22408D - Piver

4* CAMA AND DREDGE AND FILL
sr GENERAL N? 224O8--D
PERMIT
0 as authorized by the State of North Carolina
Department of Environment, Health,and Natural Resources and the Coastal Resources Commission
in an area of environmental concern pursuant to 15A NCAC `70 . 1zoo
Applicant Name TtA +.,r4 E G. ef'►1 1 IVC lr Phone Number a-10 - 422
Address p, - I O Nit a 0 (p kJ
City * M Q S.d State IU C/ Zip Q8 L 4..1
Project Location (County, State Road, Water Body,etc.) P(kiN ea eAr- CO Lk.'\4 j aGu i(',^c1 GA��
'ToPtd, —V\f\rel)S ci iC)\r( Po“..4 t r } h? 1J s r''s C J J UnCOVGrrc1 boENt ��►C4- GJ e.-x, '4't r‘ci pc..., Plr,d 4Uf k_.
PROJECT DESCRIPTION SKETCH (SCALE: NOT r0 )
Pier(dock) length
1
/�
Groin length - 0 ill13I)�C F.5
number `� �,OA; L.\�t
Bulkhead length 0 I ADO ()OS-C.1
max.distance offshore .
Basin,channel dimensions \0
0I
cubic yards A
Boat ramp dimensions 30
Other Ias X I.5 , C.X1S-‘% n
ci
UncoJr..cea L'Irt 4- c r �'`r. \v F'tc-,t, if ,��m ir gel ,.
Crii.' '
Q a' E \ \s, , I
NAA'�c \ St^or� nc.J ('L '
h Qv
This permit is subject to compliance with this application, site
drawing and attached general and specific conditions. Any �,f G[�.
violation of these terms may subject the permittee to a fine, i�T • ant's signature
imprisonment or civil action; and may cause the permit to be-
come null and void. • I'r
This permit must be on the project site and accessible to the permit officer's signature
permit officer when the project is inspected for compliance.
The applicant certifies by signing this permit that 1) this pro- ,`� ,, 7 \ 9 9 U __ '1
ject is consistent with the local land use plan and all local issuing date expiration date
ordinances, and 2) a written statement has been obtained from
adjacent riparian landowners certifying that they have no (1-1-' , 12V 0
attachments
objections to the proposed work.

ULINLRAL PERMIT COMPUTER FORM
APPLICANT N}E: cI e� P V
ADDITIONAL NAl ES: F--�l p P i JeX
AEC DESIG: DEVELOP AREA: 00 n
(will only take 6) --- PROJ DES C: f— 12-
(will only take i)
'WORK: (3 lr I3 x 15' -
(Will only take 4)
MAIIr • -ir‘?„,
(Will only
take 4)
IMP: D U
(will only take 6)
ACTION EXTIRATION
DREDGE&FILL REQUIRED: 121 91 5 / I 2/11
C.AMA MAJOR DEVEL REQUIRED:

1
CAMA PERMIT REQUEST FORM
APPLICANTS NAME-�-�- J-N---12"l ++A+--!V-APHONE
NUMBER-a-ZP--aSd 2 (P /� /
ADDRESS--42-6--0--- -.Jet:A2 al--_6•Ailp9EcrJ Rv�
CITY-h/ 111,214 i -si STATE ---
PROJECT LOCATION ( CITY,STATE ROAD,WATER BODY,ETC )-- r em GD'
TYPE OF PROJECT--A '{ I"Pt
SKETCH---- --- --
, 1 ,C
403:11,$) .
•
applicant's signature
riparian waver owner adjacent
Ate e
riparian waver owner adjacent

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CLEMENTS MARINE CONSTRUCTION
910-270-9110 NCDL 4356789 66-30/531 li 1976
sse
577 NC HIGHWAY 210 W e
l HAMPSTEAD, NC 28443
Pay tothe
Dated I
Order of
$
I:L5-1--.
1
, �
Dollars 0 ,--
BANK CITIZENS S 365 �
I' Fi',41izo,1Bank 6 Trust Company
Hempstoed,N.C.2B44J I
P
Y
For 011-1Var"
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I.'a_.1:0M 5a 3_ 100�•......-3 00-
1:003 532011803u■. 019 76 --
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