10916_General Permit_19921217

CAMA AND DREDGE AND FILL �,
GENERAL J
PERMIT G
�Ne iaals
as authorized by the State of North Carolina
Department of Environment, Health, and Natural Resources and the Coastal Resources Commissi
in an area of environmental concern pursuant to 15 NCAC i { ' 4- C.
Applicant Name tv" K./'t / f
Address
City Stte
Project Location (County, State Road, Water Body, etc.) C '
I f/ '', ( 1, r I" i l
Type of Project Activity
�C
Phone Number
zip yr'
PROJECT DESCRIPTION SKETCH '- (SCALE: CD )
Y.
Pier (dock) length
Groin length• ~/
number
Bulkhead length
L—
max. distance offshore
Basin, channel dimensions /
r
cubic yards
r
Boat ramp dimensions
Other
'C
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.
applicant's signature
permit officer's signature
issuing date expiration date
attachments / 00 U
In issuing this permit the State of North Carolina certifies that
4 this project is consistent with the North Carolina Coastal
f Management Program.
application fee Y. 4L - —no

COASTAL MARINE CONTRACTORS
PH. 919-638-6407
1897 JACK RABBIT LN.
NEW BERN, NC 28562
PAY / ,�
TO THE
ORDER OF �j' �,(
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MANGH fANNNWi ANO TIIUfT GOMrANY `/,C
FOR -e/O ` 9 3 OrRN. NORT j CA R;�380/�
000002337112 '::0S310112P:119112?923113
2337
9 Q Z ss—„z
531
DOLLARS

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to Om K1 /_3
property located at Lo f 3 7o540 Oi rde_
lot, block, road, etc.,)
on iA) 4a ke-� f--ee k in
bod o water ��e �
Y town
North Carolina in ✓3MLIc[) County. The proposal has been described to me
as shown below; the development, <21er ulkhead structure, and the proposed
circle one
location, and I have no objections to the proposal. I understand 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 =donowish to waive
(circle one)
that setback requirement.
Description and/or drawing of proposed development: Indicate the size and
location of the structure and the distance between each property line and
the water.
I
�o
E
0
U
(original must be retained in the inspections�depart`ment)
-'1 J .. '.
s-ignaturg and --date
name/please print

ADJACENT RIPARIAN PROPERTY OWDM STATEMENT
I hereby certify that I own property adjacent to
property located at
on LJh,7�ffKE�
on
��:Ek
lot, block,
in
road, etc.
etc.
(body of water) (town)
North Carolina in '1-)ihz1cO County. The proposal has been described to me
as shown below; the development,a. ier/bulkhead/structure, and the proposed
circle one
location, and I have no objections to the proposal. I understand that if the
development is a pier, it must be set back a minimum distance of 1" feet from
my area of riparian access unless waived by me. I do do not wish to waive
that setback requirement. (circle one)
Description and/or drawing of proposed development: Indicate the size and
location of the structure and the distance between each property line and
the water.
Uo' o
topp CO
910- p)#�
b ex
C
(original must be retained in the inspections department)
signature and date
name please print