18730_SLAYMAKER, GEORGE_19970711

CAMA AND DREDGE AND FILL
GENERAL a 1 730 C:
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 r
Address
City State "', �, zip C s /
Project Location (County, State Road, Water Body, etc.)'
Type of Project Activity
C- re
PROJECT DESCRIPTION I SKETCH
Pier (dock) length
Groin length
number 4-
Bulkhead length f r�
max. distance offshore rr
it Sze d , as kP C• d
Basin, channel dimensions
cubic yards
Boat ramp dimensions
Other
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.
(SCALE: A; ,,,,
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applicant's signature
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permit officer's signature
ii 97 /O- /i. 97
issuing date expiration date
attachments 0J1,1• /`00
In issuing this permit the State of North Carolina certifies that
this project is consistent with the North Carolina Coastal
Management Program.
application fee�'Jo

49-2543
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Irv,
y ADJACENT RIPARIAN PROPERTY OWNER STATEMEENT
(FOR A PIERIMOORING PILINGS/BOATLIFT/BOATHOUSE)
A,vb )9uz-t-y6-A
-"4 TT - b c.c f _ 212s/97
I hereby certify that I own property adjacent to ee, c., a 's
(Name of Proper Owner)
property located at 3 2„ ` C�
(Lot, Block, Road, etc.)
on %�e�Sr� K1ve,� , in Q. o , N.C.
(Waterbody) (To and/or County)
He has describer) 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
piling s/b oatlift/boathouse must be set back a minimum distance of fifteen feet (15') from my area
of riparian access urdess waived by me.
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)
2.
Signature
fv\
Print or Type Name
R lc? — 9 33 —3'7 3 q
Telephone Number
Date: (� f q q?

UNITED STATES POSTAL SERVICE
l
Fi st-Qi S5,Mail
Postage & Fees Paid
USPS
Permit No. G-10
• Print your name, address, and ZIP Code in this box •
Q!:x
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■Complete items 1 and/or 2 for additional services.
■ Complete items 3, 4a, and 4b.
■Print your name and address on the reverse of this form so that we
card to you.
■Attach this form to the front of the mailpiece, or on the back if spac
3. Article Addressed to:
1pe r Zz
6. Signature: (A dressee o
X
PS Form 3811, Decem er 1994
e
permit.
■ Write'Return Receipt Requested' on the mailpiece below the article
■The Return Receipt will show to whom the article was delivered an
delivered.
3. Article Addressed to:
1pe r Zz
6. Signature: (A dressee o
X
PS Form 3811, Decem er 1994
I also wish to receive the
following services (for an ;
can return this extra fee): )
does not 1. ❑ Addressee's Address -2j'
number. 2. El Restricted Delivery U)
d the date
Consult postmaster for fee. ' EL '
d ,
4a. Article Number
CC
4b. Service Type
m �
❑ Registered Certified °C ,
❑ Express Mail ❑ Insured E-;
rn '
❑ Retum Receipt for Merchandise ❑ COD
7. Date of Delivery } 3 +
0
8. Addressee's Address (Only if requested
and fee is paid) M
H
rn
8. Addressee's Address (Only if requested
and fee is paid) M
H
rn