HomeMy WebLinkAbout27019_CLARK, THEODORE_20001123MA nd DREDGE AND FILL
CAMA Pi9-
,.t 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
Project Location (County, State Road, Water Body, etc.)
Type of Project Activity
State
zip
PROJECT DESCRIPTION SKETCH
Pier (dock) Length
i"
v
(SCALE:
`'
Groin Length
number
Bulkhead Length
max. distance offshore
Basin, channel dimensions
5 _
c
_ '�
'
1 .
,J -.
-
cubic yards
Boat ramp dimensions
Other
i
i
-
'
��
• t
t^
�
+l
+t
4_7
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
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FOLEY & F LEY CONTRA!
PH. 252-636-2515
1810 OLD AIRPORT RD.
P.O. BOX 3482
NEW BERN, NC 28564
NKC( N, cs,els �° ley
3667
66-1185/531
PAY DATE
TO THE
ORDER OF_.
1�.• I. !I tl ,. �J„,� •n�� 1—�I 'cur 4�cnn�i i.. DOLLARS
AAA TMANdEHwy. 70 0
ffim
BANKNew Ben,, NC 28560
FOR � • 1 ��h �i'IT � u. A N� �Jt M,
1110000366711' 1:0531LL8521:0931000L6011'
« ___ �. _ :.>>�-•` ,,, = ,� �.•_,,.,�—_�,.—„mom:
• 10/05/00 09:02 FAX
Z01
Customer Job Requiretment Worksheet
Customer Named - Date 10 r�?p
Mailing Address 90 *3 ':�o, Job site Address_ _ Y►�)
Phone# 3 f 'iJg Fax#
Adjecent property Owner
Left side bra, e- Ij Right side Av7t a\f c-v,
Date Mailed Returned Date Mailed Returned
Cert. Mailed Returned Cert. Mailed Retumed
Permit Required
State Recived
City- Recieved
County , Recieved
Fairfield Harbour Recieved
Bulkhead
Dock
Boatlift
Jettie
DredgAll
Job Type
Boathouse
Jet Ski Lift
Ramp
Piling
Repair
10/05/00 09:02 FAX
la02
ADJACEM RIPARIAN PROPERTY OWNER sTA'I tT
I haeby acetify that I awn property adjacent to
SC, --V) v I I � r)
(IA Block. Rced, ctr-)
an ! U �, in , NC
(Watabody) (T°wn azUACC Ca *) `?? (% 0
He bas d+esaibed to me, as shown below, the development he is proposing at tbal Iodation,
sad, I have no objections to his proposal.
DE.vzRwTION AND/OR DRAWING OF PROPosm DEvEWPMWT:
(To be filled in by individual PuPoging development)
J
L;?S
D'7 (�� �'uIC>�
S
or Type Name
Telephone Number
a M 10/05/00 09: 02 FAX Z 03
I herby cw* that I awn p ope ty adjweod tD
'e property lasted at
(Name of Pmpwty Oww)
ctc-)
(Wateabody) ,in s __,NC
CTowi Awtw County) �,-? ��
Fbe hay dnmi'bed to me, as shown below, do develc>pct»nt hie is proposing at that location,
arid, I bm no objections to his ptwwd.
DESCRtMON AND/OR DRAWING} OF PROPOSED DEVELOP'MBNT:
('Ib be filled in by individual Pm'POltiMg &Wopn380t)
t
83
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e7 C-') )L
Ill'A A
A'
Phut or ape Name
601 3- -goo
Telepb" Number