28925_MARTIN, BILL_20010822

CAMA and DREDGE AND FILL
,.� G E N E R A L _
P E R M I T
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------=--R - Phone Number
Address
City
Project Location (County, State Road, Water Body, etc.)
Type of Project Activity
State
zip
PROJECT DESCRIPTION SKETCH
_ -
(SCALE:
Pier (dock) Length
f
Groin Length
.....
........
... . ...f..a... ....,..`
number
,_
Ki
r.
Bulkhead Length t
max, distance offshore
J
Basin, channel dimensions
J
..
LA
cubic yards
Boat ramp dimensions
other
i
l—... ,.l
This permit is subject to compliance with this application, site drawing
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.
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- ) -last,:
fees 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 `f:) , "'f ! �t _`; _i
is consistent with the North Carolina Coastal Management Program.
application fee

66-65/531 3769
SANDLAND, INC. 1343008308
105 GREAT NECK PH. 252-447-5898
ADAMS CREEK DATE
HAVELOCK, NC 28532
PAYTHE +� I $ Cj
� ORDERER OF � 7" _ /Y �j
a
DOLLARS
14,
ESTEEM
Centura Bank®
,�lavelock,k, /NC 28532
MEMO
1:0 5 3 1008 50i: 1 34 3008 30g11' 3 769

AUTgARIAN
I
I hereby certify thxtt I own pre�p.rty adjacent t* "Ti� �
property 3.ocated at �` block. ad, etc)
(3vt,
(body of watery has bn. eedescribedto
-worth Carolina in
y County. The proposal,
o , and the
Ae as shoes below; the developesnt, a e one)
under -
proposed location, and 3 3�ave not objection to the proms
ael.
stand that if the dave1op3¢1=nt is a pier, it Must be set back a Jwln�r+3m
distance of IS feet from ey area Of riparian access unless waived by sea
*rich . to waive that setback requirement
(circ a one}
t Ik***i*�e***�r�r�e�s devela itt** (to *be*filied in*by��
Description and/or drawing of proga Sin AND LOCATION of THB
individual proposi� developwent� 001C&TPROp THERTY hlWZ AND TUE WATIR-
STR; CTURE AND THE DMSTAll HET� I
/- aT
8 GX - !e/�I''� J�9r11
L,6: 4/7
jp/?
g lr-e sz e Xk
���****ctian *Departtt�ent)�,��*�,t**sae
(OrLginal mmt be ratalned7
in the /
AS&t
3 - 2 2-
Date
/V 17A.1
e ( lease �rl�it�

7f
I hereby certify that I own Prp.,ty add
^rAt-
property located at � a T
a, etc)
tern
a ,�' s (.town)
ca tT er d�scri.bed to
+�f `rat } sal has been
(body Of �,�,ty. The Pr�PQ
t4orth Carolina In �'
and the
7t�e as spawn bs�.ows the develormentr a e one)
p iacation, and 1 have not obje
ction to the prnpoeal • ?� under -
sot
stand that if the devel ent is a Pinar, it m=t be back a aini�
distance of 15 feat Frrno MY
area of riparian access unless Waived by as.
_ Irish . to valve tit setback
r 1�
exAmt .
(cfrc a one)
*rievel*tapaent-. (to be*filled �in�by �
iced r THE
wi of prnga GhTIQN �
i�escription and�or dra n+� nt I�I�TE �g glyg AND LC� _
individual F�OS� deve� °P ) gg M PR4P Ll"r. jMD TSE WATIM
STRUCT 7R1 BND THE DISTANCEBETS I
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(Original mst be retained in the Z S� -
gnatuxe
Date
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pie (Please print)