23693_TOWN OF PINE KNOLL SHORES_19991202

Y X(0-
CAMA and DREDGE AND FILL r/W
,.� G E N E R
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 Phone Number
Address
City State Zip
Project Location (County, State Road, Water Body, etc.)
Type of Project Activity
PROJECT DESCRIPTION SKETCH
Pier (dock) Length
Groin Length
number
Bulkhead Length
max. distance offshore
Basin, channel dimensions
cubic yards
Boat ramp dimensions 1
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.
(SCALE:
applicant's signature
permit officer's signature
issuing date expiration date
attachments
application fee

MUD BUCKET DREDGING, INC.
ATLANTIIC C BOAC CAUSE 252)72 AY CDL 8039839
ATLANTIC BEACH, NC 28512
Pay to the �C
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FIRST CITIZENS 133
KHIr First. ic118aach,N &T-2C—Pany
66-30l531 1967
133 j r7
Date G
_Dollars
For
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5-----AFEry BLUE WDOL

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
ills
I hereby certify that I own property adjacent to
f i oxaw Oy- S'404e€.5_' s property
located at I o-o woat e l - 4L..- (2-tt2ee-i-� do
(Lot, Block, Road, etc.)
�OF��tif INLET
e'1�4NNEL in ��(� fC�FoGt� �N�2�, N.C.
(Water Body) (Town and/or County)
He has described to me as indicated below the development
he is proposing at that location and I have no objections
to his proposal. I understand that a pier, pilings and
dredging must beset back a minumum distance of fifteen feet
(15') from my area of riparian access unless waived by me.
I do not wish to waive that setback requirement.
I do wish to waive that setback requirement.
Description and/or drawing of proposed development:
.(To be filled in by individual prat.josing development.)
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