14766_OVERBY, DENNIS_19950809

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CAMA AND DREDGE AND FILL
GENERAL x,? "t 1°3-- 4'
PERMIT
as authorized by the State of North Carolinali
Department of Environment, Health, and Natural Resources and the Coastal Re rces Commission
in an area of environmental concern pursuant to 15A NCAC d'2,4� doo
Applicant Name / y� «'-
Address,
City r`�'rr "F '• State
Project Location (County, State Road, Water Body, etc.)
Type of Project Activity
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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.
dA A.40 46 applicant's signature
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permit officer's signature
f issuing date expiration date
attachments ` � / ,r
In issuing this permit the State of North Carolina certifies that
this project is consistent with the North Carolina Coastal
Management Program.
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✓f application fee

CHADWICK CONSTRUCTION CO. 66-112/531 1792
LIC. 2294863 LIC. 2916140
PH. 919-728-4504
RT. 2, 327 STEAMSHIP LN. _
NEWPORT, NC 28570 19
PAYTHE '!i /•+ r / l
ORDERER OF
DOLLARS
BB&T
.......A..... An. I ....... ..
MOREM EAD CITY. NORTH CARO
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MEMO
l:05310 1 121l:51100936 26111 179 2

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to
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(Nva��me of Property �)
T -',✓ I "� 9 - _ 4-4 , i
is property located at
(Lot Block, Road, etc.)
on �• . in L �%, N.C.
(Waterbody) (Town and/or Co` —
He has described to me, as shown below, the development he is
proposing at that location, and, I have no objections to his
proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
Si h ature
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Print of Type Name
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Telephone Number
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