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CAMA AND DREDGE AND FILL (ff� i
GENERAL N'': 22207 PERMIT C-67
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 Phone Number
Address I I
City State zip
Project Location (County, State Road, Water Body, etc.)
Type of Project Activity 14o L� t 4 ✓<', 7`; , ' y n 7� 5 ,1 i f� r' < + �y t • 1=
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PROJECT DESCRIPTION I SKETCH � I
E/� %5 `- fJ
Pier (dock) length
Groin length
number
Bulkhead length
max. distance offshore
Basin, channel dimensions
cubic yards
Boat ramp dimensions
Other
I
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4 `I
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.
In issuing this permit the State of North Carolina certifies that
this project is consistent with the North Carolina Coastal
Management Program.
(SCALE:
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applicant's signature
permit officer's signature
issuing date expiration date
attachments
application fee
COASTAL MARINE CONTRACTORS, INC.
P.O. BOX 12729 PH. 252-638-6407
NEW BERN. NC 28560
PAY A
TO THE
ORDER OF
� a0
01901 -">n r
5024
DATE -6,--I-;?- � - L} 66-112/531
DOLLARS El.
375 SOUTH FRONT STREET
NEW BERN, NC 22856�0
FAR - - - - -- - - -- ---- -
NP
111000050 24ii' i:05310 112 0:511011 269130
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to
property located at 7V-' /' -/
(lot, block, road, etc)
on ree- in
body of water (town)
North Carolina in �k �e74- County. The proposal has been described to
me as shown below; the development, a ier/bulkhead/structure, and the
(circle one)
proposed location, and I have not objection to the proposal. I under-
stand that if the development is a pier, it must be set back a minimum
distance of 15 feet from my area of riparian access unless waived by me.
I do no' wish to waive that setback requirement.
(cl one)
Description and/or drawing of proposed development: (to be filled in by
individual proposing development). INDICATE THE SIZE AND LOCATION OF THE
STRUCTU::cE AND THE DISTANCE BETWEEN EACH PROPERTY LINE AND THE WATER.
61IL�elld
jokr VJJ/'-
(Original must be retained in the Inspection Department)
Signature
/-'� 25
Date
Name (Please Print)
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