10811_General Permit_19920612

CAMA AND DREDGE AND FILL
GENERAL`N
(tD)
PERMIT
�' �' o�
ve
as authorized by the State of North Carolina
Department of Environment, Health, and Natural Resources and th
tal Fesources Commission
in an area of environmental concern pursuant to 15
NCAC
11to
Applicant Name ��� 1°�f �^
Phone Number
Address C_ <r i
City
State
Zip %2
Project Location sCoun y Stat Road, Wate Bod ,etc.
�Cr
Type of Project Activity _
PROJECT DESCRIPTION J SKETCH
Pier (dock) length
Groin length
number
Bulkhead length
max. distance offshore
Basin, channel dimensions
cubic yards
Boat ramp dimensions
Other
I
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.
In issuing this permit the State of North Carolina certifies that
this project is consistent with the North Carolina Coastal
Management Program.
c
I
(SCALE;
applicant's signature
permit orticer's signature
A� — I ) �2 —
issuing date expiration date
attachments ­7N —LlGU
application fee ��©t/-

EROSION CONTROL SPECIALISTS 0287
ATLANTIC BEACH CAUSEWAY
P.O. BOX 3355 919-72&2191 88.30/531
ATLANTIC BEACH, NC 28512 19 133
PAY TO
ORDE —
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4,44 D O L L A R 5
I TCITIZENS BANK
First -Citizens Banc & Trust Company 133
Atlantic Beach, N.C. 28512
FOR
1:053L003001:L31,20.853511' 0287
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ADJACENT rRIPARIAN PROPERTY OWNER STATEA!lENT
I hereby certify that I own property adjacent to
SIEVE z "fNEn&CA ��094NL5 's property located at
(Name of Property Owner)
(Lot, Block, Road, etc.)
on 1 v6(VC S'yv/Jy kc-,r-m &AIAL- , in 4,r , Ar r (e %MCA e N I 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 DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
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Print or Type Name — r
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Telephone Number Ll �
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ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to
Doi/ �� 's ' s property located at
(Name of Pro4perty Owner)
01
(Lot, Block, Road, etc.)
on'90q6/L roodO ACCK! ' OAiVA L , in AI l-1.,/Tlc �5eAe,14 , N.C.
(Waterbody) (Town and/or County)
He has described to me, as shown below, the development he is
proposing at that lcc.ation, and, I have no objections to his
proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
OF A164V ode S'�4" LL_ (607 9 ini
OF- �.��01-24Tt�7,7 As'%5-c-7c?-oS' S&7&74 414LL
4"/"� Signature �/
Print or Type Name
() V7-)-�/2
Telephone Number