22313_SMITH, JOHN_19990525

CAMA AND DREDGE AND FILL Ce�P
GENERAL 141 22313 '°�
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PERMITY,_-y
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 fir` 0� -z, a'isz 1
Phone Number
Address
City /.. State _1. < Zip: l v
Project Location (Cou?nty, State Roa'
Type of Project ctivlty r
Water Body, etc.) -
�' J
PROJECT DESCRIPTION SKETCH
Pier (dock) length
Groin length
number
Bulkhead length
max. distance offshore
Basin, channel dimensions
cubic yards
Boat ramp dimensions
�i
Other jt � `+, ir�
e
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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(SCALE:
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permit officer's signature
r;
issuing date expiration date
attachments
V
application fee

JOHN E. SMITH 66-68/531
P.O. BOX 4525 050070797 7131
HIGH POINT, NC 27263
DATE
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HIGH POINT BANK
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050111070797
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I-- ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to nO r0 ��^�- • 's
(Name of Property Owner)
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property located at /0 � ;nl O or'- C'�—
(Lot, Block, Road, etc.)
Oil - / ��� , in �,� �-` �Q �(�r �s , N.C.
(Waterbody) (Town and/or County)
He/She has described to me, as shown below, the development he/she is proposing at
that location and I have no objections to his/her proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by individual proposing development)
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Telephone Number
Date: /� ��

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05/18/99 09:36 FAX [phone] SMITH & SHORE
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05f18%99 09:36 FAX [phone] SMITH_& SHORE
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ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
I hereby certify that I own property adjacent to
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(Name of Property Owner)
1ropeM located at log ex-J U) a o J Co u le
(Lot, Block, Road$ etc.)
ely.4�'01�
on
vJ'4-(v1 w in N.C.
(Waterbody) (Town and/or County)
He/She has de"bed to me, as shown below, the development he/she is proposing at
that location and I have no objections to his/her proposal,
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(TO be filled in by individual proposing develapr -nt)
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Signature
Print or Type Maine
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Telephone Number
Date: 1 t�14

05/18/99 09:36 FAX [phone] SMITH & SHORE
ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
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I hemby certify that I own property adjacent to �l �i �•._ • 's
(Dame of Property Owner)
pr pcm located at _ _ /cd \JJ Q
(I,ot, Sock, Road, etc.)
on in a.�,-� sar N.C.
(Waterbody) (Tows and/or County)
He/She has described to me, as shown below, the development he/she is proposing at
that location and I have no objections to his/her proposal.
DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT:
(To be filled in by inzhvidual proposing development)
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-Mew uo �i✓ti
Signature
Print or Type Name
(0OC( - a3,5 -r;o
Telephone Number
Date: !`1c.�._�t 19q3

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