25527_NELSON, PETER_20000614

CAMA and DREDGE AND FILL
G E N E R A L
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 (Count)4 State Road, Water Body, etc.)
Type of Project Activity
PROJECT DESCRIPTION SKETCH
Pier (dock) Length
(SCALE:
/
Groin Length L
number
Bulkhead Length
max. distance offshore
I
—
�(
;�
i
I
Basin, channel dimensions
cubic yards
Boat ramp dimensions
_
Other
'—
771
-
(
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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 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.
applicant's signature
permit officer's signature
issuing date expiration date
attachments
application fee

MEDFORD CONSTRUCTION 66-85/531 2069
802-B NEUSE DRIVE 252-635-5242 0390016285
NEW BERN, NC 28560
DATE
PAY TO THE Jr /�fQ Q y} ORDER OF_ 7 {i
--�—Oy DOLLARS
Centura Ban
rNm Bern, NC 28560 �fE�./l
NP
MIND
1:0 5 3 1008 501:0 3900 L6 28 Sna 206

DIVISION OF COASTAL MANAGEMENT
�f
NCDENR
NORTH CAROLINA DEPARTMENT OF
ENVIRONMENT AND NATURAL RESOURCES
151-B HWY. 24, HESTRON BUILDING
MOREHEAD CITY, NC 28557
TELEPHONE: [phone]
FAX: [phone]
TO: ��' I v � f G t`>-"
OFFICE:
TELEPHONE #: e5Ll ��S'Szy� FAX #: rzsz-] (P'S
FROM: 5G.� � Jo f 1jo
OFFICE: DIVISION OF COASTAL MANAGEMENT
RE: I'AAkAy ( ��l rod n> ?� '�:70z- I )EL5ajyLp Fir 17 .
DATE SENT: Q(� (00
TOTAL NUMBER OF PAGES INCLUDING COVER SHEET: ---3

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