12197_HARDY, BRUCE_19940609

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CAMA AND DREDGE AND FILL _ GENERAL N? 19497
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PERMIT
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auao�oh No�hOamUna
Department ofEnvironment, Health, andNnmmdRosourco and the Coastal Resources Commission
inanarea ofenvironmental concern pursuant m15NCAC
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AddressCity If 71
Project Location (County, S tate Road, Water Body, etc.)
17
Type of Project Activity I ;�,
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State Zip
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PROJECT DESCRIPTION SKETCH (SCALE:Pier (dock) length
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Groin length
number
Bulkhead length
ax. distance offshore
cubic yards
Boat ramp dimensions
Other
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,
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imprisonment mcivil action; and may cause the permit tobe-
come nuUandvoid.
This permit must be on the project site and accessible tothe
permit officer when the project is inspected for compliance.
applicant certifies by signing this ponnic that l) this pro -
is cnn,i,u`n, with the local }and use plan and all |o»u|
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.
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� -- ap'p|icant's signature
permit officer's signature
issuing date
expiration date
attachments
application fee � '

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6000521;3974 940609 285570
PAYT
CHECK WRITER
IMPRINT AREA
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UNITED STATES POSTAL SERVICE
Official Business
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NA LT FOR PRIVATE
USE, $300
Print your name, address and ZIP Code here
POLEY & FOLEY MARINE
Complete items 1 and/or 2 for additional services. I also wish to receive the
Complete items 3, and 4a & b. following services (for an extra
Print your name and address on the reverse of this form so that we can fee):
return this 'card to you.
Attach this form to the front of the mailpiece, or on the back if space 1. ❑ Addressee's Address
does not permit.
Write "Return Receipt Requested" on the mailpiece below the article number. 2 ❑ Restricted Delivery
The Return Receipt Fee will provide you the signature of the person delivered
to and the date of delivery. Consult postmaster for fee.
3. Article Addressed to: 4a. Article Number
COL. JOHN THORNELL P 677 391 489
HG — BALTAP 4b. Service Type
PSC 106 BOX 4 ❑ Registered ❑ Insured
APO — A E 09722 ❑ Certified ❑ COD
❑ Exoress Mail g] Return Receipt for
5. Si 1 res
6. Ignature (Agent)
7. Date of Delivery
171
AWy 9
8. Addressee's Address (Only if requested
and fee is paid)
L
i PS Form JU 11, November 1990 *U.S.GPO: 1991-287.066 DOMESTIC RETURN RECEIPT

ADJACENT RYPARm PROPERTY owmm sTATEblI:NT
• I'hereb certify that 1 own' ro erti ad acento_
Y . Y p. p Y j -
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sir y 's property located' at
(Name : of. Prroperty.• Ownr) -
Block, Road, .etc.)
on , in
:. (Water y) . ( Town 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
• prapos.al.
:. rrwrr rrrr rr rrrrrr------rrrrra.rrrrrrr—rr r rrr rrrrr. �. .r�r ram• r, �r r. .'
DESCRIPTION AND/OR'DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual.proposing development)
Signature
Print o Type Name
,'3Z-'
Telephone Number
Date
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Dear (�-) � , Aw 4 :
This letter� is to notify nyou as an adjacent riparian landowner- of
Mr. /Mrs. 1� 2UGT '1�6RJ� �plans to construct
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on their property located at l g
in `3I=-i2/-j � NC. The ' sketch on the xeverse
side accurately depictsoposed construction.
Should you have no objections to this proposal, please check'.the
statement below, sign and date the blanks below then statement,
and return this letter to: F—ok E �&�E�,r l -` � IJ 3
L EW 29�
as soon as possible.
Should you have objections to this proposal, please send your
written comments to the NC Division of Coastal Management, P—O.
Box 769, Morehead City, NC 28557. written comments must be
received within ten (10) days of receipt of this notice.
Failure to respond in either method within ten (10) days will be,.
interpreted as no objection.
sincerely,
I have no objection to the project as presently
proposed and hereby waive that right of objection as
Provided in General statute 113-229.
Z have objections to the project as presently proposed
and have enclosed comments.
Si tune
DATE,
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