13911_LONG, WESLEY_19950210

CAMA AND DREDGE AND FILL
GENERAL(`
PERMIT C�
as authorized by the State of North Carolina
Department of Environment, Health, and Natural Resources and the Coastal Res rces Commission
in an area of environmental concern pursuant to 15A NCAC
Applicant Name y"^� ' Phone Number
Address �" 1
City
Project Location (County, State Road, Water Body, etc.)
Type of Project Activity
State
zip
PROJECT
P ..
Groin length
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MEMO
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Bulkhead length
MMNNEMMM
max. distance .
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Basin,!
cubic yards
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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.
In issuing this permit the State of North Carolina certifies that
this project is consistent with the North Carolina Coastal
Management Program.
attachments
application fee (%'
issuing date
applicant's signature
permit officer's signature
expiration date

WESLEY C. LONG Nc 6221'155
CAROL C. LONG 66-30/531 3397
RT 4 BOX 308 726-5996
GULL HARBOR
NEWPORT, NC 28570
19
PAY TO THE '�;' C
ORDER OF.
DOLLARS
FIHST CITIZENS(� /,
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BANKf"iCouens banks IfU$1 Company
MQ�IMQQU CIly, NC 28557 /
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I:053100300-l-. IL726LL58n- 3397
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Receipt for
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Special Delivery Fee
Restricted Delivery Fee
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to Whom & Date Delivered
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Return Receipt Showing to Whom,
Date, and Addressee's Address
TOTAL Postage
& Fees
Postmark or Date h ,
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SENDER:.
y • ComptPte items '-and/or 2 for additional services.
y • Complete items 3, and 4a & b.
r ` • Print your name and address on the reverse of this form so that we can
return this card to you.
y • Attach this form to the front of the mailpiece, or on the back if space
does not permit.
L• Wrte "Return Receipt Requested" on the mailpiece below the article number
• The Return Receipt will show to whom the article was delivered and the date
Gdelivered.
I also wish to receive the
following services (for an extra ai
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fee): >
1. ❑ Addressee's Address cn
2. ❑ Restricted Delivery
Consult postmaster for fee. aVi
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3. A�icle Addressed to- �
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y PS Form 3311, December 1991 *U.S.GPO: 1992--323.4w DOMESTIC

UNITED STATES POSTAL SERVICE '��A fv ?
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Official Business `� Y NATTY FOR PRISt, ^t�
�4 g E TO AVOID PAYMENT
OF POSTAGE, $300
Print your name, address and ZIP Code here
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ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/HOORING PILINGSIBOATLIFT/BOATHOUSE)
I hereby certify that I own property adjacent to 's
n 2 (Name of ro�/perty Own )
property located at 7 � ' /��. � ,Z / f> of
(Lot, Blo k, Road, etc.)
oni in N.C.
(N' aterbody) 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. I understand that a pier/mooring
pilings/boatlift/boathouse must be set back a minimum distance of fifteen feet (15') from my area
of riparian access unless waived by me.
I do not wish to waive the setback requirement.
I do wish to waive that setback requirement.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
-- ------------- - --- --�--- --------------------- p---= -
---------------------------1--
Signature
�o6Eff- 1 I- c--P Cec
Print or Type Name
o I9-7.2b—fib 3.2
Telephone Number
Date: I Z 121 �%�

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