24499_GERSBACH, HARDIE_20000313

CAMA and DREDGE AND FILL
G E N E R A L 24499
PERMIT
as authorized by the State of North Carolina
Department of Environment and Natural Resources and the Coastal Resources Commission
in an area of environmental concern pursuant to 15 NCAC
Applicant Name Phone Number
Address
City State Zip
Project Location (County, State Road, Water Body, etc.)
Type of Project Activity
PROJECT DESCRIPTION SKETCH (SCALE: )
Pier (dock) Length
F )J I
Groin Length -
number L. -
Bulkhead Length } i
max. distance offshore
Basin, channel dimensions i
cubic yards
TTT
x; a
Boat ramp dimensions
Other
7
4)
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 become null and void.
This permit must be on the project site and accessible to the permit of-
ficer when the project is inspected for compliance. The applicant certi-
fies by signing this permit that 1) this project 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.
issuing date
applicant's signature
permit officer's signature
expiration date
attachments
application fee

&EassNg4c - 6po - rZ�j 66-1185/531 1944
MEDFORD CONSTRUCTION ' 0931000210
802-B NEUSE DRIVE 919-635-5242 n + / 3 -00
NEW BERN, NC 28560 DAl'E
PAYTOTHE Jj/�
ORDEROF Y �(��/ (OC7
©Q DOLLARS
#ATRIANGLE
tiwy.X BANK New B Office
70
� ew Bern, NC 28560 ol
MEMO r`�
�:0-53 VL L85 21:093 L000 2 L0nv 1944

ADJAC1 N'1' RIPARIAN 1'It()i'F,RTY• OWNER STA'I EMEM'
(FOR A PI R111 'OVIsRIsI) WMT l,ll,l)
I herchy certify that t own prap etly adjacent tti ✓Jl y'��( ���S�Cr9�`���
(Name (it !'rt►f�rriy t)wner)
pmtx•rty ltx atct! at �f �'� � G01-1
Rnnrl, etc.)
till orr; �� r
OV>zterUudy) ('1'nr.•11 And/or Corrnly) .
1Ec has tlescribed to mc, as slutwn ltc.ktw, the development lie is prnlxtsing at that
location, anti, I have no O jccticros kt his prr►lxwsal. 1 understancl 11ia1 a pierlurtcc vmH hcr,•tt lifl
n+tist be set lack a minintuttt tlistattcc. of fiftcY-n feet (15) from my area ul riparian ac•ccss unlcs,�
waived by me.
do n(r( wish to waive thr sclb.0 k it-quitt•nu nt.
1 OQ wish ltt waive Ihat setback requirement.
---------------------------------
DESC'f{11''1.E()N AND/mt DRAWING OF 1'1t()1'(),S1,,1) I)IsVl�l,t)1'�II:N'I': _ -
(I rt he filled in by individual pinpocirrR developmen')
l`- dl 7 _C'fijvV Z- 1h 'p--
eat L`-:r //
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Sipmuro
11tint or Type Name
I )L . r
Telephone Number
-. -J Gp

AI)JACEN'1' RIPARIAN PROPERTY OWNER STA'I'I?MEM'
(FORA P11sR/IINCOVl?Rj? ROAT LM-1)
I hereby certify that I own prolvi-ty adjacent to
(NAntc (►f 1'r•(ipelly Owl►t•r)
�/ / (I,of Block, Itonti, �•fc.) •
(WRtcrhody) ('I•osvn And/m. county)
tie has tiescribc(I to tile, as shown below. the (leveloplicnt he is I►rolx)sing at 111,11
I(Mttit►n, and, I hive no N jccti()t►s to his I)rnlx►sai. 1 i lerstan(I that a flierlone(►vcrcd 11(),1I lift
!mist be set hack n minin►urtt distance ()r tiliecn fee
waive(l by tile. t (l i') from lilyarea of rilnriar► access unless
I lit) "M wish 10 waive the s0back re(luir,•uu•nt.
_�_ 1 tiV will! 10 waive That setback retluirentct►t.
------------------------------ •----------------------------
I1'h,.Ct'Itll'HON ANDMR DRAWING OF 1'Itt)PO,`1,,1) I)tsV1?I,i)t'ltiil�;N't': ----- ---
Ub he filled in by indirldunl pmpming developrnrnI)
Ret 04- ct '�- S'/tOr-e
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..................
SiRnnturo
Print or Tylie Name
Telephone Numb r
�3 7 :4 o o
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