21425_GRAY, DAN_19990210

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CAMA AND DREDGE AND FILL �214 2
GENERAL ,y
15
PERMIT
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 15A NCAC 2 P I d rt ,
Applicant Name
Address u_ ,. `7',)r, t '
City
Project Location (County, State Road, Water Body, etc.)
Type of Project Activity
-,
PROJECT DESCRIPTION SKETCH Y rU, I)Tlt
Pier (dock) length 1 n<
Groin length rjb
number
��p g
Bulkhead length
max. distance offshore
Basin, channel dimensions
cubic yards
Boat ramp dimensions
Other
f F
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.
Phone Number
_ State zip 7
(SCALE: Irv)
�tr'�ir�7��
issuing date
applicant's signature
permit officer's signature
expiration date
attachments " c / ! •� J v ® �J
In issuing this permit the State of North Carolina certifies that �r f /
this project is consistent with the North Carolina Coastal application fee �� F � I �t G 3 �� 2 Ci J e
Management Program.

— ' - -- — x Y i? a 3l 1 k-Y "I' IR 6-. NIUVIENJ.
I hereby certify that I own property adjacent to
(Name of Pro ert p , s
property located at O� `� N � P y wuet )
�' 4+tI L
(Lot, Block, Road, etc.)
on MAP (Waterbody) L ' ui ` '9 C' Y , N.C.
cT�and/or County)
He has described to me as shown below, the development he is proposing at that locatio
and, I have no objections to his proposal. n,
DESCREP'.I'ION AND/OR DRAWNG OF PROPOSED DEVELOPMENT
(To be filled in by individual proposing development)
oM,S 1 h
(TO t �( �
f i t7�
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La
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- -- �I 1 yPC 1vame
Telephone Number
Date: C

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ADJACENT RIPARIAN PROPERTY OWNER STATEMENT (FOR A4� L, I <r--r
I hereby certify that. I own properly adjacent to
DR-f�- 'S
b-
property located at
/ (lot., block, road, eytcc..))��.J��'j
�N 1� 1 O� ��N��_ � iTl �' •!7 l /� BC# N.(;
OCl .
(water body; (town and/or county)
He has described tome as showTi below the development he is proposing at thoit location
and I have no objections t.o his proposal. I understand that a pier must be set Lack a
m.itTimurn distance of 15 feet fr^1n my area of riparian access unless waived by me.
Lido o not w! h to waive that setback requirement.
(cire
Description and/or drawing o; roposec-� development: (to be filled 11, by individual
proposing developmen?)
S
P
Phone Number

1 V
ADJACENT RIPARIAN OWNER STATEMENT (FOR A-'i'"f, )
'8,r.,ffT LIB
I hereby certify t.ha". I own pruperL . adjacent toDft 4 600
Mn-,Pk-
property located at: aQ6 _L '-.`._.cS. 44 � — ��. am � .-- --.
�.r , (iot., block, road, etc.)
o I,-l-I��--'-N
(water bod-J ) (town and/or county')
He has described tome as sho ,r, the development he is proposing at th;it loc�tt�.
and I have no objections l.o i1i!. pr(%posal. I understand that a pier must be set ha(-k
minimurn distance of 15 feet from m-' area of riparian access unless waived by ric.
I do do riot wish to waive i—, i. cle'. n.=.c:lt requirement.
role onto)
Description and/or drawing nt >r );�,js()(i development: (to be fUled In by
f
)posing development
c;: n6
6tR
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gnature
Name
�%�]
Phone Number