11841_GORHAM, M.R._19930511

r � •
CAMA AND DREDGE AND FILL
GENERAL ' , " °r 11841
PERMIT 4
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 i
Applicant Name
Address i
City.
Project. Loc tion (County, State Road, Water Body, etc.)
Type of Project Activity
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.
In issuing this permit the State of North Carolina certifies that
this project is consistent with the North Carolina Coastal
Management Program.
Phone Number
State 1 4) Zip _
rt ' , %'
attachments
application fee
i
applicant's signature
permit officer's signature
issuing date
S�3
expiration date

..,....�,....._---- ----- --- --- - - - -- ---- ..
FOLEY & FOLEY MARINE CONTRACTORS, INC. WACHOVIA BANK 5533
PRIMARY CHECKING OF NORTH CAROLINA, N.A.
PH. 919-636-2515 NEW BERN, NC 28560-1677
POST OFFICE BOX 3482 66-763/531
NEW BERN, NORTH CAROLINA 28564-3482
PAY \
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DATE 5-11-93 AMOUNT $50.00
TO THE
ORDER DEHNR
OF:
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ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER)
I hereby certify that•I own property adjacent to
CUkt 414 wk 's property
Name
located at � p �' 3 S (o SL C /7 , 7;0 4 J 146W . on
(Lot, Block, Road, etc.)
/�b►2 bJgT C2rrzcc in /tJ6-k) Q���� �2o�r� N.C.
(Water Body) (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. I understand that a pier must be set back a minimum
distance of fifteen feet (151) from my area of riparian access
unless waived by me.
I do not wish to waive that setback requirement.
I do wish to waive that setback requirement.
Description and/or drawing of proposed development: (To BE
FILLED IN BY INDIVIDUAL PROPOSING DEVELOPMENT)
Signature
Name
Phone Number

FOLEY_&
MARIN E CONTRACTORS, INC.
1902-A Highway 70 East • New Bern, North Carolina 28560 • [phone]

ADJACENT RIPARIAN PROPERTY OWNER•STATEMEt7T
(FOR A PIER)
rI�1 hereby certify, that .I own property ad j acent to
IY I - i�' Go it'' PAw� 's property
Name
located at SL'c q f 7:74,14 C'iblyV? . on
(Lot, Block, Road, etc.)
b►2-R b3faT Ce r,tc in L QeeadgD , N.C.
(Water Body) (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. I understand that a pier must be set back a minimum
distance of fifteen feet (151) from my area of riparian access
unless aived by me.
7I do not wish to waive that setback requirement.
I do wish to waive that setback requirement.
Description and/or drav7ing of proposed development: (TO BE
FILLED IN BY INDIVIDUAL PROPOSING DEVELOPMENT)
7c,
'Signatilre
Name
Phone Number