23113_GORDON, BOBBY_19990803

M AN X
' CAMA AND DREDGE D FILL
GENERAL ? 23113 - 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
Applicant Name Phone Number
Address
City State Zip
Project Location (County, State Road, Water Body, etc.)
Type of Project Activity
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PROJECT DESCRIPTION I SKETCH
Pier (dock) length
`4
!j
i
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.
(SCALE:
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applicant's signature
issuing date
attachments
application fee r'
permit officer's signature
2
10 1
expiration date

JERRY WAYNE MANN .
LIC.3771534 NCDL 66_85
P.O. BOX 956 PH. 919-247-3828 531 360
BAY MEADOWS, NO. A-3 02801�1i0940
." MOREHEAD CITY, NC 28557 DATE uu csC?
PAY TO THE
_ORDER OF C� .
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7 / 26.' 19917• ,F1 915"25r 124
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X hereby cerdty that I
i
propem Iacated at
onI�V� ` I
-__ �i �0 /♦
(Wateltody)
He bar described W me
and, Z have no objeciims to 3 j
DES CREMON )
Mo be
MUht�ttl�L! iM� +v xr��
exurr.KtY OWIqR STATEMENT
(Name of Pl op#M Owner)
A
Black, Rash,
Ul C a �tr. , N.C.
(Tpwn jdlor COunty)
below, the Oveloprnrnt he is .propodAg at that location,
DRA%-WG OFIMPOSED D.rvEWpNMNT
by ir&W(dual pr�pvs g develOptoi�,tj
i
O Ji Cswgi�
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ft
``S �� "E,
Prlr► o TType Name
T j hone Nwnber
i

'_�,,k zN PROPERTY ONivER STA
I hereby certify that I own property adjacent to l3c- tl, a or�,jd,s
(Name of Property Owner)
property located at 5 (�� 0L0—t,B—Ioc—kk,
� co s� , o n �� G (.�
Road, a c.) '
On
(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.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPAMYT
(To be filled in by individual proposing development)
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Signature
mint or Type Name
"tow ySL —zoo - i g9 3
Telephone Number
Date: