10717_General Permit_19920714

CAMA AND DREDGE AND FILE
GENERAL =I-R-In
PERMIT c NM10717
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 15 NCAC I Zf /- aOn
Applicant Name �(H00
Address r2 f L?OX 15 7
City, f%6VE St
Project L/tion (County, Stat/eRoad, Water Body, etc.) �l/P/w o
Al%
Type of Project Activity
PROJECT DESCRIPTION
Pier (dock) length
Groin length
number
Bulkhead length
max. distance offshore r
Basin, channel dimensions
cubic yards
Boat ramp dimensions
Other
SKETCH
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 S)-:� — /
ate / ^G
Div /✓/ti/Ji---
Tl o e,U eip
zip�S �[o
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applicant's signature
permit officer's signature
4;�
issuing date expiration date
- attachments . % V //00
In issuing this permit the State of North Carolina certifies that �Q O
this project is consistent with the North Carolina Coastal application fee
-
Management Program.

i
ADJACENT RIPARIAN PROPERTY OF&TER STA'MIENT
I hereby certify that I own property adjacent to Ro6cozT- 3T oZoiJjZ_ '
property located at--Lfts"� ; n ' ®F A 1 CH S T _ , 51 � I ERUV OCI C) 1 ' i D N
(lot, block, road, etc.
on Pi1'T�VI }IJ C12EE1G
(body of water) (town) '
:Iortl; Carolina in Pamlico County. The proposal has been described to me as shown belca;
the dcvelopment, a pier/ ulkhe /structure, and the proposed location, and I have no
(cir ne)
objections to the proposal. I understand that if the development is a pier, it must
!,e set back a minimum distance of 15 feet frcm my area of riparian access unless waived
!-,v me. i �-od�o not wish to waive that setback requirement.
(circle one)
�-ription and/or drawing of proposed development: (to be filled in by individual
ctr_-�ng development.) INDICATE THE SIZE AND LOCATION OF THE STRUCTURE AND `1HE
_'-��'CE BEI'�„'EEI�I EACH PROPERTY LINE AND THE WATER.
PrGfOA
b;;�Khead
q C�/ Ror)66:R&
COT- 5' i Roup Lo f
LOT
.10 1
`07- 4
'i NG GOT
L11 N ;_--
(Original must be retained in the Inspection Department)
1
- - igna ure _— ------
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�Nrz1s-r�ryPNck
Name (Please Print)

H WF' 11 >- T H 1_1 1 2*_ 5 0 O F=. F i F• U t o f It H 1 a•. Cl F-a E h 1 T F' F' 11 a
AA7AG'ftN7` P,TPARx.4�"V FROk��bc'tiY c:'S� J���`��L—`"`'
I hereby certifY that I crvm pipezt Y ad Jacent to
property (lot,
On, ( town )
of water) �„ -- hay beendes:.: ibed to r as
rlo t.}, ��rol ina in Pam11cO Ccurty. ~ -
the C?CVeioj� .nt, a Sex 2DOle;ir
;.*CSed 1C i� jam, d I ha'�e nO
tgie. �: it n;,.,st
C1hjCCtaCf:a t4 the j?}Ota4Shc I�.
',e Sit back a mrnw� inid18C11Ge Of 15
0
by rc . i 'ic
� rat w: S-n to waive that
t'" on e i
«r�►,y�►A*wA+t�kwwww,t**itkkiti�**•hft**'k*ir*�*irlrtc*NSA**�►�*�`, ,,�? 1i��G .:.;a may' �(1Ci�%sC:'.-1�!
^r;(tt�on rand/Qr dz'awing o proposed denelOpnerxt-,
INVICATE 'z'F'.� 5 AID ,-,OCATIO0 OF THE
AND ' riE 4ti ,TElk
. �''.I\'CE Br`i Li:�l EP.C'rl �'R0�'F�'S'Y LIIVF
k*�+4*1rMtF*+�*#fit*RAi�*k*#1t�k'A'*****14k�t•k,kR*#+4***d� A'ANw***t*aww*tA*r.x+twx wwy•+.,•,, '
(Original must be retained in the ri©^, DepdrC7+,G'nt)
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