10812_General Permit_19920612

O
CAMA AND DREDGE AND FIL
GENERAL �`'
PERMIT Gasp
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 ,Z/?'- //��
Applicant Name L-'''cam%
Address Q,$)X11�
Phone Number
City. P rw;rZ State Zip P ()/ ,—
Project Location (County, State �1oad, W ter Body, etc) �U' ` `�'�rJ ����� 0A/
Type of Project Activity _ 1
PROJECT DESCRIPTION I SKETCH
Pier (dock) length
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.
(SCALE:
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issuing date
attachments T ` ' //Oo
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applicant's signature
permit officer's signature
expiration date
In issuing this permit the State of North Carolina certifies that
this project is consistent with the North Carolina Coastal application fee !!��
Management Program.

[EROSION CONTROL SPECIALISTS
ATLANTIC BEACH CAUSEWAY
P.O. BOX 3355 919-726-2191
ATLANTIC BEACH, NC 28512
PAY TO THE
ORDER OF _
F(RSTCITIZENS BANK
Fint-Otlzem Banc & TnAl CompanY 133
Atlantic Beach, N.C. 2851�
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FOR
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ADJACENT 12IPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to
STEW' � -T0Ems' &CA a%.644k-5 Is property located at
(Name of Property Owner)
Zl Z �or✓r� ��i��= •
(Lot, Block, Road, etc.)
on �� tl S'VurJD 42cTS G,,✓AL- , in 4-FLAk-r(C �FA -ki N.C.
(Waterbody) (Town and/or County)
He has described to :ie, 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)
or-7 N�4� l�d�- '3641tr4L- - 40 VT)
V frGC�rL y fu T7/209-r b; j�ET '�'o�' �=� AS��5'TD S' 26A- 4d+L
Si(gnat,Ure
Print or Type Name
'f(Iq-e3.2- ©
'`?Y —
Telephone //Number
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r
ADJACENT r2IPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to
DoAl r� 's property located at
(Name of Pr rty Owner)
Z( d2 PO ,4/C> �iQl0 c-� 11
Lot, Block, Road, etc.
onT 0i?tlf S'p�,1./P 1-CCf s CA'VA � in ATL�l-�fT/C 1,5' i � N.C.
(Waterbody) (Town and/or County)
He has described to me, as shown below, the development he is
proposing at that ice2ation, and, T_ have no objections to his
proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
l AJS t � �-cA- rod o,' N64tl �'de SJ �� LL- (&.2 9 Ind 2ri.i i-
0 i= 3644114LL
Signature
lt,6 q � ��i-6z �iPrinor Type Name
( �W) �/7'? -�2ff3
Telephone Number
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