14713_LISS, GEORGE_19950524

CAMA AND DREDGE AND FILL
GENERAL I"� " ~C'
PERMIT'
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 021-1. // oc-1
Phone Number
Applicant Name
Address City , �G�L� .>. tr S State A) 17 Zip 191?01.1
Project Location (County, State Road, Water Body, etc) r r�
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Type of Project Activity
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PROJECT DESCRIPTION
Pier (dock) length
SKETCH
(SCALE:
7�
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Groin length
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number
QulkheaS length
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4
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max. distance offshore
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Basin, channel dimensions
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L.}ri'S
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cubic yards
Boat ramp dimensions
Other
1,Poll C.,
,
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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.
applicant's signature
permit officer's signature
issuing date expiration date
attachments 0.12#- //b ()
In issuing this permit the State of North Carolina certifies that
this project is consistent with the North Carolina Coastal
Management Program.
application fee �-�/�O �`"' � ��� le

CHADWICK CONSTRUCTION CO. 66-112/531
1678
LIC. 2294863 LIC. 2916140
PH. 919-72"504
AT. 2, 327 STEAMSHIP LN.
NEWPORT, NC 28570
19
PAY THE�T"l r , / ` e
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ORDERER OF
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DOLLARS
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OREHEAD CITY. NORTH CAROLINA Z0567
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1:053101121i:511009362611' 1678
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ADJACENT RIPARIAN PROPERTY OWNER STATEMINT
I hereby certify that I own property adjacent to
's property located at
(Name of Property Owner)
(Lot, Block, Road, etc.)
on / (7 �lJ in N6,uy jRr 0?04- 3 1 N.c.
(Waterbody) (Town and/or County)
fie 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
(To be filled in
e
v
PROPOSED DEVELOPMENT:
proposing development)
SignAture
L,
Print or Type Name
Telephone Number

ADJACLNT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to
Is property located at
(Nam4 of Property Owner) l
�S- %= Sew �� �`-e �� ►
r- (Lot, Block, Road, etc.) )
on L �' to A, in ) VrP ,�s�le7`e�e21 �'r ,.� N.C.
(Waterbody) ffciin 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
(To be filled in by individ
P
PROPOSED DEVELOPMENT:
proposing development)
Signaturle
1E' Ice Sly
Print or Type Name
7'
Z - 331
Te ephone Number