14583_COPELAND, GARY_19950515

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PERMIT PY
uaauthorized bythe State ofNorth Carolina (,
Department ofEnvironment, Health, and Natural Resources a
inanarea cfenvironmental concern pursuant to15ANCAC
Phone Number
City State zip
.Project Location (County, State Road, Water Body, etc,) -V
Type of Project Activity 'V
PROJECT DESCRIPTION
Pier (dock) length
SKETCH
Q,
AL I
A A
(SCALE:
Groin length
4­1__
number
Bulkhead length
to
max. distance offshore
Basin, channel dimensions
cubic yards
Boat ramp dimensions
Other
Li
This permit is subject to compliance with this application, site
drawing and attached gonom| and specific conditions. Any
violation of those terms may subject the ponniucn no u 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 l} this pro-
ject is consistent with the local land use p|an 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 6cam of North Carolina certifies that
this project is consistent with the North Carolina Coastal
Management Program.
issuing date expiration date
uV '
application fee.

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GARY B. COPELAND, MD NINON
•
JOANNE B. COPELAND NCDL 1684946 653112
BANK DIRECTOR 6901
216 DEVANE ST. 485-6250 p
FAYETTEVILLE, NC 28305-5008
M&T �
FAYETTEVILLE, NORTK CAROUNA 28302 C 1 C
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�:053i01i21�:135333727?III
690 l

72c-62
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER)
I hereby certify that -I own property adjacent to
Q .Somme C��\ate ' s property
Name
.located at
(Lot, Block, Road, etc.
, on
5 ice in N.C.
( ter Body) (Town 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 pies must be set back a minimum
distance of fifteen feet (151) from my area of riparian access
unless wain ed by me.
0
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
FILLED IN BY INDIVIDUAL PROPOSING DEVELOPMENT)
/ 'ZI&zl�'
Signature
Name
Phone Number

Im
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER)
I hereby certify that -I own property adjacent to
Is property
Name
located at lM��,�;�
(Lot, Block, Road, etc.)
in N.C.
(Water Body) (Town 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 c,f fifteen feet (151) from my area of riparian access
unless wai•,:ed by me.
do not wish to waive that setback requirement.
I do wis't, to waive that setback requirement.
Description and/or drawing,,of proposed development: (TO BE
FILLED IN BY INDIVIDUAL PROPOSING DEVELOPMENT)
signatu e
b, Gee" () .Car --
Name
7a? -SED/
Phone Number
on

-76

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