23240_NELSON, PHILLIP_19991015

CAMA AND DREDGE AND FILL
GENERAL N E3 40-7)
PERMIT
as authorized by the State of North Carolina
Department of Environment, Health, and Natural Resources and the Coastal Resources Commission
in an area of environmental concern pursuant to 15A NCAC
Applicant Name r~�'' '�+ �'' Phone Number �� k/Z �9S�?
Address p, �i� f�, r
City
Project Location (County, State Road, Water Body, etc.)
State A) C_ Zip S
Type of Project Activity
PROJECT DESCRIPTION SKETCH
Pier (dock) length
Groin length
number
Bulkhead length
max. distance offshore
Basin, channel dimensions
cubic yards
Boat ramp dimensions
Other
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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.
In issuing this permit the State of North Carolina certifies that
this project is consistent with the North Carolina Coastal
Management Program.
Ctx� l ( t''' '
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applicant's signature
J{l permit officer's signature
I
%' !1 i`% J( -CC
issuing date 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
66-30/531
33 1 877
Date
Pay tothe o 1, l /� I $ �D
Order of f�tN e K
Vy Y ��
ie ars 8
R CITIZENS
D /� Fi lardic Baa Bank N.C.Trust Company
JEJJA ABardic Beach, . 28512
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ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
r,
K ; P- C�El�, &/ r o f
SE�w�LL l/�l a LOe+�
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S6 PT lgcfI
Date
I hereby certify that I own property adjacent to
SO4 Z�Fi ^�983 s property
located at _ �% Z- 0A �LE'Q r/VI-r
(Lot, Block, Road, etc.)
(Water Body) (Town and/or County)
on
N.C.
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 proposed development:
(To be filled in by individual proposing development.)
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Signature
V 4GAm IQM lL F/AyE,�
Print Name
Phone Number

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to
"?NILLIP ICE&, 04 0*? �983 , s property
located at _ 2% 2 - 0A �L�'q /ULr on
(Lot, Block, Road, etc.)
in 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.
41 l do wish to waive that setback requirement.
Description and/or drawing of proposed development:
(To be filled in by individual proposing development.) CL
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Date
cig-nature
Print Name
Phone Number