24593_FULCHER, DOUG_20000524

CAMA and DREDGE AND FILL
G E N E R A L 24593
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
PROTECT DESCRIPTION SKETCH
Pier (dock) Length
Groin Length
number
Bulkhead Length
max. distance offshore
Basin, channel dimensions
cubic yards
Boat ramp dimensions
Other
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
(SCALE:
applicant's signature
permit officer's signature
issuing date expiration date
attachments
application fee

10ERrIFIED
1815 COUNTRY CLUB ROAD
MOREHEAD CITY, N.C. 28557
7099 3220 0006 6412 1888
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Restricted Delivery Fee
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Certified Mail Provides:
■ A mailing receipt
■ A unique identifier for your mailpiece
■ A signature upon delivery
■ A record of delivery kept by the Postal Service for two years
Important Reminders:
■ Certified Mail may ONLY be combined with First -Class Mail or Priority Mail. !i
■ Certified Mail is not available for any class of international mail.
■ NO INSURANCE COVERAGE IS PROVIDED with Certified Mail. For
valuables, please consider Insured or Registered Mail.
■ For an additional fee, a Return Receipt may be requested to provide proof of
delivery. To obtain Return Receipt service, please complete and attach a Return
Receipt (PS Form 3811) to the article and add applicable postage to cover the
fee. Endorse mailpiece "Return Receipt Requested". To receive a fee waiver for
a duplicate return receipt, a USPS postmark on your Certified Mail receipt is
required.
■ For an additional fee, delivery may be restricted to the addressee or
addressee's authorized agent. Advise the clerk or mark the mailpiece with the
endorsement "Restricted Delivery".
■ If a postmark on the Certified Mail receipt is desired, please present the arti-
cle at the post office for postmarking. If a postmark on the Certified Mail
receipt is not needed, detach and affix label with postage and mail.
IMPORTANT. Save this receipt and present it when making an inquiry.

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Postage 1 $
Certified Fee
Return Receipt Fee
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Restricted Delivery Fee
(Endorsement Required)
Total Postage & Fees
Street, Apt. No.; or
City, State, ZIP+ 4
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APR 2.4100 j
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mailer)

Certified Mail Provides:
■ A mailing receipt
■ A unique identifier for your mailpiece
■ A signature upon delivery
■ A record of delivery kept by the Postal Service for two years
Important Reminders:
■ Certified Mail may ONLY be combined with First -Class Mail or Priority Mail.
■ Certified Mail is not available for any class of international mail.
■ NO INSURANCE COVERAGE IS PROVIDED with Certified Mail. Fo'
valuables, please consider Insured or Registered Mail.
■ For an additional fee, a Return Receipt may be requested to provide proof d
delivery. To obtain Return Receipt service, please complete and attach a Returr,
Receipt (PS Form 3811) to the article and add applicable postage to cover the
fee. Endorse mailpiece "Return Receipt Requested". To receive a fee waiver foi
a duplicate return receipt, a USPS postmark on your Certified Mail receipt is
required.
■ For an additional fee, delivery may be restricted to the addressee or
addressee's authorized agent. Advise the clerk or mark the mailpiece with the I
endorsement "Restricted Delivery".
■ If a postmark on the Certified Mail receipt is desired, please present the arti-
cle at the post office for postmarking. If a postmark on the Certified Mail
receipt is not needed, detach and affix label with postage and mail.
IMPORTANT: Save this receipt and present it when making an inquiry. j
PS Form 3800, July 1999 (Reverse) 102595 99-M-1938

■ Complete items 1, 2, and 3. Also complete
item 4 if Restricted Delivery is desired.
■ Print your name and address on the reverse
j so that we can return the card to you.
■ Attach this card to the back of the mailpiece,
( or on the front if space permits.
Article Addressed to:
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A. Received by (Please Print Clearly) B. Date of Delivery
C. Signature
X &xjj4�-Jatfitl]
❑ Agent
Addressee
D. Is deliv cads nt from item 1? ❑ Yes
If Y 4M ss below: ❑ No
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3. Servic
Certified Express Mail
❑ Registered ❑ Return Receipt for Merchandise
❑ Insured Mail ❑ C.O.D.
4. Restricted Delivery? (Extra Fee) Cl Yes
2. Article Number (Copy from service label) 11 / Z7/7
PS Form 3811, July 1999 Domestic Return Receipt 102595-99-M-1789

UNITED STATES POSTAL SERVICE
First -Class Mail
Postage & Fees Paid
LISPS
Permit No. G-10
• Sender: Please print your name, address, and ZIP+4 in this box •
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■ Complete items 1, 2, and 3. Also complete
item 4 if Restricted Delivery is desired.
j ■ Print your name and address on the reverse
so that we can return the card to you.
f■ Attach this card to the back of the mailpiece,
or on the front if space permits.
1. Article Addressed to:
I J1r -t9, \A V { A 1V t7'c� �A1w
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A. Received by (Please Print Clearly) I B. Date of Delivery
C. Signature
X ❑ Agent
❑ Addressee j
D. is delivery address different from Rem 1? ❑ Yes
If YES, enter delivery address below: ❑ No
3. Service Type
i ied Mail ❑ Express Mail
❑ Registered ❑ Return Receipt for Merchandise
❑ Insured Mail ❑ C.O.D. }
4. Restricted Delivery? (Extra Fee) p Yes
2. Article Number (Copy from service label)
PS Form 3811, July 1999 n,-.,ti, Return Receipt 102595-99-M-1789
f

UNITED STATES POSTAL SERVICE
First -Class Mail
Postage & Fees Paid
USPS
Permit No. G-10
• Sender: Please print your name, address, and ZIP+4 in this box •

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1901 94 to OR
DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Individual applying for Permit: ' ()J2-b6 W- +--kQ
Address of Property: �� c� V T 5 I Lk S�
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(Lot or Street #, Street or Road, City & County)
I hereby certify that I own property adjacent to the above referenced property. The individual
applying for this permit has described to me as shown on the attached drawing the development
they are proposing. A description or drawing, with dimensions, should be provided with this
letter.
I have no objections to this proposal.
If you have objections to what is being proposed, please write the Division of Coastal
Management, Hestron Plaza II, 151-B, Hwy. 24, Morehead City, NC, 28557 or call (252) 808-
2808 within 10 days of receipt of this notice. No response is considered the same as no objection
if you have been notified by Certified Mail.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boat house, lift or sandbags must be
set back a minimum distance of 15' from my area of riparian access unless waived by me. (If you
wish to waive the setback, you must initial the appropriate blank below.)
S i anature
Print Name
I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
Date
Telephone Number With Area Code