21097_USA, DUANE_19981217

CAMA AND DREDGE AND FILL C Co
GENERAL
N. 021097- c
PERMIT 1511
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
City State Zip
Project Location (County, State Road, Water Body, etc.) 11 i3� �tJ LL(_i ii iI,)
Type of Project Activity �_�tLc_.kkt 1vEs
PROJECT DESCRIPTION I SKETCH
Pier (dock) length
Groin length
number
Bulkhead length—
('.
max. distance offshore
Basin, channel dimensions 1
cubic yards
- ji—
Boat ramp dimensions _
1 , _ - • i c•Ycr
Other v 7
L5
i F_ } �i t�Ivv lr ,��� ��'' U1 ?Pl.c, h;, F IN
This permit is subject to compliance with this application, site
drawing and attached general and specific conditions. Any <—*\vt"' cep• l�"'v�tz`i•�
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.
attachments
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permit officer's signature
issuing date expiration date
In issuing this permit the State of North Carolina certifies that
this project is consistent with the North Carolina Coastal application fee
Management Program.

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BROAD CREEK 4208
B CONSTRUCTION INC 66-152/531
PH 252-249-0523
11 CREEKVIEW COURT DATE V /
MERRITT, NC 28556
PAY TO $
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ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to N) 0/1 IAe, U S l�- 's
(Name of Property Owner)
property located at ,Lr, 3- /iJ 7 j..e-
(Lot, Block, Road, etc.)
on C° (VI �-od4 E�4't-, in 1V`rra1ec11n_, , N.C.
(Waterbody) (Tor 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.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(To be filled in by individual proposing development)
Signature
Print or Type Name
Telephone Number
Date:

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to �c -, a 0 � LI S ,Pg is
(Name of Property Owner)
property located at l o
(Lot, Block, Road, etc.)
on �G� r�r ar�� �,�-u 1 � in , N. C.
(Waterbody) ( 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.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(To be filled in by individual proposing development)
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Signature
Y (A).L3/0tJ
Print or Type Name
-94 ` L Z 3 - z2 G
Telephone Number
Date: l/ Q