22210_HOOKS, TAYLOR_19990527

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CAMA AND DREDGE AND FILL
GENERAL 22210_ C.
E P RIOi1 I T
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
n
City ✓�cc l�
Project Location (County, State Road, Water Body, etc.) L
Type of Project Activity
PROJECT DESCRIPTION SKETCH r W
Pier (dock) length
Groin length
number
Bulkhead length
max. distance offshore
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.
In issuing this permit the State of North Carolina certifies that
this project is consistent with the North Carolina Coastal
Management Program.
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State Zip
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(/ applicant's signature
permit officer's signature
issuing date expiration date
attachments /'� rr /
application fee ? '

UNITEDSTATES ���� � ,� �n .���� ,�:�v ��®�1��� g 15-800
POSTAL SERVICE® 9 H000
SERIAL NUMBER YEAR. MONTH. DAY POST OFFICE U.S. DOLLARS AND CENTS
PAY TO '� CHF.CKW RITER i I �I � I' i I I
ADDRESS IMPRINT A .A
• IMP
ADD
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1:00000EI0021: (�Pt�g36 2907 2 293111

t1f4Y-19_-.G?__-WED 09:22 VEP.TIC:AL UP_GE
919 81 5756 P. 02
ADJACENT RI,PA -X N FRo ERTY OWNER
(FORA L,
SC' AT
I hereby certify that -I own property adjacent to
Ca rQ Q )4a,n k-t - _4 _ I s property
located at
on
(Lot; Block, Road; etc.)
_SQ ire CAO -Y-fe ` N.G
(Water q y) (Town and/or County)
Ho has described to me as shown below the development he is
proposing at that location and I have no objections to his
64,ot UPf
proposal. F understand that a per must be set back a minimum
distance of fifteen feet (15') from my area of riparian access
useless waived by zoo. '
I do not wish to waive that setback requirement.
...__ I do wish to waive that setback requirement.
Description and/or drawing of proposed development: (TO BE
PiLL13D IN BY INDIVIDUAL PROPOSING DWLOPlENT)
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/r►. r�, � %� dal C�'�t- P.z�!-GZe��.s
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Signature
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C� Name
�'/5 '!q-) g--
Phone Number

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
( FOR A Wit)
8� aTL� C7
I hereby certify thatI own property adjacent to
r
ame
's property
located at l 1 S Eoia Q- i,-j JL- S-r. Vet,, po dt /V, C. on
(Lot, Block, Road, etc.)
11!:4 t.tt = S Lk. (-ICJ in co. , N. C.
later Body) (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 per must be set back a minimum
distance of fifteen feet (151) from my area of riparian access
unless waived by me.
I do not wish to waive that setback requirement.
I do wish to waive that setback requirement.
Description and/or drawing of proposed development: (TO BE
FILLED IN BY INDIVIDUAL PROPOSING DEVELOMM)
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W
I I - 4 �11 0
Signature
Nampa. - �824- -53Y1`
Phone Number