22303_JOHNSON, EMMITT_19990430

CAMA AND DREDGE AND FILL
GENERAL N? 22303
PERMIT
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 G' l
Project Location (County, State Road, Water Body, etc.) f" k
Type of Project Activity/
PROJECT DESCRIPTION SKETCH r %' r (( �q�t (� 7 J i �y 'i(SCALE'i )
f Pier (dock) length
Groin length
number
Bulkhead length '
t J i a
max, distance offshore
Basin, channel dimensions / 'T l 14
cubic yards ,
Boat ramp dimensions "� (? �_• ---- -=- J) , r
Other
This permit is subject to compliance with this application, site
general and specific conditions. An
drawing and attached g p Y
violation of these terms may subject the permittee to a fine, applicant's signature
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's signature
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 issuing date expiration date
ordinances, and 2) a written statement has been obtained from
adjacent riparian landowners certifying that they have no
objections to the proposed work. attachments
/ _ I
In issuing this permit the State of North Carolina certifies that y F . ('
this project is consistent with the North Carolina Coastal application fee i r !
Management Program.

EMMITT H. JOHNSON
ANN B. JOHNSON
350 JA-MAR DRIVE PH. 336-788-1850
KERNERSVILLE, NC 27284
PAY TO THE
ORDER OF
14�'t
66-7783
2531 3095
DATE 1 3 D 6 P7
Al FAMILY
Federal Credit Union
WINSTON- ,SAIEM�p 2--ST
niI;�u)
1: 2 5 3 1 7 78 3 21:0000 2 38 70 2 3 i loll' 30 9 5
DOLLARS
IVP
J

ADJACENT RIPARIAN PROPERTY OWNER STATENIENT
(FOR A PIER/MOORING PILINGSIBOATLIFT/BOATHOUSE)
Mlk,`tt �I: s h��'�/4_
I hereby certify that I own property adjacent to AA v,. 3, 1- A A-( ( c).'\-- is
&g l Sis Jr;,; e (Name of Property Owner)
property located at act )Y, 1/-av 91 /,4rA& -?1)1P. tS,U-u,s,>'A /�y-7pC4 4Ph
(Lot, Block, Road, etc.) T�� r
on . S,fr,� r S , in ('4r7ere I (6wt&�' , N.C.
(Waterbody) (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/mooring
pilings/boatlift/boathouse must be set back a minimum distance of fifteen feet (15') from my area
of riparian access unless waived by me.
I do not wish to waive the setback requirement.
a r
I do wish to waive that setback requirement.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
� o
I
00
ITZ
a'' d `l pest '3att
Signature
Print or Type Name
Telephone N mbe q
Date: t

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIERIMOORING PILINGSIBOATLIFT/BOATHOUSE)
M ,`P 9; .I o Anse �
I hereby certify that I own property adjacent to Aix v, 2, J-D h A10i',-- 's
'*g' l Str t> .>r"'; e (Name of Property Owner)
property located at � t t )Y, 31otr� i? . / /4,- b W 1413c c_ �T
(Lot, Block, Road, etc.) /
on 3" r,' 1,t� , in (Arrer2 ( tz , N.C.
(Waterbody) (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/mooring
pilings/boatlift/boathouse must be set back a minimum distance of fifteen feet (15') from my area
of riparian access unless waived by me.
G P�o j�'L
I do not wish to waive the 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)
� o
jJj�� D C
S-e 7"ti
Print or Type Name
-Z
Telephone Number
Date: p�

yR Y, 1
ay 60 u s s, 9 9 rCE�'D ON
�i Ctt 7336.01 - 1917
If
7
3879
0877
L �tA 2A
7822 ] ►) 3850 5880 )162A)
r 8756
3679
110
~
'
6579 75" 9529
V;A 4509
M T�
y,
+r 3418
4483
4432
4
11 •
�}7v
pr CEY E;F-
C�/ O
rr
5324•,
Y
1
o•
S-JpS 11.19Af
.'�!.'
SiID9 9237
� 6A 22 10
. 9
7206
2e
4
11 4291
19
3221
11
147i ;
S)
30
17 `t'4y
4I43 tit
Z
27
\,79, t1T1A1
G�.
`9p
so58
?iJ%�`�•
5057
90M
i6
) 3
5969
9909
26
99
44
5965
25
0995
18 (1j7A) LS
5888
rr
6�
9814
• 3
18034
/s
24
5798
6736
60
-
9723
> 37HZ' i
SJ
l)bSAI
.)648 A6'
I>
6677,
0665
44
zz
1)
4558 •�
\i1+
6587
s
4493
74 i8
i
M99
tI.K4)
8444
Z44Fn
(
7A) 11.00A) 2481
_
rr`
0
19 1368
zj}g.
6337
/9
CiEt
lzn)
mar
r�3 6285.
pay
�°
s
(1-21A) 2
3lffT
/s
7290
7164 60
/r
so ��''r6175
ue`
s
3522al
59W
hU'� l-(
/ni, bert-
�,-1�,-A-
4 a -A
7336.03
3814
l l_94A)
2684
449
12,65A )
3439
56Q
(so9A)
3114
2909 � �1
t22A
3449
L 7A
37Z6
�191 A)
1262
16SA
216,�3