Davis, Randy

ICY VV' } / ❑ DREDGE & FILL No. 75786 A B �� D
®GUN =RAL PERMIT Previous permit#
[44ew ]Modification ❑Complete Reissue El Partial Reissue Date previous
///permit issued
As authotvzed bir_tha State of North Carolina, Department of Environmental Quality
and the Coastal Resources Co mission in an arenvironmental concern pursuant to 15A NCAC
/� Rules attached.
Applicant Name - �f <: g ✓ If, Project Location: County C I- / '
Address
StateZIP
Phone # ( ) t` i U �.� E-Mail
Authorized Agent
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AEC(s):
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Subdivision
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Phone # R/yQrBasI
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compliance statement on back of permit •r Signature
Check#

Davenport, Ryan
From: Ryan Davenport <[e-mail]>
Sent: Monday, October 14, 2019 1:39 PM
To: Davenport, Ryan
Subject: [External]
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Davenport, Ryan
From: Ryan Davenport <[e-mail]>
Sent: Monday, October 14, 2019 1:40 PM
To: Davenport, Ryan
Subject: [External]
CAUTION: External email. Do not click links or open attachments unless you verify. Send all suspicious email as an
attachment to [e-mail]<mailto:report.spam nc.gov>
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CARTERET COUNTY HEALTH DEPARTMENT
ENVIRONMENTAL HEALTH DIVISION
3820 Bridges Street, Suite A, Morehead City NC 28557
J.T. Garrett, Ed. D., M.P.H.
Improvement Permit 3476
Expiration Date: 12/31/2015
OWNER: BERNIE DAVIS
Construction Authorization 3476
APPLICANT: Bernie Davis
PROPERTY LOCATION: RAY DAVIS ROAD Carteret County NC, 28553, MARSHALLBERG, NC 28553
PARCEL ID: 734614445311000
SITE PLAN
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*A pre -construction conference is required before system construction \
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Environmen}a Health Specialist
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I hereby certify that I own property adjacent to Y/n �l 5 IJh� k. s
property located at /c3-y t I
(Address, Lot, Block, Road, kc.)
on Gl (_/I�aJVI_ in n11 �n ��nI(�on. N.C.
(Waterbody) (Ci /Town and/dt County)
The applicant has described to me, as shown below, the development proposed at the above
location.
1 have no objection to this proposal.
—
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(Individual proposing development must fill in description below or attach a site drawing)
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boathouse, lift, or groin must be set
back a minimum distance of 15' from my area of riparian access unless waived by me. (If you
wish to waive the setback, you must initial the appropriate blank below.)
I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
(Pro e y weer In rmation)
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(Revised 611812012)