27998_CHAMBLEE, JOHN_20010515

CAMA and DREDGE AND FILL
0 27998
G E N E R A L 1:r1
PERMIT 1-
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
Applicant Name l k- ( I,10JI(,.Q Phone Number
Address 1 a n e
City
Project Location (County, State Road, Water Body, etc.)
Type of Project Activity 1 '±' b,G ,. !n
State Zip
and attached general and specitic conditions. Any violation or tnese 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.
applicant's signature
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permit officer's signature
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issuing date expiration date
attachments
application fee

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MUD BUCKET DREDGING, INC. 2664
ATLANTIC BEACH CAUSEWAY NCOL 8039839
PO BOX 3355 PH(252)726 2191 %/ �� �D I 66-30/531
ATLANTIC BEACH, NC 28512 DaLe 133
Pay to the /�
Order of& � `�%! /e I $ 7—ev f
'q Dollars 8 �
FYRsT CITIZENS-,
13/krK *JFirst-Citizons Bank & Trust Company
ara Atlantic Beach, N.C. 28512
For-
1:0S3L003000DL312160673110 02664
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ADJACENT PIPARIAN PROPERTY OIINER STATEMENT
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I hereby certify that I own properly adjacent to
is property
located at _ �d �Oc)4JZ52 10,e10 - on
(Lot, Block, Road, ,'-c. )
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AecEss e1-14AIAI;! c_ in 1A i c 4, ric Tdrg,f�! ZBSrZ N.C.
(Water Body) (Town ar,d/or County)
He has described to me as indicate(' below the development
he is proposing at that location and _. have no objections
to his proposal. I understand that a bier, pilings and
dredging must be set back a minumum dj-,tance of fifteen feet
(15') from my area _.f riparian access snless waived by me.
I do not wi:;h to waive that s(-�back requirement.
I do wish to waive that setbac: requirement.
Description a,td/or drawing of pr:'Dosed development:
(To be filled its by individual prc.)osing development.)
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Date
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ADJACENT PIPARIAN PROPERTY OUNER STATEMENT
I hereby certify that I own property adjacent to
VoN(2kIA1429L44- is property
located at _ /d S oydp VA?06- , on
(Lot, Block, Road, :etc.)
ASCEs$ (D-IAW44l L i n .A I "N T/cT, &AeF/ 765-12 N.C.
(Water Body) (Town ai_3/or County)
He has described to me as indicate(below the development
he is proposing at that location and =: 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.
I do not wish to waive that s(cback requirement.
I do wish to waive that setback requirement.
Description and/or drawing of rr-,-,00sed development:
(To be filled in by individual proposing development.)
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