24812_VERMILLION, GORDON_20000229 (2)

CAMA and DREDGE AND FILL
G E N E R A L N's? 2481 2
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 csrr.. tzoo
Applicant Name _6o2Dta.1 e_L4\t_ktoP1 Phone Number 26? L(3-24
Address N + L_,._M A,J 2 a
City ---mr-�, State NCB Zip 76D)
Project Location (Count)4 State Road, Water Body, etc.) rrnmt,_k z) Cn . PtOT
LC W1 I tJ �t Pa �J 5 CF;7_ JzF j rAETT TAD I ►� t� t t�rJ� 3r c �t .
Type of Project Activity )tom
PROJECT DESCRIPTION SKETCH
Pier (dock) length
I
Groin Length
number PIE 4
Bulkhead Length
max. distance offshore
Basin, channel dimensions 4
cubic yards
Boat ramp dimensions
Other V-D FT
R-A7Fy24-1 t 172 hT K
t7 ��- r r.
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.
01 N . Iztzc7
C 11 ITT- E_-
(SCALE: IJ c�tJ C.
applicant's signature
permit officer's signature
issuing date expiration date
attachments
application fee

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT ;1
I hereby certify that I own property adjacent to GoROoAJ's
(Name of Property Owner)
property located at 15'-udF5 Z�1-?I ViE7
(Lot, Block, Road, etc.)
on A45—::Tu5rE -10VEs2 , in 4�qAlll-ICe Cau�v j -1 , 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 DRAWING OF PROPOSED DEVELOPMENT
(To be filled in by individual proposing development)
Signature
w1LL14i-vL c . 1-1a&3Aqi&C>
Print or Type Name
I?/4- 78Z-/733
Telephone Number
Date: 2

.-Ivvf- IIII ZoC eD
JUN 2 3 2000
gxo,.SL.'f�'j O�r Lo"� '`fjOASTAI�q _AGDErrtENi
Qa u
b.- -ec C." sst, 1411LA- r->LD " CS Vroftq--x,-e—

W11"nm C Hubba;o, MD. Fw
WailaCe D Brown, M0. F4AP
Jelly C Apmgreln. MD. FMP
Sr'Mn M Gosw,, MD FAHP
J i1BnOy HedmPelh MD FMP
Kagan A i(a, i%+user. M0. F: AF
Walre, T Kosc,etnlek. Mo. FAAP
Mednoa C. Taylor. MD. FMP
Aoben C Npin,s. MD. FW1P
"n AID, FA_ef,
Jerauy C Jdhhson.MO FAW
James W GOV. MD.FAAP
Candace L 90yet4e RN FNPL
S2ndra C. BUMP() RNC
4%5 Professional Court
Leigh, Norrh Carolina 27609
ieleahone 919-872-0250
Fax [phone]
B00 Benson Road
1fn jf Nnrfh Camime 27529
76t6PAunr 919-779-i 23
Fax 919, $2-2021
R025 C,eedmoor Road
Digh. North Cdroiina 276i3
ielephona 919-844-5600
Fax 919-B45-8997
RALEIGH PEDIATRIC AsSoc:IATES, P.A.
FACSIMILE COVER SHEET
PLEASE DELIVER IMMEDIATELY
COMPANY:
FAX S -7.
FROM: Q%•- te,rer2�v[�
DATE- 6 /1-5—/,erD
JUN 2 3 2000
COASTAL MANAGEMENT
MOREHEAD
+r OF PAGES: A9
(including cover sheet)
If you have any trouble receiving thi_ +ransn:lssicr,, please cull 872 - ;C ,.
AACJJ An-
The information contained in this facsimile message is physician privileged and
confidential information. If the reader of this message is nn+ the intended
recipient, you are hereby notified that any disst-;ina•iar� distribution or
conV'71 of this .'-t---nun cation is str ictly prohibited. if you have received this
in error, please immediately notify us by telephone and return
the original message to us at the above address via the u.S- Postal Service.

JUN 2 3 2000
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