10712_General Permit_19920421

Applicant Name
Address
City
Project Location
CAMA AND DREDGE AND FILL �w
GENERAL
PERMIT N19 10712
as authorized by the State of North Carolina
Department of Environment, Health, and Natural Resources and kthebastal Resources Commission
in an area of environmental concern pursuant to 15 NCAC '7y- Ppv
P f' t
LC__ 11
Phone Number o<�tf ;) /
State %1 zip _�) `7S
State Road, Water Body, etc.) �� M iy All I- — 11�)4LIISO IV
OL 1(,-- --
PROJECT DESCRIPTION I SKETCH
Pier (dock) length
Groin length. S�-`wn
Z, t e ! P Cla(ID
number
Bulkhead length
max. distance offshore
Basin, channel dimensions
cubic yards
Boat ramp dimensions
Other
i�-,) �,o,T
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.
Q .
("te4k
l
r% l u n7
issuing date
attachments . 7Y v6 U
(SCALE:
4�
13u11 t"J
applicant's signature
permit fficer'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.

Personal Account Information Redacted

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to
Gerald W. and Loraine H. oIy 's property located at
(Name of Property Owner)
Camp Jo Jane at end of NCSR 1350
(Lot, Block, Road, etc.) '
Dawson Creek
on , in Rt. #1 Oriental -Pamlico Co, 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,
(To be filled in
Plan to continue bulkhead
from adjacent property on I F
each side along waters edge,y
and add boat ramp
v
DAWSON
OR DRAWING OF PROPOSED DEVELOPMENT:
by individual proposing development)
4UG 1959
boat ra
V Y f
(/ I
444 • � _ so o i
I
CREEK
signatures
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Print or Type Name -r---
���3Y/Y
Telephone Number

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ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to
Gerald w. and Loraine H. oiey 's property located at
(Name of Property Owner)
Camp Jo Jane at end of NCSR 1350
(Lot, Block, Road, etc.) '
Dawson Creek
on , inRt. #1 Oriental -Pamlico Cc, 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
(To be filled in by
Plan to continue bulkhead
from adjacent property on
each side along waters edge,", -
and add boat ramp
DAWSON
DRAWING OF PROPOSED DEVELOPMENT:
individual proposing development)
4U6 /939
/•I/boat ra
CREEK
Signature
rlor�da jx�i5e.
Print or Type Name
cfi1-a49- 1LL27
Telephone Number

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