28107_FORBES, CRAIG_20010702

CAMA and DREDGE AND FILL
G E N E R A Lr��
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 (County, State Road, Water Body, etc.) -
Type of Project Activity i t .,� , >,Y-•� �; ,i ,- ;:
_Cry
PROJECT DESCRIPTION SKETCH (SCALE:
Pier(dock)Length
Groin Length }tiz
number
Bulkhead Length
max. distance offshore _ 3 ! c-
Basin, channel dimensions
cubic yards
Boat ramp dimensions
Other t'
This permit is subject to compliance with this application, site drawing N,. 'Y
and attached general and specific conditions. Any violation of these terms applicant's signature
may subject the permittee to a fine, imprisonment or civil action; and
may cause the permit to become null and void. ==p t i�
This permit must be on the project site and accessible to the permit of- permit officer's signature
ficer when the project is inspected for compliance. The applicant certi- yi Uv c�i
fies by signing this permit that 1) this project is consistent with the local issuing date expiration date
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. attachments
In issuing this permit the State of North Carolina certifies that this project CJ Sri
is consistent with the North Carolina Coastal Management Program. application fee

l
BROAD CREEK CONST INC. 7077
eC Ph [phone] 55-152/531
eeelJJ 11 Creekview Court 7' -2 U DATE
Merritt, NC 28556
PAY TO
THEORDEROF
DOLLARS
Wachovia Bank, N.A.
g Baybo.o,NC28515
FORj% 16, �dK RCS
1:0 5 3 LO L 5 291: 0 78 L 00 L 240u■ 70 7 7

I hereby certify that I own property adjacent to s
(Name of 100
erty Owner)
property located at � '�a S. 1 0 ii\'C\
(Lot, Block, Road, etc.)
on �%�- knawn `>ree le , in 1M t� �C� N.C.
(Waterbody) (Ta 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.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(To be filled in by individual proposing development)
n
Signature
�V-J'r� cal Z'k
I 6; - S,-N D
Print or Type Name
w�-,�a3-6�6�
—.Lq_aSz- Sao- z"73/
Telephone Number
Date:

I hereby certify that I own property adjacent to —a�InIMx3 Is
(Name oOwner)
property Iocated at -Q�'vk CX v �- -0. 4_
(Lot, Block, Road, etc.)
on ��� ►wu►,n N .4 k , in �U t,N� I vy , N.C.
(Waterbody) (T 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)
1
TO
LO-Vi
Print or Type Name
-/a 33 -q3/D
Telephone Number
Date: & 'aq- 0/