26699_JACKSITS, LOUIS & JENNIFER_20001024

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CAMA and DREDGE AND FILL "� ���
G E N E R A L 26699 .. -
PE R M I T (BPS Ftlf TIct'lls A Aw me
as authorized by the State of North Carolina i A of A.' C'- t, A/T'!
Department of Environment and Natural Resources and the Coastal Resources Commission
in an area of environmental concern pursuant to 15 NCAC tr'
Applicant Name T clgilss Phone Number "'
Address
City �_► !I V
Project Location (County, State Road, Water Body, etc.)
Type of Project Activity
State
zip
PROJECT DESCRIPTION SKETCH <<
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Pier (dock) Length
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number
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Bulkhead Length
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max. distance offshore
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Basin, channel dimensions t
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cubic yards
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Boat ramp dimensions
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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
u
issuing date
permit officer's signature
expiration date
attachments
application fee

C — BROAD CREEK CONST INC.%%���j, [phone]
t
II Creekview Court
Merritt, NC 28556
PAY TO
THEOKDEROF_ �� x ( l�
6138
66-152/531
$
Wachorlm Bank, N.A —~ "•'•"• ^� w,w
Bores Ncsasis
FOR
1:053 0015LED: 0781
001240ua 6136

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to otl j d6,,'5 l'f S 's
(Name of Property Owner)
property located at c> `f I rt? i t-L-e it 6-ar6e)C" t� ,
(Lot, Block, Road, etc.)
on �� Tc e1 �'v�e , in 6-�m &�e N.C.
(Waterbody) (7C#0r 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)
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1�� � ,
Signa
JRwAg-s
P ' or Type Name
'i o 3 S (°'y`'
Telephone Number
Date: `�(Z`�10,6

I hereby certify that I own property adjacent to , oy T cic)C-s tqs 7s
(Name of Property Owner)
property located at o i "-), PA "-e (C 1� u4-ba w
(Lot, Block, Road, etc.)
on i ",ej I (°X e,e- , in ii'hcw e- 1- , N. C.
(Waterbody) ( 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)
/D
G
l
Signature
Print or Type Name
4-6g-a4�1
Telephone Number
Date: -S / 0 o
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