13975_DAVIS, ROY_19950216

O
CAMA AND DREDGE AND FILL
GENERAL
� PERMIT Cam/
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�• �� `
Applicant NameSUC%
Address J:3
City
Project Location (County, State Road, Water Body, etc.
Type of Project Activity
Phone Number
State t�Lf zip
F
PROJECT DESCRIPTION
SKETCH
(SCALE: 6� )
Pier (dock) length
Groin length
number
I
i
Bulkhead length
I l
1
± r
j
max. distance offshore
Basin, channel dimensions
I
t
cubic yards
Boat ramp dimensions
Other
1
-
rCi
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.
f r f Cc �i
applicant's signature
permit officer's signature
issuing date expiration date
attachments . ' ///6o
In issuing this permit the State of North Carolina certifies that o / /
this project is consistent with the North Carolina Coastal application fee —�� S
Management Program.

s
' CHADWICK CONSTRUCTION CO. 66-112/531 1492
LIC.2294863 LIC.2916140
PH. 919-728-4504
RT, 2, 327 STEAMSHIP LN.
NEWPORT. NC 28570p G 19
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PAY TO THE /- ) �J $ I(�._d -
ORDER OF y( t // ��1 . _ .
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OR EAQ TY. NORTH CAR041 66
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ADJACLNT RIPARIAN PROPERTY OWNER STATEMi'.NT
hereby cektify that I own property adjacent to
`�,AName of Property Owner)
A
,(Lot, Hlc
o n i/ e(')
T(Waterbody)
's property located at
k, Roa n etc/. ) /
in � �r7` ) N . C .
(To 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.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
)ZIP
01 if 114 t- LL L q /,//
141-
4 S2- \ /
9 nt r Type Name
7� l
Telephone Number

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
hereby certify that I own property adjacent to
's property located at
($ame Coif `gropert owner)
�e
,� _t (Lot, Block, R ad, etc.),/
(Waterbody) ( own 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.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
Signature
Print or Type Name
Telephone Number
P