25690_COASTAL DOCKS_20000619

CAMA and DREDGE AND FILL
� G E N E R A L ��� V.
� �_;
PERM
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
Project Location (County, State Road, Water Body, etc.)
Type of Project Activity
PROJECT DESCRIPTION SKETCH
Pier (dock) Length FF
Groin Length
number
Bulkhead Length
max. distance offshore
Basin, channel dimensions
cubic yards
Boat ramp dimensions
Other
n
State zip
(SCALE:
This permit is subject to compliance with this application, site drawing i i
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. ! �J
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
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.
permit officer's signature
expiration date
attachments
application fee

SAILING PLACE, INC.
PH 252-726-5664
612 ATLANTIC BEACH CAUSEWAY
ATLANTIC BEACH, NC 28512
PAY
TO THE
ORDER OF.
C
1
8173
66-152/531
DATE
DOLLARS
Wachovia Bank= NA,
Morehead (lily, NC=57 /
FOR
11'0000817311' 1:0S3101S291: 5469 �070 -2110

THE SAILING PLACE
Home of the "Yacht Doctor"
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34°42"30'N • 76°44"15'W
612 Atlantic Beach Causeway • Atlantic Beach, NC 28512 • [phone]

UNITED STATES POSTAL SERVICE
First -Class Mail
Postage & Fees Paid
USPS
Permit No. G-10
• Sender: Please print your name, address, and ZIP+4 in this box •
rc
ma's i

■ Complete items 1, 2, and 3. Also complete
item 4 if Restricted Delivery is desired.
{ ■ Print your name and address on the reverse
jso that we can return the card to you.
■ Attach this card to the back of the mailpiece,
! or on the front if space permits.
1. ArtiqQ Addressed to: qq
A. Received by (Please Print Clearly) I B. Date
C. Si re '
e 1 v 1(C it Pi ❑ Addressee
D. Is delivery address differ em 1? ❑ Yes
If YES, enter deliv pAls ❑ No
3. Service TyMai
pe
jj (/ ( ❑Certified ❑
VVV"`��� ❑ Registered
❑ Insured Mail ❑
'40
loan 00
Mail
Ie . t forINVOWdise
4. Restricted Delivery? (Extra Fee) ❑ Yes
2. icle Nun -Aber (o y from service label)
l � 9 COO Y�29 '?�7/ r
1 PS Form 3811, July 1999 Domestic Return Receipt 102595-99-M-1789

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to �� 2�--Fo 17�Is
(Name of Property Owner)
property located at 6 (U
M
(Lot, Block, Road, etc.)
on n-CIF 5(�4r0,6t� , in j Z f'� C � �`f . , 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.
a
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(To be filled in by individual proposing development)
--(-6 `5 �z 1AA L-�
Signature
f=�2� It COGS
Print or Type Name
Telephone Number
Date: le -Gc�d

c C)
sue ' P � ---- , (, 10 ti�
ou krt(� ?I L-(W&!6 "
11,

State yG
Zip
2r Body, etc,)
7 /,P
��T� ('SCALE:
kA
{
2,40
.IZX-mot _s 2
o WT'
o
- Etc i� ii r GjTbdcs t
:h this application, site
:cific conditions. Any
ie permittee to a fine,
.ause the permit to be-
e and accessible to the
pected for compliance.
)ermit that 1) this pro -
use plan and all local
has been obtained from
(2f---�I- 0-- /�
issuing date
applicant's signature
permit officer's signature
e440- ,
expiration date