22314_MCCOOL, STEPHEN_19990526

CAMA AND DREDGE AND FILL
GENERAL tire: 22314
PERMIT /�
as authorized by the State of North Carolina (c
Department of Environment, Health, and Natural Resources and the CQa�stal Resources Commission
in an area of environmental concern pursuant to 15A NCAC
Applicant Name T `r� Phone Number
Address -
City W.-
Project Location (County, State Road, Water Body, etc.)
Type of Project Activity
State F 0%' zip
f
jol
P
PROJECT DESCRIPTION
SKETCH
ld -t,4
(SCALE:
Pier (dock) length
Groin length
number
Bulkhead length
4_1
max. distance offshore
Basin, channel dimensions
cubic yards
It
Boat ramp dimensions
Other
hc
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.
.g
applicant's signature
permit officer's signature
issuing date
attachments
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.

UNITED STATES 110STAL.NIONEY ORDER 15DOO-800
POSTAL SERVICE®
8362907222
SERIAL NUMBER YEAR. MONTH. DAY POST OFFICE U.S. DO[ I ARq AND CENTS
CHECKWRITER
PAY TO y ".)
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May-25-99 10:11A Guilford Mod Assoc
P-03
(FOR A PllWUlVC0VrJ(SD ROAT UM17VT -- 7110- Y?K
i hereby ca-rdfy that Y a" piny adjc to � � _
of b ovv )
(Lot, Mmu, acmi. eft-) _.�...--__.... ,
an
c7Cowe door Copy)
He bait descaibcd +n MC, %j Ovwn Wow, the dewjupnmt he ipr opoli
-Owiian, and, d have �3o Objet-tiOns W his prowal. d undcraimW thsat pd�x�.W �+
,r
� .�w►c ta�
trout be set back am=imum dix�(,e of fffto a feat (!S') from mar am of xip u,&n
waived by me.
I dcL= wish to waive tg,-z 3ek;u-k iTquircment.
�.� ,.. d2 wish to waive i- u sftbuJr t4uimrent.
AND/OR Drj.At�v'Vt; OF PROMSM DEVYJ.a.tPWNT:
he 1Wtd i7s by IT&VUwtl rupoaing ade"lopment)
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Print of Type parse
Teleprione Nunl1W i

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/UNCOVERED BOAT LIFT) p
I hereby certify that I own property adjacent to
-4 's
ame of Property Owner)
Property located at
_ (Lot, Block
,Road, etc.)
on-r�' �2c� in /L
(Waterbody) N.C.
(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 pie;c/uncovered boat lift
must be set Lack a minimum distance of fifteen feet (15') from my area of riparian access unless
waived by me.
IAQ—n--01 wish to waive the setback requirement.
I dQ wish to waive that setback requirement.
DESCREMON AND/OR DRAWING OF PROPOSED DEVELop ENT: ---
(To be filled in by individual proposing development)
Print or Type Name
30
l
Telephone
Date: '511 #