16385_JONES ISLAND CLUB, INC._19960820

CAMA AND DREDGE AND FILL
GENERAL
PERMIT
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
Applicant Name ���='''� ,r Phone Number"
Address�'� S
City
Project Location (County, State Road, Water Body,%etc.)
Type of Project Activity 1"e_:
PROJECT DESCRIPTION j SKETCH
Pier (dock) length
Groin length
number
Bulkhead lengthy f
max. distance offshore
Basin, channel dimensions
cubic yards
Boat ramp dimensions
Other
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This permit is subject to compliance with this application, site
drawing 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 be-
come null and void.
This permit must be on the project site and accessible to the
permit officer when the project is inspected for compliance.
The applicant certifies by signing this permit that 1) this pro-
ject 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.
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appl
ature
permit officer's signature
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issuing date expiration date
attachments G / /Y - //Oy
In issuing this permit the State of North Carolina certifies that 1 d✓ �t�
this project is consistent with the North Carolina Coastal application fee ��' !��'� o 2
Management Program.

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SENDER:
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I also wish to receive the
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following services (for an extra
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• Print your name and address on the reverse of this form so that
we can
fee):
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4) return this card to you.
y • Attach this form to the front of the mailpiece, or on the back
if space
1. El Addressee's Address
I does not permit.
t • Write "Return Receipt Requested" on the mailpiece below the article number.
• The Return Receipt to the article was delivered and the date
2 ❑ Restricted Delivery
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will show whom
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yPS Form 3811, December 1991 *U.S.GPO: 1993-352-714 DOMESTIC RETURN RECEIPT
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UNITED STATES POSTAL SERVICE
Official Business
PENALTY FOR PRIVATE
USE TO AVOID PAYMENT
OF POSTAGE, $300
Print your name, address and ZIP Code here
cI"�

SENDER:
p
y� Complete items 1 and/or 2 for additional services.
I also wish to receive the
• Complete items 3, and 4a & b.
following services (for an extra
v
Print your name and address on the reverse of this form so that we can
fee):
>
CDreturn this card to you.
• Attach this form to the front of the mailpiece, or on the back if
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space
1. ❑Addressee's Address
tj
does not permit.
t• Write "Return Receipt Requested" on the mailpiece below the article number.
2. ❑ RBStrlcted Delivery
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" • The Return Receipt will show to whom the article was delivered and the date
o delivered.
Consult postmaster for fee.
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3. Article Addressed to:
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7. Date of Delivery
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5. Signature (Addressee)
8. Addressee's Address (Only if requested Y
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6. Signature (Agent)
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PS Form 3811, December 1991 *U.S. GPO: 1993--352-714 DOMESTIC RETURN RECEIPT

UNITED STATES POSTAL SERVICE
Official Business
PENALTY FOR PRIVATE
USE TO AVOID PAYMENTU.S.MAIL
OF POSTAGE, $300
Print your name, address and ZIP Code here

SENDER: I also wish to receive the
y • Complete items 1 and/or 2 for additional services.
y • Complete items 3, and 4a & b. following Services (for an extra
r • Print your name and address on the reverse of this form so that we can fee):
ireturn this card to you.
m • Attach this form to the front of the mailpiece, or on the back if space 1. ❑ Addressee's Address
does not permit.
• Write "Return Receipt Requested" on the mailpiece below the article number.
s p v p 2. El Restricted Delivery
• The Return Receipt will show to whom the article was delivered and the date
i C delivered. Consult postmaster for fee.
p 3. Article` Addressed to: 4a. Article NumberCL ^�
laid � �e
4b. Servicee Type
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Registered ❑ Insured
.h T %Certified ❑ COD,
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5. Signature (Addressee)
7. Date of Deliver
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8. Addressee's A re (Only if reque
and fee is paid)
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y PS Form 3t$I1, December 1991 *U.S. GPO: 1993-352-714 DOMESTIC RETURN RECEIPT
1

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UNITED STATES POSTAL SERVIC <
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Official Business 2 _
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PENALTY FOR PRIVATE
USE TO AVOID PAYMENT ' u
OF POSTAGE, $300
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Print your name, address and ZIP Code here
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JONES ISLAND CLUB, INC.
P O BOX 8365 PH 919-745-7877
HOBUCKEN, NC 28537
2264
66-301531
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PAY
TO THE
ORDER OF
DOLLARS
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r etails
eiaas ,n e.�.
FIRST CITIZENS
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Boybororo. NC 28515
FOR 62 -14� D/1�39.6 —C
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