22265_BALSOME, JOSEPH_19990513 (2)

CAMA _,�N.D DREDGE AND FILL
N? ­22265
ZENERAL­...`--......
tJ Lj ea— CD
-PERM I T
AF
.�as authorized by the State of North Carolina
Departme I nt of Environment, Health, and Natural Resources and the Coastal Resources Commission
in an area of environmental concern pursuant to 15A NCAC 0*1
Phone Number C�0 G j
Name
Address`-� 2 0 i'A
'City State t— Zip
L-j L co, 6D. 1')q FA� r0l —1
Project Location (County, State Road, Water 13ocly," etc.) J
11-4 THE �'�L 114 1?blN-7 Eli= 07 1 Crr L
— % k " 7t A-TFL�?�,-A
-TH N FT L
Type'of Prqj*ect Activity* —CLT,)-r?UC-7 f Z F
TI E
To 29 ApL;i-*bL,0 A
PROJECT DESCRIPTION SKETCH (SCA L E: a
_ r
Pier (dock) length I V.7 TIN
ra Lk 0F7. IC I ?I- OF A
Groin length
number
Bulkhead length
max. distance offshore
Basin, channel dimensions
cubic yards
Boat ramp dimensions
Other 2
TIEy
cjz
141W "" -',. , 7
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 officer7'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.
7
applicant's signature
permit officer's signature
-:rA-q t 3 (qq
issuing date expiration date
attachments
In issuing this permit the State of North Carolina certifies that
this project is consistent with the North Carolina Coastal application fee
Management Program.

IM-'ARLA PROPaTY OWNER STATENEI ; F'
I hereby certify that I own Property a4jacrnt to J osf: Qa E>,&L'So M E
--- �•o— s
(Name of
property located at LoT 3 3 Gjt•. �.1D t�i ��e pei tv Owner) D
on Reek
(Lot, Block, Road, etc.) --- i'
�I >:lzG � %�
, 111 �QMLIGt� G
(Vvate>:body) i (Town and/or Co ty) _ _, N.C.
He has d?scribed w me as shown below, the development he is j in ,•siii� at that location,
and, I have no obrraio.0 to his proposal.
llF-" 'V'f—zON AND/OR DRAW-P;c OF PROPOSE: _;, ,c ul'�I �T--
(o be filled in by individ.cal proposin; dev�l�,,, .o ;
I wee ATTAC 4iaU> �X>.1�,` "
-----------------
Signature
C VI
Print or Type Name
a 4-11 �
Telephone Number
Date:

AD14f AMNT IM)ARUN PROPERTY OW-N-jM STATENGIN I.'
I hereby certify that I own property adjacent to J Qa _ 7 sLso H E Ys
(Name of Pi opei ty Owner)
property located at L oT— 3 3 —`2A -1D ?CV DQi_V_C_
(Lot, Block, Road, etc.)
on �lL�� /^Reek
in AralLIz-z) Gu o,►
(Wates-body) — Y _ _, N.C.
(Town and/or Coi�,1ty)
He has described ii me as shown below, the development he is y .ir; ,, �siti� at. that location
and, I have no ob;(r:Eojis t0 his proposal.
DFSCRUrf—ION AND/OR DRAWLIIC, OF PROPOSHj .t,-,,�/'.,: OI' /m.NT
(%o be filled in by individaal proposin; ctevalc,,, ,•� ,
(c ,--;7eE ATTAC-4F-D i ,` II
Signature
S
Print or Type Name
'2 �� cr�- ty
Telepnone�NNumbe:
Date:.

r" ALI le, 11
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NOTE: SOLINOIN6S ARE SHOOK Off'.4801le SEA LEVEL
No VD.
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