23680_FIELD, PAUL_19991123

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CAMA and DREDGE AND FILL 4 `
,.� G E N E R A l� L 23680
PERM 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 Phone Number
Address
City State Zip
Project Location (County, State Road, Water Body, etc.)
Type of Project Activity
PROJECT DESCRIPTION SKETCH (SCALE: )
r
Pier (dock) Length
Ad__ 4 f
Groin Length
number
Bulkhead Length
max. distance offshore
Basin, channel dimensions
cubic yards
Boat ramp dimensions
Other
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.
"I" applicant's signature
permit officer's signature
issuing date expiration date
attachments
application fee

( mu 6-1165l537
MEDFORD CONSTRUCTIO3lo��l Fl—oss10002io 1684
802-B NEUSE DRIVE 919-635-524 3io'7g
NEW BERN, NC 28560
DATE 1
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IWDEROFF�% (` c, /�f/%/�� / /S 0,0
c�� DOLLARS �R","a
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4053 11185 24093 1000 2 1011 i684

1500
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+UPARIAN P O PER'I'Y OWNER STA'I'I?MEN'I'
(FOR A PIER/UNCOVERED R(MT UPI)
t herct►y certify that i own properly adjaccn( to Pq.
(Name of Pr•olKily Owner)
r Owfc y located at 5 cc 4- -7 L .
(IA►i, till►(-k. Ronde mr.)
S r Creek , in FFN, /V,.
(3 Ricrbott } � N.C.
Y (Torn and/or Comity)
He has described to Inc, as shown below, tilt (levelo{m Ill he is htolxrsing at that
location, arltl, I have no N)jections to his ln-olx►sal. I tinclerstiml that a pierlunc ove.ml heat lift
mist be set hark a minimum dist,"We of fifteen fcct (15') from my area of ril)arian :1(-c.css Unless
waived by tilt•.
11t►( wish to a,livr thv selback iviluiu,mvilt.
i tIp wish to waive that setback l-equirement.
•-------------------•------------------------------
DESCEtiMION ANDMIZ DRAWING OF PliOPO,SIJ)
(I i) he filled in ht' indirldunl piaposinR del-eloprnint)
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Pritlt or Tylx Natttc
Telephone Number
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INYISION OF COASTAL MANAGE'
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Addmts of Prapeaty.Dr
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OAA cc f "0, BMW of 104 cil it Como
I hweby cerdty tfiat I own property ftlamt m the above relbr+ =W progastr. no fe,dividual
afllying fur Us permit tw desedb d to ma as shown an tttia attached dmw#ng dw davak m w
they wvrepoing. A da cdptian or dmwfn;, with d omdana. dwuid be pwi&d with this
i
I hwe no objeatkm to this ympoul.
If you have objedfoin to Ww is bad prlapow4 pkmn w#** Ow Dhbim Qj C*cAW
AtaXOSMl44 RUftM PAW A ISZJ, AVIVY. M, Mo CAO�i NC, 2WT cw caati (PISj 86&
2M trM& 18 deter vInatt qFA& aadm Na roqoxw & mddamd du anu or ao o4 fog fen
VYOV hm been a04led by Cex
WAIYRR SZCTWN
I uuderamd that a pier, doc% mooft pilis4M brealcvnier, bat hoes% M or unftW mug be
ut buk a minimum & anco of i S` firm my area of riparian am= w1w waived by ma. (Ifyca
wlh to welvre the sdback, you mag initial the apprqxieft blovk Now)
JYete - >
I do wih to wave the 15' setback raquirmmat,
I do nt wbb to waive the 1 S' sic rs FirmuwL
l�imNaala % f� -97D / 1
Teslapham Number Wft Area Cade

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