19820_RHORA, CHARLES_19980422

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CAMA AND DREDGE AND FILL
GENERAL Y
y?I9820- 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 f = `�°= Jd �� Phone Number ---j6C
Address ✓• ''<�, ,.:cv .
City%� f \i("e,, x,r State Zip S S
Project Location (County, State Road, Water Body, etc.) ��• ''� T r -
Type of Project Activity
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PROJECT DESCRIPTION
SKETCH
(SCALE:
Pier (dock) length
Groin length
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S
number
Bulkhead length
max. distance offshore
Basin, channel dimensions
cubic yards
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Boat ramp dimensions
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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.
attachments
applicant's signature
permit officer's signature
issuing date expiration date
In issuing this permit the State of North Carolina certifies that
this project is consistent with the North Carolina Coastal application fee
Management Program.

31
MUD BUCKET DREDGING, INC. 66-30/133 1142
ATLANTIC BEACH CAUSEWAY NCDL 8039839
PO BOX 3355 PH(919)726-2191 Q
ATLANTIC BEACH, NC 28512 Date l
Pay to the r � c I $
Order i-1
Dollars 0.
FIRST CITIZENS 133
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ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
Is
hereby certify that I own property adjacent to
�i1 Lf(1' is property
located at _��(`' /'� /�� �,' on
(Lot, Blocky -,Road, tc . )
/ in N.C.
JJ— (Water Body) (Town and or County)
He has described to me as indicated below the development
he is proposing at that location and I have no objections
to his proposal. I understand that a pier, pilings and
dredging must be set back a minumum distance of fifteen feet
(15') from my area of riparian access unless waived by me.
I do not wish to waive that 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.)
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Signature
Print Name
as- -
Date Phone Number

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I obi property adjacent to
.� /�� ' s property
located at lr/f2�, on
(Lot, Blo k, Road, etc.)
at'X101 �17
in
7 I.C.
(Water Body) (Town and/or County
He has described to me as indicated below the development
he is proposing at that location and I have no objections
to his proposal. I understand that a pier, pilings and
dredging must be set back a minumum distance of fifteen feet
(15') from my area of riparian access unless waived by me.
I do not wish to waive that setback requirement.
Y_ I do wish to
waive that setback requirement.
Description and/or drawing of proposed development:
(To be filled in
by individual proposing development.)
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