20495D - Croom

• ;`. CAMA AND DREDGE AND FILL
GENERAL ISPii 020495-D
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 7 Al .1..)00
Applicant Name �, C RooN !U` v4"1 3"A'" 6o (
Phone Number
/ is. 3 7
Address i5194 S �11 FAite JNr
City G,�,fivY1, r` •JJ State /VC Zip 211-y0 S
Project/ Locatiop ( unty,Stated, Water Body,etc.)__ _47i"�y Ae1,�e �,,7iI' Ci &? IC,
lV"' MAOifeA vv • /
Type of Project Activity (30kt L rW d 0,.. IN) f 2 f`'r",Q
PROJECT DESCRIPTION 4 4 kt\( \r(
(SCALE: 1 l_ 3J )
if
Pier(dock) length �� ,.ti 1 i.c _ (,
C� /t p -
�
Groin length 7347g
� '�'Pi
number `/ Nc �e
Bulkhead length �"�""'�4 , Pr
,,,,,y
max.distance offshore
1\ik
Basin,channel dimensions
cubic yards
Boat ramp dimensions
i
Other C t-i4 10'X11 .
,) 'cr /j.je-/�1 •ey'(-41 ( i---c n ,_
This permit is subject to compliance with this application, site ���^`
drawing and attached general and specific conditions. Any A'
violation of these terms may subject the permittee to a fine,
imprisonment or civil action; and may cause the permit to be applicant's signature
come null and void.
444
This permit must be on the project site and accessible to the permit officer's signature
permit officer when the project is inspected for compliance.
The applicant certifies by signing this permit that 1) this pro- — 91 /0'6'-T9/
ject is consistent with the local land use plan and all local issuing date expiration date
ordinances, and 2) a written statement has been obtained from ,
adjacent riparian landowners certifying that they have no 7/7. /...)0 0
objections to the proposed work. attachments
fi I I' .. . r-1

GENERAL PERMIT COMPUTER FORM
APPLICANT NAME: A (4-0 Q.
ADDITIONAL NAMES: P!\±
AEC DESIG: _ (� "� • DEVELOP AREA,_[v \ PROJ DESC: P- 3-
(Will only take 6) (Will only take 1)
WORK: g L (0 I
(Will only take 4)
MAINT:
(Will only take 4)
IMP: 01,1 110
(will only take 6)
ACTION EXPIRATION
DREDGE&FILL REQUIRED:
CAMA MAJOR DEVEL,REQUIRED: 7-6 -S y (t7--f --5

DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER. FORM
Name Of Individual Applying For Permit: NI
Address Of Property:
(Lot or Street IF, Street or Road, City & County)
I hereby certify that I own property adjacent to the above-
referenced property. The individual applying for this permit has
described to me as shown on the attached drawing the development
they are proposing. A description or drawing, with dimensions_,
should be provided with this letter.
I have no objections to this proposal .
If you have objections to what is beina proposed , please write the
Division of Coastal Management , 127 Cardinal Drive Extension .
Wilmington , North Carolina , 28405 or call 910 395-3900 within 10
days of receipt of this notice . No response is considered the s
as no objection if you have been notified by Certified Mail are
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boat
house, lift or sandbags must be set back a minimum distance of 15 '
from my area of riparian access unless waived by me. (If you wish
to waive the setback, you must initial the appropriate blank
below. )
I do wish to waive the 15 'setback requirement.
I do not wish to waive the 15' setback requirement.
64019
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Date
//Mr T #20_9/19
Pri9/0Nam2"v,6—so 7 z
Telephcne mber With Area Code �� F-1NR
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DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER. FORM
Name Of Individual Applying For Permit:
L/Cow_____ _
Address Of Property: Fcp 1.16.: ,� � �A)
(Lot or Street #, Street or Road, City & County)
I hereby certify that I own property adjacent to the above-
referenced property. The individual applying for this permit has
described to me as shown on the attached drawing the development
they are proposing. A description or drawing, with dimensions,
should be provided with this letter.
J I have no objections to this
proposal .
If you have objections to what is beina proposed , please write the
Division of Coastal Management , 127 Cardinal Drive Extension ,
Wilminaton North Carolina 28405 or call 910 395-3900 within 10
days cf receipt of this notice . No response is considered the same
as no objection if you have been notified by Certified Mail
WAIVER SECTION
I understand that a pier, dock, mooring pilings , breakwater, boat
house, lift or sandbags must be set back a minimum distance of 15 '
from my area of riparian access unless waived by me. (If you wish
to waive the setback, you must initial the appropriate blank
below. )
I do wish to waive the 15 'setback requirement.
I do not wish to waive the 15' setback requirement.
'S . gnature
Date ' •
•
Print Name
Telechcne Number With Area Code H NI R

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