18614_SLAUGHTER, GLENN_19980212

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CAMA AND DREDGE AND FILL
GENERAL
--Y P18614 - PFR &A IT
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
City State
Project Location (County, State Road, Water Body, etc.)
Type of Project Activity
3
PROJECT DESCRIPTION I SKETCH
Pier (dock) length
Groin length
x]
d J,�FiJ
C /
(�
F r I
number
Bulkhead length
max. distance offshore
Basin, channel dimensions
cubic yards
Boat ramp dimensions
Other
Phone Number
Zip
(SCALE
� / 'p""
41/111-11
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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.
issuing date
attachments �%���• 4`��� C .��u'
permit officer's signature
expiration date
In issuing this permit the State of North Carolina certifies that
this project is consistent with the North Carolina Coastal application fee .a� / �»
Management Program.

I
1
SLAUGHTER & SONS 66-112/531 1711
P.O. BOX 727 PH. 919-241-3676 5112687892
ATLANTIC BEACH, NC 28512 � DATE
PAY TO F I $ IG
ORDER OF / ,�/ I`
TL D /Y� , DOLLARS
23 BIB&
wwcn ewHKir.a ^ I -11T comrwHv
2905 BRIDGES STREET
;OOF�EHEAD CITY, NC 28557
MEMO O/ G/w-G _ M,
11:0 S q.10 1 1 2 L1: 5 1 L 268 7El9 211' 1 7 1

ADJACENT RIPARIAN PROPERTY OWNER STATTAIENT
(FOR A PIERIUNCOVERED BOAT LIFT)
I hereby certify that I own property adjacent to�fb' s
i' (Name of Property Owner)
property located at
C'�05� 1."N / W':�
(Lot, Block, Road, etc.)
on-fW'4'YL 4--� r-F G' G�"s� ��� d , ;n x" r--, z I N.C.
Materbody) (Town an&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 lit
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 DEVELOPMEW:
`0 �rein�divulpQs� g eve pmentj
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ti
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a 7" .
'�P. I ---y
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Signatu
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Print or ype Name
2--7aa--<? o
Telephone Number
Date: -/ I

ADJACEhtT RIPARIAN PROPERTY OWNER STA
TFMENT
(FOR A PIERIuNcOVER£D BOA F EIF?)
I hereby certify that I own ro
P
Perty adjacent to
(Name of Property Pe y Owner)
property located at
(Lot, $lock, Road, etc.) '
on e-,c
lit- /1 T C :b'+�.�y•C�3"f , N. C. �I
(W�terbody) (Town and/or County}
He has described to me, as shown below, the development he is proposing at that
location, and, I gave no objections to his proposal, I understand that a Pierluncovered boat lift
must be sec back a minimum distance of Fft= feet (15') from my area of riparian access unjess
waived by me.
I do -not wish to waive the setback requirement.
I 4o wish CO waive that setback requirement.
DFSCRIP77ON AND/OR DRAWING OF PRISED DEVELOPMENT: w
toiiidivr�i�alpr33$ent}
L
P90
XI
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Signature
Pnnt or Type Name
1 1'
felephoni Numb r
Date: