23190_MULLENIX, GERALD_19990812

CAMA AND DREDGE AND FILL G✓ �.
GENERAL o 28190.
PERMIT}pY
as authorized by the State of North Carolina
1(✓�� y/ Department of Environment, Health, and Natural Resources and the Coastal Resources Commission
in an area of environmental concern pursuant to 15A NCAC
Applicant NamePhone Number 2'C�37 ^kly6-.
Address
city State Zip
Project Location (County, State Road, Water Body,"etc.) 1-2.AJC--rJ 6-s • f1bInCe-�� � ?o illC— —I4��1
Der SN�1L"(- INc i>z. (N TT'G Vkj> ? 'a--- NG CdMMc�N�TY tacA? ►ycti.� 2n1"i NG':
Type of Project Activity l(-�= r. ter A? Fc,�M a( N t40214_1
i`T• C),2"_i,
1-4 EC -
PROJECT DESCRIPTION
Pier (dock) length
SKETCH
(SCALE -
A.'_
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,Inumber ! IS-1
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Groin length
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length
max. distance offshore
Basin, channel dimensions
cubic yards
IFTij
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Boat ramp dimensions
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Other
C rig-
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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.
applicant's signature
permit officer's signature
issuing date expiration date
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.

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Mr. Gtrgld 1�1u11tnix
M-71fY�6
MEDFORD MARINE CONST.
P. 0. #CX 3556
NEW KERN, NC 28564-3556
[phone] - FAX [phone]

...:..... -ham'-: g»• , ,.�.;._.-±r.`fiF:�'c,E;Qi�
DIVISION OF COASTAL MANAGEMENT
hDJACENT RIPARIAN PROPERTY OWNER NOTIFICATION WAIVER FORM
Name of Individual Applying For Permit::_ Gergjd
Address of Property: efe l,',e Dom.
(Lot or Street f, Street or Road, City & County)
I hereby certify .-that I own property adjacent to the above -
referenced property. The individual applying for this permit has
described to me as shown on the attached drawing the development
they are proposing. A description or drawing, with dimensions,
should be provided with this letter.
X I have no objections to this proposal.
f you have oblections to what is_beina prcoosed.-ulease_write the
Division of Coastal Management..127 Cardinal Drive Extension,
Wilmington, North Carolina, 28405 or call 910-395-3900 within 10
days cf receivt of this notice. No response is considered the same
as no cbiecticn if you have been notified by Cprtifigd Mail
r
aAIVER SECTION
I understand that a pier, dock, mooring pilincs, breakwater, boat
house, lift or sandbags must be set back a minimum distance of 15'
from wv area of riparian access unless waived by me. (If you wish
to waive the setback, you us,- initial the appropriate blank
below.)
I do wish to waive the 151setback requirement.
PA- I do not wish to waive the 15'setback requirement.
X
Sit ature
Y �� �n
Print Name
Y' ',252-- � 3 3-0 y
Telephcne Number With
FP_
ea Code
c
d,
Date' •
r
ED FE F3

- s.w.az,:,, — n-t.. .. ,. .. • - �rsti;. ,:ar,�,.,xyd,. - `A'd=
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION /WAIVER_FORM
Name Of Individual Applying For Permit:, 6ee4/d MV/le""N
Address Of Property: a �- p Shape I%n e �Or''
IVe,-,,. &0,.-7 A;C �/Z: �sr 8,,,d J Cry"Ots.
(Lot or Street i, Street or Road, City & County)
I hereby certify - that I own property adjacent to the above -
referenced property. The individual applying for this permit has
described to me as shown on the attached drawing the development
they are proposing. P_ crescription or drawing, with dimensions,
should be provided with this letter.
X S I have no objections to this proposal.
biections to what is beingproposed a
Wilmington North Carolina 28405 or call -910 '395-3900 within 10
days of receipt of this notice. No response is considered the same
as no objection if you have been notified by Certified Mail
FiAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boat
house, lift or sandbags must be set back a minimum distance of 15'
from ry area of riparian access unless waived by me. (If you wish
to waive the setback, you Tnust initial the appropriate blank
below.)
I do wish to waive the 15'setback requirement.
X,� I do not wish to waive the 151setback requirement.
X
cnature Date
,c fC8 r 5 C
Print Name / �
- g5z 3d- 17 S
Telephcne Number With Area Code
A4LJr'
.47;A
Ma
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