11806_BROWN, MORES_19930427

CAMA AND DREDGE AND FILL
GENERAL �c'c. jiff
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 15 NCAC
Applicant Name
Address
City State
Project Location (County, State Road, Water Body, etc.)
Type of Project Activity
PROJECT DESCRIPTION I SKETCH
Pier (dock) length
Groin length
number
Bulkhead length
max. distance offshore
Basin, channel dimensions
cubic yards
Boat ramp dimensions
Other
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.
Phone Number l
Zip
(SCALE: __�.,V )
applicant's signature
permit officer's signature
issuing date expiration date
attachments
In issuing this permit the State of North Carolina certifies that
this project is consistent with the North Carolina Coastal application fee
Management Program.

THE CAPTAINS TABLE 7557
A DIVISION OF THE DOUGHNUT PALACE, INC.
4109 ARENDELL ST. PH. 919-726-0253
MOREHEAD CITY, NC 28557
66-112
PAY 531
TO THE
ORDER
ORDER OF
DOLLARS
BBU
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HEAD CITY, NORTH CARD N 337 IIIl l
FOR GQC, -1 a _
'0 007SS711- 1:0S3LOLL20:L22L02906911-

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D SENDER: I also wish to receive the
rn Complete items 1 and/or 2 for additional services. following services (for an extra V
y • Complete items 3, and 4a & b.
• Print your name and address on the reverse of this form so that we can fee):
0 return this card to you.
d • Attach this form to the front of the mailpiece, or on the back if space 1. ❑ Addressee's Address U)
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does not permit. a
m • Write "Return Receipt Requested" on the mailpiece below the article number. 2 ,� Restricted Delivery y
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• The Return Receipt will show to whom the article was delivered and the date U
c delivered. Consult postmaster for fee. cc
3. Article Addressed to: 4a. Articl�j�JurppEr 3� 73O M
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z 8. Addressee's Address (Only if requested .1,5. Signature (Addressee) and fee is paid)
to
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6. Signature (Agent)
° STIC RETURN RECEIPT
> PS Form 381 1 , December 1991 pus. ram taa� ��zero nnne�
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P 256 635 305
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CARTLRCT COUNTY COURT NOOSE
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1'I.ANhIn(� CI)�1111�ti1111 ,' `I'..,
r. t,KAwtat 610
BEAUFORT, N. C. 28516
0
ADJACENT RIPARIAI; PROPERTY OWNER STATEMENT
i erep
by certify
that I own property jacent to
/ zoperty located at
in (county)
e went he is
(water body) = elow
He has described to mes show and Ibhave nob j actions to this
proposing in that location
proposal.
If
Description and or drawing of proposed development:
signature
nase
phone number

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