38032_BRADLEY_20040330

r
'c John Leeuwenburg
J ,Vllt /
�Ys Mark Johnson /
?Xof) 0 This is my dock approved by CAMA
q (e
GENERAL
PERMIT [want you to build it and suggest an installer.
Mike Bradley - 252-241-6841 (cell)
WNpever ❑Modification ❑Complete Reissue ❑Partial Reissue -
"
As authorized by the State of North Carolina, Department of Environment and Natural Res%-, �T[r— 1���' )
to I SA NCAC 1 C� d�=ched
and the Coastal Resources Commission in an area of environmental concern pursuant
Project Location: County ''
Applicant Name
Street Address/ State Road/ Lot #(s)
Address
C
�o -�^� lnstl
Stag ZIP -
City
9l-1
Fax # (—) Subdivision
Phone #
ZIP
City
Authorized Agent
^_
Phone # r Basin
(_) -
❑ CW
Affected ❑ OFA ElHHF
A El ES ❑ PTS
IH ❑ USA ❑ N/A Adj. Wtr. Body
at m unkn
AEC(s): ❑ PWS:
iio PNA
❑FC: Closest Maj. Win Body
yes / Crit. Hab. yes / no
no
ORW: yes /
Type of Project/ ActivitY `I C 1� (Scale:
f- )
N.•
a
Pier (dock) length t —r- T --
i ._1
Platform(
s)i
I I
Fingerpier(s)��'
r_ ir
Groin length a
number I I I�I I j I I 1�-_ 1 i I f ( I t I_ I Q
-- i- 1 i
� _�1 i _ I
Bulkhead/ Riprap length
avg distance offshore-
�
max distance offshore
I i i
Basin, channel-
1
cubic yards 7 TI
l - --- r
ram I- I -�- �I--�--• -- -- — - -'-'-I - -- ' --- � , � �� t_�
Boat p, I��-{
Boathous oath
J.
Beach Bulldozing
Other _I
�i`� o� _ � I I — --
T
Shoreliit
ne Length----
iI
SAV: not sure yes Mn---
�_ { t
Sandbags: not sure yes -� l I
Moratorium: n/a
I. YI .j��
r I I(es
Photos: Y -
Waiver Attached: es% no -- -- -
i River Basin rules.
❑See note on back regarding -
A building permit may be required by: n
Notes/ Special Conditions
1 w
Agent or Applicanf Pritfted III
Signature '* Ple ad compli a statem t on back of permit �*
Permit
01 r4-
L[) 0 k__--

lei DI : 0 0 011.01. 00 G : to) : ►: J: 01110XIN 01 1
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Individual applying for Permit:
Address of Property: 0
P Y=
3e 4w �w f--_ W 'C- 2-8 s / L
(Lot or Street #, Street or Road, City & County)
I hereby certify that I own property adjacent to the above referenced property. The individual
applying for this permit has described to me as shown on the attached drawing the development
they are proposing. A description or drawing, with dimensions, should be provided with this
letter.
I have no objections to this proposal.
If you have objections to what is being proposed, please write the Division of Coastal
Management, Hestron Plaza II, 151-B, Hwy. 24, Morehead City, NC, 28557 or call (252) 808-
2808 within 10 days of receipt of this notice. No response is considered the same as no objection
if you have been notified by Certified Mail.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boat house, lift or sandbags must be
set back a minimum distance of 15' from my area of riparian access unless waived by me. (If you
wish to waive the setback, you must initial the appropriate blank below.)
�- I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
G
Print Name
Telephone Number With Area Code

Ex�si'�nc� 0oc.�tS A �� P�'Iis+SS
4
o 2
Be �� 9.

DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM
Individual applying for Permit:--G ac P �rn �k ��
Name of Inds
10
Address of
1VC 2 $ 5-
(Lot or Street #, Street or Road, City & County)
I hereby certify that I own property adjacent to the above referenced property. The individual
applying for this permit has described to me as shown on the attached drawing the development
they are proposing. A description or drawing, with dimensions, should be provided with this
letter.
V I have no objections to this proposal.
If you have objections to what is being proposed, please write the Division of Coastal
Management, Hestron Plaza 11, 151-B, Hwy. 24, Morehead City, NC, 28557 or call (252) 808-
2808 within 10 days of receipt of this notice. No response is considered the same as no objection
if you have been notified by Certified Mail.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boat house, lift or sandbags must be
set back a minimum distance of 15' from my area of riparian access unless waived by me. (If you
wish to waive a setback, you must initial the appropriate blank below.)
I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
2-1, D
Signa ure Date
Bruce_ Efhri�ge !
Print Name2-600
!
Telephone Number With Area Code

4i
f �
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wa /
BQA�O iL� • �- \ /
C• \ 1e,o bo.�5
�, -�leoe elev.•Iza3
o
mi•s' l�
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8ivee—
ADJACENT RIPA:RMN PROPERTY OWNER STATEMENT
own property acent to
ert 4 °� r %tS s( �'' s
I hereby certify that I r Y ad'J
(Name of Property Owner)
property located at '
(Lot, Block, Road, etc..))
on Q��ne �, in � h/,ITI' , 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.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(To be filled in by individual proposing development)
Re tss ve A CAli,- pes-m � 2clo Vo �
r
of �xt,.�� d�►�S w�-�� d�w�Aie 4#,I,-4ed cvpl o4
Signature
Print or Typ:. Name
Ti-ipnhnnP Nnmhrr
J4 11