24364_WELTON, RICHARD_19991203

CAMA and DREDGE
�G E N E
PERM
as authorized by the State o
Department of Environmen
in an area of environmental
Applicant Name
Address
City
t
AND FILL ,
R A L3
I T
f North Carolina
and Natural Resources and the Coastal Resources Commission
concern pursuant to 15 NCAC
Project Location (County, State Road, Water Body, etc.)
Type of Project Activity
PROJECT DESCRIPTION SKETCH
Pier (dock) Length
Groin Length
number x
Bulkhead Length
max. distance offshore
Basin, channel dimensions
cubic yards
Boat ramp dimensions
Other
State
Tkic n=rmit is ciihior-t to %A/ith thic — N—finn cito rlr %A1;nn
�. -_ - - -_-�- -- -- ---- 1--------- --- -- - --f 1------'- --. ---- '--'----0
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

a
I hereby certify that I own property adjacent to
(Name of Property Owner)
/-
property located at �� -�-3 &i-(,-tk
(Lot, Block, Road, etc.)
on G aST�' C / l� > 1,%�' (Z; in �a wt/t,C- c , N.C.
(Waterbody) (T'o ounty)
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)
Print or Type Name
Telephone Number
Date: f / ---� - q 7
y3&s���I

PAY TO
5 THEORDEROF
E
524'5 ' 4
1� � _ 66-152/531
DATE /
LLAD B sea ,ur b.wnl
Deelale on peck. "
Wachovia Bank, N.A.
&lyl.-, NC 29515 -
FOR GLkZZ-/t- Af?-)saJ/ �Ct7-&d
l:0 5 3 LO I S 291: 0 78 1 OO 1 21,O11' S 2t S
BROAD CREEK CONST INC.
[phone]
II Creekview Court
Merritt, NC 28556
U

Pamlico Home Builders and Supplies, Inc.
Hwy. 55 East • P.O. Box 69 • Alliance, N.C. 28509
[phone]
BUILDING MATERIALS AND HARDWARE SUPPLIES
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