27022_BJORK, LESLIE V_20001128

Applicant Name
Address
CAMA and DREDGE AND FILL use 27022
G E N E R A L
PERM I T
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
T
City
Project Location (County, State Road, Water Body, etc.)
Type of Project Activity
PROJECT DESCRIPTION SKETCH
Pier (dock) Length
Groin Length
number
Bulkhead Length
max. distance offshore
Basin, channel dimensions
cubic yards
Boat ramp dimensions
Other
State
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 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
zip
issuing date
(SCALE: i, -. )
applicant's signature
permit officer's signature
expiration date
attachments
application fee

i9
FO
PH. 252-636-2515
1810 OLD AIRPORT RD.
P.O. BOX 3482
NEW BERN, NC 28564
PAY
TO THE
ORDER OF
Al; CAols
!r ley
DATE- /%C�-0C7
3667
66-1185/531
All, !nlll IIIflI .,,„,
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A&TRIANGLE
M\ BAN K Ne �t<«
-� ,, ^��New Bern, NC 28560
FOR1 ,l�I�it4rt F�'�7' a- u•(3� � N��j�i„ M,
II'0000366711• 1:05311113S 21:093100016011' .�

Customer Job Requiretment Worksheet
Customer Name 1, E S L l E V 3r011e, K Date / 0- 3- D O
Mailing Address ?0,41 f-1,414JKS,B1GL CT, Job site Address IF014 Cou? l
/1il�-z vu B rkrr , t I C 2-852 o
Phone# �, 3 F- 6-0 / Fax#
. , Adjecent Property Owner
Left side TsEt H MCCA,3i Right side ::(-oAIQ cNVQA/eL-WA6t-,Dk-rCV.
-
Date Mailed
Cert. Mailed
State
City
County
Fairfield Harbour
Returned Date Mailed lb Returned
Returned Cert. Mailed Returned
Permit Required
Bulkhead
Dock
Boatlift
Jettie
Dredge
Recived
Recieved
Recieved
Recieved
Job Type
Boathouse
Jet Ski Lift
Ramp
Piling
Repair

I hem -by o mtify that I own propaty adjacent to
I- F51,, / /C::- V 't TVR- V- �'a property located at
(Name of Property Owner)
L D 5 EGT/O�
WK'5'F'1LL-- (20up-T F-AJRrcLLD /-)ARB31 au 1�
OAt, Block, Road, etc.)
(Waterbody)
Cj4A /FN
(Town and\or County)
He has described to me, as shown below, the development he is proposing at that location,
and, I have no objectiams to his proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPNMNT:
(To be filled in by individual proposing development)
I.
-Signature
27 a 22 sc A
Print or Type Name
Telephone Number

no�
Fol-,EY F®LEY
M A .1 1 N* F CONT gd�CT0RS, I H C.
P.O. Box 3482
Npw Bern, North Carolina 28564-3482
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P 839 475 360
Receipt for
Certified Mail
No Insurance Coverage Provided
UNITED STATES Do not use for International Mail
POSTAL SEMCE
(See Reverse)
nt to
Slr,eet and No.
6-1
P.O., State d ZIP Code
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Postage
$ .�
Certified Fee
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Special Delivery Fee
Restricted Delivery Fee
Return Receipt Showing
to Whom & Date Delivered
Return Receipt Showing to Whom,
Date, and Ad
TOTAL P ,.
8 Fee
Pos r Date
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CERTIFIED MAIL FEE, AND CHARGES FOR ANY SELECTED OPTIONAL SERVICES (see front).
1. If you want this receipt postmarked, stick the gummed stub to the right of the return address
leaving the receipt attached and present the article at a post office service window or hand it to
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2. If you do not want this receipt postmarked, stick the gummed stub to the right of the return
address of the article, date, detach and retain the receipt, and mail the article.
3. If you want a return,receipt, write the certified mail number and your name and address on a
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endorse RESTRICTED DELIVERY on the front of the article.
5. Enter fees for the services requested in the appropriate spaces on the front of this receipt. If
return receipt is requested, check the applicable blocks in item 1 of Form 3811.
6. Save this receipt and present it if you make inquiry. 102595-93-B-0290
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I hereby certify that I own property adjacent to
(Lot, Bloc1c� Road, etc.)
in ckw1lelj C D . NC
(Waterbody) ,��� (Town andlor Co )
He has described to me, as shown below, the development he is proposing at that location,
and, I have no objections to his pmpowd.
DESCRIPTION • •• DRAWING • • ••••• -DEVELOPMENT:
Cro be filled in by fixfividual proposing development)
1 �zq d
1 3I
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Print or Type Name
Telephone Number

40 SENDER: I also wish to receive the
■ Complete items i and/or 2 for additional services. fOIIOWIn services for an
i rn ■ Complete items 3, 4a, and 4b. g
W ■ Print your name and address on the reverse of this form so that we can return this extra fee):
card to U.
■ Attach this form to the front of the mailpiece, or on the back if space does not 1. ❑ Addressee's Address
` permit. 2. ❑ Restricted Delive
■ Write "Return Receipt Requested" on the mailpiece below the article number. n1
0 ■ The Return Receipt will show to whom the article was delivered and the date delivered. Consult postmaster for fee.
0 3. Article Addressed to: 4a. Micle Number
E'0.)'6hV...�0
5C� � ^�r-Z--�^aye--` C' � 4b. Service Type
Cy �p� �a���51rj, \� \ �.Eiegistered E<Certified
\�� ❑ Express Mail [I insured
w ro ❑ Return Receipt for Merchandise ❑ COD
CY 7. Date of Delive
¢ 5 ceived By: (Print Na e) 8. Addressee's Address (Only if requested
and fee is paid)
j . Sign re: (Address a orAgent)
L
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w PS orm 3811, Dec mber 1994 102595-98-B-0229 Domestic Return Receipt

UNITED STATES POSTAL SERVICE
First -Class Mail
Postage & Fees Paid
USPS
Permit No. G-10
• Print your name, address, and ZIP Code in this box 0
FOLEY&FOLEY
MARINE CONT RP Clogs, INC.
P.O. Box 3482
Npw Bern, North Carolina 28554-3482

I hereby certify that I own property adjacent to
I - 6 S 1- I C \/, a' Ois property located at
(Name of Property Owner)
H/4vuKSBtL-L Cpv/ FA!RF'rrL1> (!Aa8ouR-
(14 Block, Road, etc.)
BRA✓E�
on SARI 6- CR.GE 9-- , in NEW j34 &J cov"TY _, NC
(Waterbody) (Town 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.
------------------------------------------------------------------------------------------------------------------------
DESCRIPTTON AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
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Print or Type Name
Telephone Number