21597_HARRIS, TILGHMAN M_19990427

O
CAMA AND DREDGE AND FILL
GENERAL 1i 021197-<f-
PERMIT
as authorized by the State of North Carolina
Department of Environment, Health, and Natural Resources and the Coastal Resources Commission i
in an area of environmental concern pursuant to 15A NCAC _ ` ✓ 1 i­ . 1, loo
Applicant Name 't��I��+ `�
Phone Number
Address 4��? ' 'y%rrZ
_X2
City
State 1Ji .
Zip
Project Location (County, State Road, Water Body, etc.)
Type of Project Activity
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PROJECT DESCRIPTION
SKETCH �/ (SCALE:
Pier (dock) length
f i
�C�hr1�Gi t�A � 4-� jw)?
Groin length
!_� •!
number
Bulkhead length
{� x l l,K�IJr• TZi 27t- jY;
I
max. distance offshore
$1
Basin, channel dimensions
_`� E-=_ rAZPMENT
cubic yards
dimensions
Boat ramp
Other
( j�L11C, Wl6X7 J J✓
J �
o�e?r ry
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,
applicant's signature
imprisonment or civil action; and may cause the permit to be-
null and void.
comef
ts-
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. ((//r/
A,,�% -7 197
The applicant certifies by signing this permit that 1) this pro- 1�lCj 1 � y
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
In issuing this permit the State of North Carolina certifies that I.,
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this project is consistent with the North Carolina Coastal application fee
Management Program.

66-30/531
TILGHMAN M HARRIS 472 141
W MALLARD DR
MERRfTT, NC 28556
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Pay to the �7y { �f
Order of
` ' • i� (• �7 �Qa
Dollars 8
FIRST CITIZENS 472
1 /A NK FlrrtLlllum B.rk d Truxt Company
J�rat �i� Orlantrrl, N.C. 28571
For 66 �--
1:0 5 3 100 3001:004 7 L 7 54 5 580ii' 00 L4 L

ADJACENT RIPARIAN PROPERTY OWNER STATEIIIE�4I'
(FOR A PIER/MOORING PILINGS/BOATLIFT/BOATHOUSE)
I hereby certify that I own property adjacent to /iz S 's
(Name of Property Owner)
property located at -'7� 199f e&5 Jle 1C. C67 /9 ,
(Lot, Block, Road, etc.)
on MV 0 6&,z-16 , in 1129 6 C'O --5/ 4/&Z iC.CES , 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
piEngs/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.
I do wish to waive that setback requirement.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
Q
a
Print or Type Name
Telephone Number
Date: P14VC / �/ /� �

ADJACENT RIPARIAN PROPERTY OWNER STATENIENT
(FOR A PIERIMOORING PILINGS/BOATLIFT/BOATHOUSE)
I hereby certify that I own property adjacent to / /L- )s
(Name of Property Owner)
property located at 112 % 1- C9c &37 y2, /I,
(Lot, Block, Road, etc.)
on ���l�D C���` . in Aqwq�/CC , �ri����z �cS , 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/boatliftlboathouse must be set back a minimum distance of fifteen feet (15') from my area
of riparian access unless waived by me.
%�ESE.Q✓E D
,DRIVE,
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)
Lo7-'Zo
LoT'1Q
7L f,/A,eeis
�B sTA,�os
./�OdSt �i�ODoSt D (�uG�/iCPAD
wig Week
Signature
Print or Type Name
IV/- 6 �/z- sz>;, 6
Telephone Number
Date: