25641_ROMING, MARTY_20000621

CAMA and DREDGE AND FILL
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
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
i
(SCALE:
- )--
Groin Length
number
Bulkhead Length
max, distance offshore
t ,;
i
__. . _
Basin, channel dimensions
_
I
i
f
cubic yards
Boat ramp dimensions
Other
777
This permit is subject to compliance with this application, site drawin /
Lo �-
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.
��L
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
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
is consistent with the North Carolina Coastal Management Program.
application fee

FOLEY & FOLEY CONTRACTORS, INC.
PH. 252-636-2515
1810 OLD AIRPORT RD.
P.O. BOX 3482
NEW BERN, NC 28564
PAY
TO THE
ORDER OF
3339
/ 66-1185/531
DATE 1�--�/'dO
$ Sa ov
'ate DOLLARS
I� ANGLE
ASX BANK N w Bem, NC 28560
FOR S1
on oi;:iqi\oi i:0531118521:0931000160no

05/18/00 07:51 FA.1
[a01
0 C)
Customer Job Requiretment Worksheet
vC�1
stomer Name. Date_j
Mailing Address
Job site Address_ � Y�
Phone# Fax#
Adjecent Property Owners
Left sideA� Right side
(.90
Date Mai led��L�eturned -0O Date Mailed-Q eturned
Cert. Mailed Returned — Cert. Mailed Returned
Permit Required
t/
State (CAMA) Recieved
City Recieved
County �� Recieved
Fairfield Harbour
Bulkhead
Dock
Boatlift
Jettie
0
Recieved
Job Type
Boathouse
Jet Ski Lift
Ramp
Piling

05/18/00 0 7 : 5 1 FAX Z 02
ADJACENT RIPARIAN PROPERTY OWNER STATEMLENT
I hereby certify that I own property adjacent to A iz 's
(N a of Prape y Owner)
property located at 19 J j U ,
(Lot, Block, Road, etc.) '
on u F-�. , in �V F� ,� �� G�Au E.� , N.C.
(Waterbody) (Town and/or County)
He has described to me as shown below, the development he is proposing at that location,
i
and, I have no objections tq his proposal.
1 2,
(k
in
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVLLOPMENT
(To be JWed in by individual proposing development)
�J'ik-A4- uygAL-
41
Signature
i� s / . / a•rai,1
'411ef-lloa 19�0C(+WJ „4re
Print or Type Name
2 f ) — 6—f'or If-f4
Telephone Number
Date; 211f14o0

05/18/00 07:51 FAX [a03
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER)
I hereby certify that,I own property adjacent to
A
ame
located at 19
(Lot, Block, Road, etc.)
's property
FAIM-,1
in N aw Z7'. r4 C'rZl�t,� �,..� N.C.
(Water Body) (Town and/or County)
He has described to me as shown below the development he is
proposing at that location and I have no objections to his
proposal. I understand that a pier must be set back a minimum
` 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 PROPOSING DEVSGOPMENT)
'6")���
ON
0
11
How r
19717
A4 1
Name
Phone Number

t?Ew1 o u
eryL Ls�
o�
19n•� T.��1aLc.
—Add 2,r co;dn
4►Skk 604y
?00-11 Ao»•°,ti5
Y lA,oaOe- W-14 Rd-
AEJPO, /U ,,
AfsZa
0
MR
9