27062_ALLEN, LEROY_20001130

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CAMA and DREDGE AND FILL n-6,27062 <<
G E N E R A L
PERMIT
as authorized by the State of North Carolina
Department of Environment and Natural Resources and the Coastal Resources Commission
in an area of environmental concern pursuant to 15 NCAC CCO
Applicant Name
Address
City
Project Location (County, State Road, Water Body, etc.)
State
Type of Project Activity t= r) z
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 become null and void.
This permit must be on the project site and accessible to the permit of-
ficer when the project is inspected for compliance. The applicant certi-
fies by signing this permit that 1) this project 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.
In issuing this permit the State of North Carolina certifies that this project
is consistent with the North Carolina Coastal Management Program.
Phone Number , .'r
zip
issuing date
applicant's signature
permit officer's signature
expiration date
attachments
application fee

MUD BUCKET DREDGING, INC. 2465
ATLANTIC BEACH CAUSEWAY NCDL 8039839
PO BOX 3355 PH(252)726-2191 ( 66-30l531
ATLANTIC BEACH, NC 28512 Date / 133
Pay to the
Order of_ (� (� s / cz
dpi
�r ollars
fIRST CITIZENS-,
B /� N lI FirstCiti=ons Bank $ Trust Co—,
jjru �i� Atlantic Boach, N.C. 28512
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1:053100300i:001312160673u' 02465
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GUARDIAN® SAFETY BLUE WDBL

ADJACENT RIPARIAN PROPERTY OvNER STATEMENT
I hereby certify that I own property adjacent to.
,A/ , s property
located at 14(04'6-146--o Aot`-') -Po, /dok 2.�(0 on
e
(Lot, Block, Road, tc.)
N.C.
(Water Body) (Town a)id/or County)
He has described to me as indicated below the development
he is proposing at that location and I have no objections
to his proposal. I understand that a pier, pilings and
dredging must be set back a minumum distance of fifteen feet
(15') from my area of riparian access unless waived by me.
U
I do not wish to waive that sEtback requirement.
I do wish to waive that setback requirement.
Description and/or drawing of proposed development:
(To be filled in by individual proposing development.)
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ADJACENT RIPARIAN PROPERTY Di7:JER STATEMENT
I hereby certify
that I own property adjacent to.
�i_ LC-i�dCr
,�LLE�1 %ZC, 8768 , s property
located at -
o�Ei� rG7 �}cJcr -:�)o11,30 Zj�*, on
/� -7LL.4u
(Lot, Block, Road, etc.)
i
L'�I4c/N�L
S/Z , N.C.
in
(Water Body)
_141-LAAlr-t-
(Town and/or County)
h
He has described
to me as indicates below the development
he is proposing at
that location and 7 have no objections
to his proposal. I
understand that a ;pier, pilings and
dredging must be sec
back a minumum distance of fifteen feet
(15') from my area
of riparian access unless waived by me.
I do not wish to waive that setback requirement.
I do wish to waive that setbacK requirement.
Description and/or drawing of proposed development:
(To be filled in by individual proposing development.)
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Date
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Prir.'= Name
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Phon -, 'Number