11797_MOORE, STANLEY_19930408

CAMA AND DREDGE AND FILL9 GENERAL �r - ( 117917
PERMIT
as authorized by the State of North Carolina 1
Department of Environment, Health, and Natural Resources athe Coastal Resou s Commission
in an area of environmental concern pursuant to 15 NCAC / --
Applicant Name
Address `� (Pill
City . v
Project Location (County, State Road, Water Body, etc.) _
Type of Project Activity L x [l
PROJECT DESCRIPTION SKETCH
Pier (dock) length
Groin length
number
Bulkhead length
max. distance offshore
Basin, channel dimensions
cubic yards
Boat ramp dimensions
Other
r
Phone Number
State Zip
i
(SCALE
r�
This permit is subject to compliance with this application, situ
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- applicant's signature
come null and void.
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-
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
objections to the proposed work. attachments
In issuing this permit the State of North Carolina certifies that /
this project is consistent with the North Carolina Coastal application fee ^ 3 27
Management Program.

FOLEY & FOLEY MARINE CONTRACTORS, INC. WACHOVIA BANK
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
Owl
DATE
TO THE 04-08-93
ORDER
OF: DEHNR 7 ,
G PC. )1 '7 917
G.P. Moore
II■0000539711' II:0531076331: 5806 00090711'
5397
AMOUNT
$ 50.00/100
URES REQUIRED

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8
16

ADJACENT. RIPARIAN PROPERTY OWNER STATEMENT
_ (FOR A PIER)
I hereby certify that I own property•adjacent to
's property located at
(Name bf Property Owner)
(Lot, Block, Road, etc.)
on ' 0 in . N.C.
(Waterbody)• Mown -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 (15+) 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, fired in by individual proposing development)
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Signature
. � ��►: LrJ 4� Acti�q./ gtterJ� ►�1::
• Print or Type Name
Telephone Number

'J ADJACENT. RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER)
I hereby certify that I own property.adjacent to
•.T''� r y o o �-�= 's property located at
(Name of Property Owner)
o� 2cac„��s
(Lot, Block, Road, etc.)
,.N.C.
(Waterbody)• (Town and/or County)
He has described to me, as shown below, the development hd-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 (I51) from my area- of riparian access
_ unless -*waived by me.
I do not wish to waive that setback requirement.lA�4,4L /'-59)
I do wish to waive that setback, requirement.
--•---------------------------------------------------------------
DESCRIPTION AA'D/OR DRAWING OF PROPOSED DEVELOPMENT:I
(To be fi1?ed in by individual proposing development)
x
STANLEY F. DZIMITROWICZ
N
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A.C.S.W., C.C.S.W.
a v
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CLINICAL SOCIAL WORKER
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OFFICE LOCATIONS
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HAVELOCK OFFICE
NEW BERM OFFICE WESTBROOKE PLAZA
504 POLLOCK ST. HIGHWAY 70 WEST
638-3881 919-447.4151
Print or Type Name
Telephone Number

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