15912_MCCOTTER, PAT_19960104

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CAMA AND DREDGE AND FILL
GENERAL
PERMIT
01591-2-12
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 4y,'/Y• 1OC"-
Applicant Name �ti�r Phone Number 91"X
Address 1-Y. tips
City yr2r e«,, s✓�� State _Z-it3—'� t f
Project Location (County, Sta_t_e Road, Water Body, etc.) n�' • , �•'� E'
��• !�(.:'ft 'fir �4..r l_.C/'fr7..,'✓-d'.� i
Type of Project Activity '
s �
PROJECT DESCRIPTION SKETCH (SCALE:
Pier (dock) length * C�G 7D �.es✓�/Z o
rA9 Q�D� uec� QY/
Groin length
number
B,ulklie'aPlength
max. distance offshore - � P
Basin, channel dimensions
cubic yards 4
Boat ramp dimensions
Other
1iv'ky�
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.
tt applicant's signature
permit officer's signature
V-1 l2`r t lilt / c[
issuing date expiration date
attachments t)Y// mq0
a
In issuing this permik the State of North Carolina certifies that
this project is consistent with the North Carolina Coastal
Management Program.
application fee d 1vr A /Z3 Z

BROAD CREEK CONSTRUCTION INC. 6195 1232
112 Creekview St Ph 919-249-0523 66-30/531
Merritt, NC 28556
PAYTU F/i1S lU)EILo/— Q � " , 4 `S I $
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BANKBAl►T�[ Flrtt�ClAsens Bank k Iml Company
Boybom, NC 25515
G Pe.1S9.25 - Boxin0�K
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ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to
I& C404 / is property located at
(Name of Property Owner)
, Block, Road, etc.
on �j f1� t/ �� v 2\-r- , in Ico (,4 , N.C.
(W terbody) (Town and/or ty)
He has described to me, as shown below, the development he is proposing
at that location, and, I have no objections to his proposal.
DESCRIPTION AND/
OR DRAWING OF PROPOSED DEVELOPMENT
(To be filled in by individual proposing develogoent)
V
ICI P RCAInb �)I
p� -v' d
4pead
h Ouse,
Signature
All—
Pri t or Type Name
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Telephone Number

ADJACENT RIPARIAN PROPERTY OWNER STATFAM4T
I hereby certify that I own property adjacent to /%��,� 's
(Name of Property Owner)
property located at IA
(Lot, Block, Road, etc.)
on I Je Vl�l� �i(� in ii � eo, -i �'/ , N. C.
(Water ody) (Town and/or ounty)
He has described to me as shown below, the development he is proposing at that location,
and, I have no objections to his proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT
(To be filled in by individual proposing development)
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p
hUu5
Que&'wk
Signature
D5) N c , K9&XreK
Print or Type Name
q/q- 14 - 4 %bS
Telephone Number
Date: I 1., q�