23694_MOORE, EDGAR_19991208

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CAMA and DREDGE AND FILL
G E N E R A L - 23694 r
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
Address
City
Project Location (County, State Road, Water Body, etc.)
Type of Project Activity
PROJECT DESCRIPTION SKETCH
Pier (dock) Length
Groin Length
number
Bulkhead Length
max, distance offshore
r'
Basin, channel dimensions
cubic yards
Boat ramp dimensions
Other
Phone Number
State Zip
(SCALE: )
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-
permit officer's signature
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
issuing date expiration date
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
In issuing this permitthe State of North Carolina certifies thatthis project
is consistent with the North Carolina Coastal Management Program.
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
66-30/531 1967
133
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Date
$
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Dollars
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FYIiST CITIZENS 133
BANKFirst-Ci,i ,Bank6T,u, Company
R�1� �tlarxic Boach. N.C. 28512 �
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ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to
4Q
' s property
located at_ v Ao,,x�o J k l-Ac on
(Lot, Block, Road, etc.)
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k4 4, /f-(c= L in _�� ��L' �� o L � � I-�t� i�ES N.C.
(Water Body) (Town and/ol: 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.
x,
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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Date
Print Name
Phone Number
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SENDER:
I also wish to rece,'✓e the
■ Complete items 1 and/or 2 for additional services.
■ Complete items 3, 4a, and 4b.
ln f0II0Wservices for an
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■ Print your name and address on the reverse of this form so that we can return this
extra fee):
card to you.
■ Attach this form to the front of the mailpiece, or on the back if space does not
1. ❑ Addressees Address
ai -
2 1
rmi■ Wr et"Return Receipt Requested" on the mailpiece below the article number.
2. ❑ Restricted Delivery
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■ The Return Receipt will show to whom the article was delivered and the date
delivered.
COnSUIt postmaster for fee.
P
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3. Article Addressed to:
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5. Received By: (Print Name)
6. Signature: Oddressee or A
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PS Form 38 , December 1994
4a. le Number
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4b. Service Type
istered
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❑ Return eiT t for Merchandise
7. Date of D fvkry
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and fee
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102595-98-13-0229 Domestic Return Receipt

UNITED STATES POSTAL SERVICE
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First -Class Mail
Postage & Fees Paid f
USPS
Permit No. G-10 i
• Print your name, address, and ZIP Code in this box •
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d SENDER:
o r Complete items 1 and/or 2 for additional services.
rn r Complete items 3, 4a, and 4b.
0)■ Print your name and address on the reverse of this form so that we can return thi .y card to you.
ry ■ Attach this form to the front of the mailpiece, or on the back if space does not
permit.
■ Write "Return Receipt Requested" on the mailpiece below the article number.
■ The Return Receipt will show to whom the article was delivered and the date
delivered.
0 3. Article Addressed to: 4a. v
a YLIKS f-�A
also wish to receive the
s
following services (for an
extra fee):
1. ❑ Addressee's Address
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2. ❑ Restricted Delivery
Consult postmaster for fee.
to
a
Number
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4b. Service Type
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5. Received By: (Print Name) I/ 8. Addresef
l'- and fee h
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X 6. Signature• ddressee or
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PS
PS Form 38 , December 1994 102595-98-8-0229
/fail
1\t for Merchandise
Tr ry
's ddress (Only
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Certified
Insured
❑ COD 3
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if requested
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Elrnestic Return Receipt
Page 2 of 2
11 /27/99

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