25608_NICHOLSON, HENRY_20000602

CAMA and DREDGE
G E N E
PERM
as authorized by the State o
Department of Environmen
in an area of environmental
t
rku F
AND FILL /
R A L
I T
f North Carolina
and Natural Resources and the Coastal Resources Commission
concern pursuant to 15 NCAC
Applicant Name Phone Number
Address
Citv
Project Location (County, State Road, Water Body, etc.)
Type of Project Activity
PROJECT DESCRIPTION SKETCH
Pier (dock) Length F+7
Groin Length
number
Bulkhead Length
max. distance offshore
Basin, channel dimensions
cubic yards
Boat ramp dimensions
Other
State zip
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.
(SCALE: K I _ l ; )
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applicant's signature
permit officer's signature
issuing date expiration date
Attachments
application fee

BLUE WATER MARINE CONSTRUCTION, INC.
P.O. BOX 93
MOREHEAD CITY, NC 28557
PAY
TO THE
ORDER OF 42�
02301
1229
L 66-112/531
DATE - � f/
DOLLARS M
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DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Individual applying for Permit: `��A.1 �V ,, 6 o %JC).✓
Address of Property: �� �" V0-14- S'
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(Lot or Street #, Street or Road, City & County)
I hereby certify that I own property adjacent to the above referenced proper-Lv. 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.
V have � I ha ,, no objections to this proposal.
If you have objections to what is being proposed, please write the Division of Coastal
Management, Hestron Plaza II, 151-B, Hwy. 2.4, Morehead City, NC, 28557 or call (252) 808-
2808 within 10 days of receipt of this notice. No response is considered the same as no objection
if you have been notil ed by Certified Mail.
WAIVER 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 my area of riparian access unless waived by me. (If you
wish to waive the setback, you must initial the appropriate blank below.)
✓ o wish ish to waive the 1 5setback requirement.
I do not wish to waive the 1 5' setback requirement.
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lam' Z.
ure Date
Print Name
ZS z . 72-/, . Zo,-g C1,A
Telephone Number With Area Code

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
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I hereby certify that I own property adjacent to ' " \
is
3 (Name of Property Owner)
property located at
(Lot, Block, Road, etc.) '
on Cy (3 /7-, �-4 /9 Al J , in ' 1,
(Waterbody)
Pown
N. C.
and/or County)
He has described to me as shown below, the development he is proposing at that location,
and, I have no objections to his proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(To be filled in by individual proposing development)
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perk
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Signature
/ ' / ' I 1 1'� it '(f _
Print or Type Name
Telephone Number
X Date:

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
ISav
I hereby certify that I own property adjacent to
CZ S—% 3 (Name of Property Owner)
Property located at /
i r
(Lot, Block, Road, etc.) 0on ;J
' C7 lP �9 1( , in j/ , N.C.
(Waterbody) (Town and/or ounty)
He has described to me as shown below, the development he is proposing at that location,
and, I have no objections to his proposal.
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DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(To be filled in by individual proposing development) ,
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Cat ,u--IK 12 3'
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Signature
Print or Type Name
S 27Z'FL4�
Telephone Number
Date: