10772_General Permit_19920910

iN.
DREDGE AND FILL
PERMIT
N TC '72
as authorized by the State of North Carolina
Department of Environment, Health, and Natural Resources and jhfe stal Resgt/iAr l 1ii}nission
in An area of environmental concern pursuant to 15 NCAC f _ —'C�'
Applicant N
Address --j
City, f�
Project Locz
Type of Project Activity
PROJECT DESCRIPTION I SKETCH
N�mber 12 '����,
(SCALE:
Pier (dock) length
Groin length
number i' ✓�
Bulkhead length
�y
. distance offshore jAj L
' n P%
Basin, channel dimensions
cubic yards
Boat ramp dimensions
Other
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. /
I
This permit must be on-fhe 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-
fs consistent with the local land use plan and all local
nces, and 2) a Wrjjt .n ctatPmr nt hac hPPn ob ained from
-IWent ri arian 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.
ap
permit officer's signature
issuing date
expiration date
attachments
application fee. l /

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to
6f-Jr % r- 's property located at
(Ngfine of Property Owner)
-- O (Lot, Block, Road, etc.)
on i nIp.�� N . C .
(w erbod ( own 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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�oPr' i
r
Signature
Print or Type Name
q1%- 7Z61- IY25
Telephone Number
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ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to
Is property located at
Nano of Property
- � F
(Lot, Block, Road, etc.)
on , iI� a���, N.C.
aterbody) Town and/or Cou
I
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 propo�si�n�g7 development)
4r(s%T"'R'a—R''
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14 Rai
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Signature
711
Print or Type Name
Telephone Number
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ADDRESS
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COD NO.
GP #C-10772
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GENERAL PERMIT APPLICATION INFORMATION
APPLICANT'S NAME:
i (FiJqst
K ADDRESS:
I
Middle
Last
PZAiAKENf) rY LL %��,,AI/ — iSZ---STATE J), C-1 ZI %D
TELEPHONE: WORK ( ) ,IL7-- Y `� HOME
CONTRACTOR'S NAME: TELEPHONE NUMBER
PROJECT LOCATION: N.C. SR # Road/Street Name j �J
• Waterway Name County
Townj.1 n� Subdivision
PROJECT ACTIVITIES:
PIER: Total dimensions of pier from MHW to platform
(Length) (Width)
'T' or 'L'-head platform
(Length) (Width) (Number of Mooring Piles)
Water depth at end of pier
HOUSE/BOAT LIFT:
Length
Number of Piles
Number of Mooring piles
Width
Water Depth
BULKHEAD: III Total length Ar
Average distance waterward MHW zr
Maximum distance waterward MHW
#2
Total length
Average distance waterward MHW
Maximum distance waterward MHW
RIPRAP: Total length
EXCAVATION: [MAINTENANCE 'ONLY']
Length Width
Base width from MHW
Depth of Cut
Adjusted water depth on MLW Existing water depth(s)
Estimated Cubic Yards (length x width x depth/27)
Type of spoil: Sand
Dragline
OTHER STRUCTURES:
Mud
Backhoe
Hydraulic

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