19634_HUMIENNY, SIAS_19931014

CAMA AND DREDGE AND FILL
GENERAL
PERMIT
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1963`4-c
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
Project Location (County, State Road, Water Body, etc.) —
Type of Project Activity
PROJECT DESCRIPTION SKETCH
Pier (dock) length r
Groin length
number
Bulkhead length
max. distance offshore
Basin, channel dimensions
cubic -yards
Boat ramp dimensions
Other
State
r�f: c- -_- F 1. .,
Zip
(SCALE:
i
This permit is subject to compliance with this application, site
drawing and attached general and specific conditions. Any 1,
violation of these terms may subject the permittee to a fine, X
imprisonment or civil action; and may cause the permit to be -
applicant's signature
come null and void. h
This permit must be on the project site and accessible to the permit officer's signature
permit officer when the project is inspected for compliance.
The applicant certifies by signing this permit that 1) this pro- 4�
ject is consistent with the local land use plan and all local issuing date
ordinances, and 2) a written statement has been obtained from
adjacent riparian landowners certifying that they have no
objections to the proposed work. attachments
In issuing this permit the State of North Carolina certifies that
this project is consistent with the North Carolina Coastal application fee
Management Program.
expiration date

4672
COASTAL MARINE CONTRACTORS, INC.
P.O. BOX 12729 PH. 252-638-6407
NEW BEnN. NC 28560
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/ 4 66-112/531
DATE
PAY
TO THE 07)
ORDER OF -- — - -- - - - - -- - — - --- -- -- - -- -- _J
d�
- DOLLARS
1'1!�" V l 0 M,
01901 B&F
375 SOUTH FRONT STREET
NEW BERN, NC 28560
FOR i I! U CG����1 l l ` t J -_ -_ C G'(�l-+• nr
- - - -
C'ii'000 N,67 20 1:0531011 2 0:SILO 1126913

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIERIMOORING PILINGS/BOATLIFT/BOATHOUSE)
I hereby certify that I own property adjacent to J5 4tb HuM ) eNti ,s
(Name of Property Owner
property located at ---5 -223 TK�N T L006d6 Dr.
(Lot, Block, Road, etc.)
on `T � C N I '�k 1y,e ✓ , in —r(e ti4 LJ &&dt; - LT dy 6)- ti C D , 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.
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DESCRIPTION AND/OR DRA WM OF PROPOSED DEVELOPSiENT:
(To he filled in by individual proposing development)
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�ulkhead
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- M e Print or Type Name
Telephone Number
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