposing at that location, and, I have no objections to his
proposal.
------------------- ----------- 9`=-":--------------------
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in individual proposing de v 1 pment)
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P� t or Type Nam
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Telephone Number

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to
&z r' 7' . Ll,&- ' s property located at
of Property Owner
(Lot, Block, Road, etc.)
on in l_ N.C.
(Wafer (Town and or County)
He has described to me, as shown below, the development he is
proposing at that location, an "Iha a no objections to his
proposal.
----------------------- /------------------------
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual propoping development)
i
Signature
Print or Type Name
(5;/S) 7�-4-3-r'S-
Telephone Number

GENERAL PERMIT APPLICATION INFORMATION
LICANT'S NAME:
(First) i (Middle) (Last)
LING ADDRESS:
(PERMANENT)
STATE ZIP �` O
TELEPHONE: WORK ( )�°�,� --/�� HOME ( ) r
CONTRACTOR'S NAM: TELEPHONE NUMBER /,,,'�to,,r %0
PROJECT LOCATION: N.C. Hwy. (( SR $ Road/Street Name c's-O ( J��
Waterway Name 4P44,4, County ��z
Town Subdivision
PROJECT ACTIVITIES:
PIER: Total dimensions of pier from MHW to platform
(Length} (Width)
'T' or 'L'-head platform
(Length) (Width) (Number of Mooring Piles
Water depth at end of pier
10 HOUSE/BOAT LIFT:
Length
Number of Piles
BULKHEAD: #1 Total length
Number of Mooring piles
Width
Water Depth
Average distance waterward MHW<—,Jf'�Je
Maximum distance waterward MHW
#2 Total length
Average distance waterward MHW /!
Maximum distance waterward MHW/
RIPRAP: Total length
EXCAVATION: [MAINTENANCE 'ONLY']
Base width from MHW
Length Width Depth of Cut
Adjusted water depth on MLW Existing water depth(s)
Estimated Cubic Yards (length x width x depth/27)
•
Type of spoil: Sand Mud
Dragline Backhoe Hydraulic
OTHER STRUCTURES: