23105_AYCOCK, JULIAN_19990721

M E AN <cJ''
CAMA AND DREDGE D FILL
GENERAL ? 23105
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 of ' /4 b. c- ',c
el
Address c} Li /� Y! f t�'
City State
Project Location (County, Stag.Road, Water Body, etc.) C- r
of Project Activity
Phone Number �� 1 �� "' ��'9' "4 -3 �� l
zip e' 7 k 3 G'
PROJECT DESCRIPTION
SKETCHY lc �T17
(SCALE:
)
Pier (dock) length
Groin IengtFr
number
Bulkhead length
A
max. distance offshore
Basin, channel dimensions
..f�
cubic yards
�' y h ' r' i e/,f
Boat ramp dimensions
C�
Other
ff
t^
VA �
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.
J
applicant's signature
permit officer's signature
issuing date expiration date
attachments "
In issuing this permit the State of North Carolina certifies that �f j/
this project is consistent with the North Carolina Coastal application fee r7 . L! 1 �l.`L
Management Program.

• ' �+ +; Official Check 66-713 / 531 %� A-10V
1002507141 W
To replace this Official check for any reason
will require an indemnifying Agreement or a Bond.
Date jul y 21, 199Q
PAY TO THE ***DENR***
ORDER OF
Issuing Office Mi tohel 1 Vi l l age
T SUM �`:!,E) Uo I ''
$ ***50.00***
FOred Z)1/4 JOC-901
Wachovia Bank-�—Raleigh, NC i , f �,
,1
.11 i (1'-1 �u (nr v — (-.P4 7 -?/6S �•'�iJ ,-AUTHO IZED' IGNATURE
II5100250714Lill i:053107633':016260 99EI0020

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIERIUNCOVERED BOAT LIFI)
I hereby certify that I own property adjacent to 1-N -q-�Coc-K ,s
(]Name of Property Owner) -
property located at r 3 k�, —r�-AC E-59
(Lot, Block, Road, etc.) �l
on��CDye SaCAND in TCI--t��C C-
TN.C.
(W'aterbody) (Town and/or County)
He has described to me, as shown below, the development he is proposing at that
locacon, and, I have no objections to his proposal. I understand that a pier/uncovered boat lift
must be set back a minimum distance of fifteen feet (15') from my area or riparian access unless
waived by me.
not wish to waive the setback recuirement.
I do wish to waive that setback recuirement.
DESCR-=ON A-.r'D/OR DR NIVDi G OF PROPOSED DEVELOP-NfEN ':
(7'o be felled in by individual proposing development)
'OLO�
` s
Signature
�n �t)0t4
Print or Type Name
aI I - / 0 �-
Telephone Number
Date:

e� �L � Vc o CK 7>n(r-,f (�
T�Le nl-c)NT P C- a �©
P(9 ig) (:�? 4,9

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIERIUNCOVERED BOAT LIFI)
I hereby cer-dfy that I own property adjacent to -3-LAQ AtJ i4-fC-0
(dame of Property Owner)
property located at If C_E iS S
(Lot, Block, Road, etc.) ,, / 1
on b6�t� SailN in dq?,(z f� �-�T N.C.
(K'aterbody) (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/uncovered boat lift
must be setback a minimum distance or riite`n rat (I5') from my area of riparian access unless
waived by me.
I do not wish to waive the seiback reeuirement.
I do wish to waive that setback requirement.
DESCRIP'ITON :-N-D/OR DR WDiG OF PROPOSED DEVELOPMENT:
(7"o be �z11ed in by individual proposing development)
�� 17
i,;nature
IFS
Print or Type Name
Telephone Number
Date:

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/UNCOVERED BOAT LIFT)
I hereby cer-dfy that I own property adjacent to--�-(A L.1-A-N Al C-c' CK 's
(Name of Property Owner)
property located at 13 (o -Fr-I FLF ESS f y) AjZ/ PA
(Lot, Block, Road, etc.) ,, ! l
on ce C� (.A e Sa LA��I` tqD in TI C -e
(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 pier/uncovered boat Litt
must be set back a minimum distance of fifteen fit (I5') from my area of riparian access unless
waived by me.
I do not wish to waive the setback recuirement.
I do wish to waive that setback recuirement.
DESCRIPTION A-N-D/OR DR IVVD G OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
<1--�
----------- ------------ - - -------- -- - - - ----------
Sid azure
::S-o+4N t"DL,) Y3r �-Ds
Print or Type Name
Telephone Number
Date: