23595_LAYNO, GEORGE_19991202

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CAMA and DREDGE AND FILL
G E N E R A L n9
PERM I T
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 / gyNln Phone Number
Address
City
Project Location (County, State Road, Water Body, etc.)
Type of Project Activity
State Zip
This permit is subject to compliance with this application, site drawing
and attached general and specific conditions. Any violation of these terms applicant's signature
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 thatthis project
is consistent with the North Carolina Coastal Management Program.
issuing date
permit officer's signature
expiration date
attachments
application fee

MUD BUCKET DREDGING, INC.
ATLANTIC BEACH CAUSEWAY NCDL 8039839
PO BOX 3355 PH(252)726-2191
ATLANTIC BEACH, NC 28512
Pay to the
Orderof_ 6inc.1-t
r
PRPUST CITIZENS
R 4 NK F"stLitQz Bank 8 Trust Company
il' ABaMIc Baach. N.C. 28512
For
1.0 5 3 100
66-36/531
133
Date C2fL G`
e 300i.00 13 1 2 1606 7 3n' 0 196 7
1967
sw
—Dollars

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to
's property
located at _ (�� LLi'%I (200,27— , on
(Lot, Block, Road, etc.)
a
,a 4?e 6� 0-"j4 N L 6-i n �f t4JS K/ (a L- L S 6-� 02 CS , N.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 i:nderstand that a pier, pilings and
dredging must be set rack 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.
j/ I do wish to waive that setback requirement. .
Description and/or drawing of pr�2posed development:
(To be filled in by individual proposing development.)
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Signature
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Prinr_ Name
Date Phone Number

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own proper`•: adjacent to
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property
located at (o8 LL(20u2 k- , on
_
(Lot, Block, Road, etc.)
--gDope 'SODN✓,
Aaeee-5t; Qi4,Qs�NJ L in �iccE KA40LL t4011-1C'S N.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.
I do wish to waive that setback requirement.
Description and/or drawing of p-_,.)posed development:
(To be filled in by individual proposing development.)
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Sign at/ure
P r n _ Name
D to Phone Number