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CAMA and DREDGE AND FILL r_
G E N E R A L t665
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 r
Other
Thic narmit is cuhiPrt to cmmnliance with this anolication. site drawine
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.
issuing date
(SCALE: r,_
applicant's signature
permit officer's signature
expiration date
attachments
application fee
EAST CAROLINA MARINE CONSTRUCTION
TERRY HANNAH NCDL 5737502
252-745-3860
394 HOLLY POINT RD
LOWLAND, NC 28552
PAY
TO THE
ORDER OF
DATE
nni I ARS
1060
W258/531
SmdhemBank
Aurora. NC 27806-0427
Np
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. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to `
am of P-rope9ty Owner)
property located at LDf 4-
(Lot, Block, Road, etc.)
on _ �EQ 11 Cfuk , in F 1 Da _t/) , N.C.
(Waterbody) (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.
DESCRIPTION AND/OR
(To be filled in
�O- U
OF PROPOSED DEVELOPMENT
p4posing development)
0
r
%a Ft
x
Iv Ft
4"I'l
Signature
/0 A'4+cz
Print or Type Name
C � - /113 /—
Telephone Number
Date:
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to
Q261ne of PropMy Owner)
Property located at i®� -*-)
(I,ot, Block, Road, etc.)
L
on 1 U , in aS"L.I() , N.C.
(Waterbody) (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.
DESCRIPTION ANVOR
(To be , fdled in
OF PROPOSED DEVELOPMENT
p4posing development)
0 f-" �
-------------
Print or Type Name
),�� �) - 7 _
Telephone Number
Date: � ^ 3