28880_JOHNSON, JEFF_20011031

CAMA and DREDGE AND FILL
G E N E R A L
bdPERM IT
as authorized by the State of North Carolina
Department of Environment and Natural Resources and the Coastal Resources Commission
in an area of environmental concern pursuant to 15 NCAC
Applicant Name
Address
City
Phone Number '
State 1\1( Zip
Project Location (County, State Road, Water Body, etc.)
Type of Project Activity I
I • L.
PROJECT DESCRIPTION
SKETCH
- i 1 r
(SCALE:
Pier (dock) Length
Groin Lengthn
-,Z.
number
f
Bulkhead Length
il'I<
i
max. distance offshore
1q,bd
1
4
AY A
Jff
Basin, channel dimensions
47
if
cubic yards
Boat ramp dimensions
Other
I
t
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 become null and void.
This permit must be on the project site and accessible to the permit of-
ficer when the project is inspected for compliance. The applicant certi-
fies by signing this permit that 1) this project 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.
�frc
issuing date
Ira. ilto. /.?oo
applicant's signature
permit officer's signature
expiration date
attachments
,.
"Y%
application fee

BROAD CREEK CONST INC.
IV)11 Cree view C 3
11 Creekview Court
Merritt, NC 28556
7484
66-152/631
PAY TO
THEOR EROF_
F•C,l,
n C' DOLLARS
� WACHOVIA
wachovia Bank, N.�A-
g Baybom NC 28515
F Y"d day 6RW
88v---
1:0S310 IS 291: 0781 00124011' 7484
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I hereby certify that I own property adjacent toTKO^„ s
(Name of Property Owner)
property located at �Lo /'1 ? j a , 7'
(Lot, Block, Road, etc.)
on� �e �G , in 7
N. C.
(Waterbody)
(T ounty)
He has described to me as shown below, the development he is proposing at that location,
and, I have no objections to his proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(To be filled in by individual proposing development)
l�
Signature �-4 1
L PrR,(2 4A G w Ati- \ is Cy _
Print or Type Name
11 4'rt- M 4E�-1
Telephone Number
Date: ka I F7— 1 0 k

07
0
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