HomeMy WebLinkAbout27023_GOTTSCHALK, ATRHOR_20001128i
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CAMA and DREDGE AND FILL �S6
023
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 SKETCH
Pier (dock) Length
Groin Length
number i
Bulkhead Length
max. distance offshore
Basin, channel dimensions
cubic yards
Boat ramp dimensions
Other F4
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
issuing date
(SCALE: r )
applicant's signature
permit officer's signature
expiration date
Attachments
application fee
M
PAY
TO THE
ORDER OF
3 � gr /BizalK f btrt+sclwlk��l,•c'1„� /� ��,
LEY CONTRACTORS, IN
IC
252-636-2515
1810 OLD AIRPORT RD.
P.O. BOX 3482
NEW BERN, NC 28564
DATE_ I-ak-o-C7
1 $ 246
3667
66-1185/531
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FOR t l &L ��'IT
1100000366711' 1:053LLL8521:0931000L601I'
I hereby certify that I own p mpeity adjacent to
FAVINIMM
s
in , NC
(Way) j�IL. (Town and\or unty)
He has described to me, as shown below, the development he is proposing at that location,
and, I have no objections to his paraposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
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Print or Type Name
Telephone Number
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a SENDER:
:2 ■ Complete items 1 and/or 2 for additional services.
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I also wish to receive the
following services for an
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■ Complete items 3, 4a, and 4b.
■ Print your name and address on the reverse of this form so that we can return this
extra fee):
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card to you.
■ Attach this form to the front of the mailpiece, or on the back if space does not
1. ❑ Addressee's Address
d
permit.
■Write 'Return Receipt Requested'on the mailpiece below the article number.
2. El Delivery
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■ The Return Receipt will show to whom the article was delivered and the date
delivered.
Consult postmaster for fee.
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3. Article Addressed to:
4a. Article Number
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4b. Service Type
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Registered C�'� tied
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❑ Express Mail ❑ Insured
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❑ Return Receipt for Merchandise ❑ COD
7. Date of Delivery
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5. Repeived By: (Print Name)
8. Addressee's Address (Only if requested
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and fee is paid)
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6. Signature: (Addressee or Agent)
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pS Form 8811: Decem bfr 1' - 102595-98-13-0229 Domestic Return Receipt