27009_FULLER, WALTER B & BAILEY, ALAN_20001103

CAMA and DREDGE AND FILL �,
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
Address
City
Project Location (County, State Road, Water Body, etc.)
Type of Project Activity
PROJECT DESCRIPTION
Pier (dock) Length
IGroin Length
number _
Bulkhead Length
max. distance offshore
Basin, channel dimensions
cubic yards
Boat ramp dimensions
Other
State
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.
Phone Number
zip
applicant's signature
permit officer's signature
issuing date expiration date
Attachments
application fee

f..
BLUE WATER MARINE CONSTRUCTION, INC.
P.O. BOX 93
MOREHEAD CITY, NC 28557
PAY � / /�
TO THE / �[,�
ORDER OF
1326
DATE 66-112/531
DOLLARS Ifl
02301 ■ 1IB&T
4408 ARENDELL STREET
r MOREHEAD CITY, NC 28557
FOR
ow
11.00001326112 1:053LOLL2If: 52It, 986592110

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT'
(FOR A PIER/MOORING PILINGSIBOATLIFTIBO/ATHOUSE)
I hereby certify that I own property adjacent to ��� -�i/ 's
(Name of Property Owner) 'a 5-2 - 6,33
Property located at
(Lot, Block, Road, etc.)
on �``�� , in , N.C.
(Waterbody) (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 proposal. I understand that a pier/mooring
pilings/boat ift/boathouse must be set back a minimum distance of fifteen feet (15') from my area
of riparian access unless waived by me.
I do not wish to waive the setback requirement.
I d-Q wish to waive that setback requirement.
DESCRIPTION AND/OR DRAWEiG OF PROPOSED DEti-ELOP-NIEN­T:
(To be filled in by individual proposing development)
le
lie
�� 2 0- test, �
Pe, posed' li,/,i I K if ea4
Signature
J
Print or Type Name
Telephone Number
Date: / / ' ut

ADJACENT RIPARIAN PROPERTY OWNER STATEINIEl"N"T
i �1,Jcs•
�o^b% 1
(FOR A PIER/MOORING PILINGSIBOATLIF (BOATHOUSE)
I hereby certify that I own property adjacent to ,(�� �' 'Zcr`e�
(Name of Property Owner) 2s-2--- 633 - 3 71'7
Property located at �-; 7`
(Lot, Block, Road, etc.)
on in �� e� N.C.
(Waterbody) (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 proposal. I understand that a pier/mooring
pilings/boatlift/boathouse must be set back a minimum distance of fifteen feet (15') from my area
of riparian access unless waived by me.
I do not wish to waive the setback requirement.
I dQ wish to waive that setback requirement.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPINIENT:
(To be filled in by individual proposing development)
l 1)s ' r Ii__.
E-'A e-r-
E Cis+1N� &A KHiraJ
1� so �asr.� u fc Hec-'J
A"� ae-"e'
Print or Type Name
Telephone Number
Date: // `"r— ego

MONITORING & COMPLETION REPORT
[LAMA Major Development & State Dredge & Fill Permits]
PERM=E'S NAME: �L� ,� PERMIT #
LOCATION:
PHONE: - �c (6,-� ----> I L q
DATE OF INSPECTION �J (r)(J
FIELD REP.
DATE REPORTEDLY COMPLETE:
1) Do thp-measured dimensions of the development differ from those indicated in the permit and workplat?
YESNO [circle one].
COIVI�ENT:
2) SEDIMENTATION & EROSION CONTROL: Has Permittee seeded, grassed, or otherwise stabilized all
disturbed areas? (YF.�/NO [circle one]
COMMENT:
3) FUTURE MONITORING & ENFORCEMENT ACTION: Is further investigation or enforcement action
needed? YES O [circle one].
COMMENT: