23150_POLO, BOB_19990721

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CAMA AND DREDGE AND FILL
GENERAL fli? 23150 -G
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
Applicant Name Phone Number
Addressz-
City State Zip
Project Location (County, State Road, Water Body, etc.)
Type of Project Activity! -F,2' N '"
PROJECT DESCRIPTION SKETCH (SCALE: )
Pier (dock) length
41 �.
Groin length
number
Bulkhead length
max. distance offshore `
Basin, channel dimensions
cubic yards
Boat ramp dimensions
1
Other T
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 Iotal 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.
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t !
applicant's signature
permit officer's signature
issuing date expiration date
attachments
application fee

3056
FOLEY & FOLEY CONTRACTORS, INC.
PH. 252-636-2515
1810 OLD AIRPORT RD.
P.O. BOX 3462
NEW BERN, NC 28564 '� DATE / 66-1185/531
-��
4 PAY
i TO THE
ORDER OF
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_ ��� A� 1 1 � I� � 1 I I I I � �' DOLLARS 0 ��,M��
&TRIANGLE 6T 5-a3150 —
BANK Hwy. 70 O�I� as s
� New Ile-, NC 0
FOR O — r� t ) r9 1/ C 1� � Yt �I j h NP
- - --- ---- - --L----------- ---
II10000 30 S P30 i:0 5 3 L L L8 5 2i:0 9 3 L000 L 60lim

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(TOR APIER/1N0ORING PILINGS1R0ATLjjT1R0ATjj0U,5rT)
I hereby certify that I own proj)crty adjacent to
(Name of Prolierty Owner)
property located at Vo-T Sr 14
(Lot, Block, Road, etc.)
on , in FItoi-j
(Waterbody) ('Town and/or Connty)
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/boatliftlboathouse must be set back a minimum distance of fifteen feet (15') from my area
of riparian access unless waived by me.
I d9 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)
So I � Q v cco PFR Rmil,
/-v aw 13 54 ; N -C.
gUUf re
s t- (o
S�`ignature -� --- -
Print or Type Name
Telephone Number
Date: `%-- / 6 -- l

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/MOORING PILINGS/BOATLIFT/BOATHOUSE)
I hereby certify that I own property adjacent to E0 �,- 1- d 's
(Name of Property Owner)
property located at k T a %Co S.FC -, j"f14
(Lot, Block, Road, etc.)
on tio4 war-T-" egg(t i c- , in /u l� 13F�i� 44UF11) , N.C.
(Waterbody) ('Town 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)
------------------------------------------------------------- ------ - - - - - - - - - - - - - - - - -
Si nature
Print or Type Name
Telephone Number
Date: 7Z � — 9

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