25589_FIELD, PAUL_20000607

CAMA and DREDGE AND FILL Qi_�
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 3
Applicant Name Phone Number
Address
City State zip
Project Location (County, State Road, Water Body, etc.) b - f
Type of Project Activity
IN
PROJECT DESCRIPTION SKETCH
Pier (dock) Length
%
(SCALE:
)
_
..
(
I
......._._. ._...,
£
i.
77
�J
Groin Length
number
Bulkhead Length1
max. distance offshore
Basin, channel dimensions
L
-
/I
cubic yards
Boat ramp dimensions
Other
53!
IS
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 Ian and all local ordinances and 21 a written statement has
1 �
Y
applicant's signature
permit officer's signature
issuing date expiration date
been obtained from adjacent riparian landowners certifying that they
have no objections to the proposed work. c ',i' Attachments
In issuing this permit the State of North Carolina certifies that this project
is consistent with the North Carolina Coastal Management Program. application fee

MEDFORD CONSTRUCTION 0390016285 214 2
802-B NEUSE DRIVE 252-635-5242 / �]
NEW BERN, NC 28560 DATE
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NP
MEMOl:0 5 3 L008 50l:0 3900 16 28 511' 2 L4 2

MEDFORD i'v;,/,RliNE CONST.
F. (I. QOX 3556
NEW BE - N, C 28564-3556
(252) 635.52 �i • JAX (252) 63&4970
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W,f...7 4000 4tf

ADJA(;!?.I�'t' RIPARIAN IM0111t.WrY OWNER XtATVMRN1'
OVIt A PIRRAINC OVERAP ROAT lJFV
J liert iiy ccrfiry thtit ! owtt prtyrriy atijac.rnl t» r1 Rol i�,t
(Noute at 1'rIVIIty tlNarr)
prnrcrty Wcatedvt m St7�tt 6m`. _._' J. f e
(ttttt. ltktrtt, itual, elf.)
0
(1 tetlsc►dy) it'atrNxiullnrtlawaty)
tic liar de.wrilwd tr nit, lei shown below, dit der,tkitiucltt he Is rUll Ldnit at 111:11
h-cation, arnd.1 have no ttttycettt►nt M his PVIVAAt - t t+nekTMRtu! "I a 14"Mrawmet( await "A
mini he W 1uult a minimusil dislahrr ortitimt fed VS 'I fr(sut lily ttccx of titutimu aCrrm units.,
wAiVO by me.
t du tuft wiaft to wmvt• file selkwk Imptitrtttrttt.
t 0 wixh 1, wAivc tlud whmck rrt(ttitteitrttt.
_.-�tUSCRtrrSON A11fWOR PRAWING OV;i OIN)ti'IrD l7l�.VF,I,I)1'Ml;N�!'t
(TO he f3lipd in by indittld► ril ptupodn't krelopnteni)
(P41
"'!' 5 °'' AF`�)
.............. ...... .. ...................... ...
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MEDFORD i'vLOINE CONST.
F, P. ROx 35%
r NEW BE `N,
l5z 635 52 it iJ( {25Z U5470

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIERIMOORING P1UNGS180A7VF r1B0ATHOtlSR)
I hemby certify that I own property 4acau to c"Z 's
OQM of Property Owner)
property located at dIr 0,5 .W LM A CV.&YO sae.
(I,ot, Blocks toad,
on S1*1A4 �'��,� , in 141�s� , N.C.
(WoUrbody) (Town mWor County)
He has dea bed to me, ss dvo m below, the development he is pmpoain& at that locadoa,
and, I have no objection to his proposal. I understand that a pier/mooriq
pilinpsWoadiR/boathouse must be set back a minimum distof itttm feet (15') from my area
of riparian accem unless waived by me,
y. I tbLd wish to waive the setback requirement.
I da wish to waive that setback requirement.
DESCRW nON AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To b AIUd In by Individual propo*g developmunt)
(1A)A W: n� an BTC If
nature
Print or Type Name
7.4 IN �
Telephone Number

t
�z MEDFORD iA@,RlivE CONST.
F. ft. ROX 3556
IYEW BE A C 28 �84-56
(?5Z 635•52 l P
X 1e"57, 6"7g
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