18707_FULLER, BEN_19970711

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CAMA AND DREDGE AND FILL 9
GENERALw s.L0;f 7
PERMIT r°f
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
Applicant Name
,r
Address f (;A 0
City 0 t/ -Z [
Project Location (County, State Road, Water Body, etc.)
Type of Project Activity
PROJECT DESCRIPTION SKETCH ,.. u
Pier (dock) length
i
or
Groin length
number
Bulkhead length
max. distance offshore
Basin, channel dimensions
cubic yards
Boat ramp dimensions
Other
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.
State
Phone Number
Zip
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issuing date
attachments l
application fee
1e
applicant's signature
permit officer's signature
expiration date

66-112 2110
OSPREY MARINE CONSTRUCTION 5110941
2773 HWY. 70 BFT. PH. 919-728-4980 �-, J
BEAUFORT, NC 28516 DATE
PAYT01'HE '// y,/ // I Jr0
ORDER OF l
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4408 ARENDELL STREET
/1/'j'JMOOR/E��H'�E/AjD�CIITTNp NC 28557
MEMO (9W-' It� /�/ ` 1 "1-KRt?(]::)
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AD U 4 7 ?d t-(301 380 8949
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
[ FOR A PIER/MOORING PILINGS/BOAT LIFT/BOATHOUSE]
I HEREBY CERTIFY THAT I OWN PROPERTY ADJACENT TO
/ [NAME OF PROPERTY/OWNER]
PROPERTY LOCATED AT
{JAP j 5_ [LOT, BLOCK, ROAD,ECT.]
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./boat lift/boathouse must be set back a minimum distance of fifteen feet [15'] from
my area of riparian access unless waved by me
do not wish to wave the setback requirement.
I do wish to wave that setback requirement.
----------------------------------------------------------------------------------------
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
[ To be filled in by individual proposing development ]
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. SIGNATU�E
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TELEPHUM
ONE NBER
DATE: 5 / o�,