10763_General Permit_19920624

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INS
Applicant Name
Address
City
CAMA AND DREDGE AND FILL
GENERAL"Y
P E R M I T M 10763
A
as authorized by the State of North Carolina �/�
Department of Environment, Health, and Natural Resources and tfa2tal Re mmission
in an area of environmental concern pursuant to 15 NCAC �/ ;' ° C
�le_ f A24Phone Ne4er
Project Location (CoXnty, State Road,
Type 6T Project Activity
Body, etc
1
State
M
Y
PROJECT DESCRIPTION SKETCH (SCALE:
FT
Pier (dock) length
y 07
V
Groin length •
XY
number G' C
Bulkhead length FT
ax. distance offshore
A116r' 2 FT Basin, channel dimensions NO)f jM/,�`J�ef � / �cW � vvJ CAM-- W •�(., P 0� .
cubic yards
Boat ramp dimensions
Other
k This permit is subject to compliance with this application, site
drawing and attached general and specific conditions. Any
i 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 thee•
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
antes, and 2) a written statement has been obtained from
_cent -ripAria.n landowner s certifying that they hav no
o
objections to the propo—se-TW rTc. _ �~
In issuing this permit the State of North Carolina certifies that
this project is consistent with the North Carolina Coastal
Management Program.
applicant's signature
permit officer's signature
2�
issuing date `;expiration date
attachments _i Z,
application fee L G

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LARRY G. ARNOLD 1215
P.O. BOX 2277 I
MOREHEAD CITY, NC 28557 19-4-1 66-152/531 �I
009
PAY TO THE
ORDER OF Vz—:: _/;� 4( $ 0 �D' 60
I
D O L L A R S I.
a ovia
Wachovia Bank & Trust Company, N.A.
Morehead City, NC 28557 I
FOR,—�
1:053 i0 i 5 291: 5466 1894 2811' 0 5
P
.W,

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
( FOR A PIER) alaW /�is
I hereby certify that -I own property adjacent to
,��r�f% �,r�� Is property
Name
located at // 644rz,,-vl .ram, n", , on
(Lot, Block, Road, etc.)
in , N.C.
(Weiter ody) I (Town and r 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. 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 wish to waive that setback requirement.
V I do wish to waive that setback requirement.
Description and/or drawing of proposed development: (TO BE
FILLED IN BY INDIVIDUAL PROPOSING DEVELOPMENT)
Z- -'4

4
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to
's property located at
/(Name of Property Owner-)) - ,✓
! / ,
(Lot, Block, Road, etc_)
on in .1'6o -,fie/I , N.C.
( aterbody) (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 DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
REPAIR/REPLACEMENT OF BULKHEAD
R
Signature
Print or Type Name
Telephone Number