24887_BETTS, ED_20000323

L CAMA and DREDGE AND FILL
�.. G E N E R A L 24887
PERM I T
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 M.,2k
numberBulkhead Length
max. distance offshore
Basin, channel dimensions
cubic yards
Boat ramp dimensions
Other
i nis permit is subject to compliance wim tnis appttcauon, site orawing
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
i

PAY TO
THEORDEROF
BROAD CREEK CONST INC. 5 5 5 8
[phone] 55-152/531
11 Creekview Court 3 - ,2g-- oo
Merritt, NC 28556 Dnre
d�
$
- A� CHUVIA
Wachov[a Bank, N.A.
Bsyboro, NC 28515
FOR
a`4 e
i:053LOIS291: 0781 OO1240u' 5558
F�

.� f � f' • t - ' � • • fit• • fit' f �l
I hereby certify that I own property adjacent to i-c,() 30. / l s 's
(Name of Property Owner)
property located at j' h ►hz i� �� ��r%�' '� `-�
(Lot, Block., Road, etc.)
on 1) 2�1� , in [ / y cv - , N.C.
(Waterbody) ( r 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
(T'o be filled in by individual proposing development)
0
L'
i
Signature
Print or Type Name
9 .s6 -f -N, ,y -- 0 +q
Telephone Number
Date: 3 G

0
ADJACF-'f RIP. R-1A v PIM PER'r ' O NT it STATEMENT
I hereby certify that I own properry adjacent to �' � Re �`-_ is
(Naive of Property Owner)
property iocatedat l c�v��,�- _ ,� c + 7 ,
(Lot, Block, Road, etc.)
Oil t�N.C.
— (Waterbody) (T-o we-aoWar County)
Ee � described tome 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)
----- _-_-__
Signatsre
Print or Type Name r C
.:ephone Number
Date: _ f V�L