21565_UPCHURCH, DAVID AND LYNN_19990409

r CAMA AND DREDGE AND FILL
565
GENERAL �� + �`�-�
_Y
PERMIT
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
CityState Zip
P
Project Location (County, State Road, Water Body, etc.)
Type of Project Activity
PROJECT DESCRIPTION I SKETCH
(SCALE:
Pier (dock) length
Groin length 'c'''r <<, i
l ,
number
Bulkhead length
max. distance offshore ` ,�"
Basin, channel dimensions
cubic yards
Boat ramp dimensions ��-- —•_ _ I
�' :..:ray l• •. j
Other
C
/ 1t I .�7 1
f
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.
applicant's signature
r' permit officer's signature
e
issuing date expiration date
attachments
application fees

DAVID T UPCHURCH NCDL 3108079 7929
LYNN UPCHURCH NCDL 1402749 l / / h lqy
66-1040/531
190 Woodland Dr Ph 910-692-7504 ` � / BRANCH 39001
Pinehurst, N`CC 228)374 DATE
FAY TO THE
ORDEROF
First Union National Bank
FN, R/T 0531 10400
FUR
1:053 L L0L,001: L0639L, 2 26091,1A07 q
— $ S— i D
- _ DOLLARS
Performance Banking°
M

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIER/MOORING PILINGS/BOATLIFT/BOATHOUSE)
I hereby certify that I own property adjacent to V 10 U 's
(Name of Property Owner)
property located at l S PO 6A-) C-eZ , S
(Lot, Block, Road, etc.)
on SPozoo C-'n--5 C� , in M b&r H-GrA-D �f- 1 TY , 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/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)
P
C)
DGG-LL. APR 0 6 1999
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e
Print or Type Name
� l C S22---g �L 0 0 �� � - ;-z( 9 & Z
Telephone Number
Date: . A A

ADJACENT RIPARIAN PROPERTY OWNER STATEMENT
(FOR A PIERIMOORING PILINGS/BOATLIFT/BOATHOUSE)
I hereby certify that I own property adjacent to _UA\j1D %. l ��C_"Up -lk 's
(Name of Property Owner)
property located at ►�0t\ J G2.5 S 1 .
(Lot, Block, Road, etc.)
on'SPodo,j&h-S G✓LLs-G 1Z , in M h2.�I+G—Ar� (' I Ty , 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/boatlift/boathouse must be set back a minimum distance of fifteen feet (15') from my area
of ripari access unless waived by me.
7 I do not wish to waive the setback requirement.
I do wish to waive that setback requirement.
DESCRIPTION AND/OR DRAWING OF PROPOSED
�(To be filled in by indivri'u1a1 proposing devel
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y
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--Co 6 \'0 CA-Tcto
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IS i ►N(�.
APR 0 6 1999
--� ex'o-- e, i-� , '--PL�
Print or Type Name
a-0, -I(38
Telephone Number
Date: -� —1 'q - q '?