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DEPARTMENT OF TP~.SPORTATION <br /> P£~IT FOR STATE.LIC£NSINC <br /> PRIVATELY-OWNED AIRPORTS <br /> <br />Name, Address, and Telephone N~mbe? of ~roponent. <br /> <br />Location of Proposed Airport: : <br /> <br />3. Name of ,Proposed Airpor=: <br /> <br />4. Type o£ Use: <br /> <br />Personal: <br /> <br />Res~ric=ed X P~blic <br /> <br />Airport Dace: <br /> <br />Runway ~ldth: 64>0' <br /> <br />Type of <br /> <br />Lighting (circle as appropria=e): Runway T~xi~ay <br /> <br />Regurn ~o: N. C. Department of Transportation <br /> Chief Engineer - Divlsiou of Nlghways' . -~ <br /> P. O. Box 25201 .. <br /> ....R~el~,.Ng..276~ · ' <br /> <br />On Reverse Side, Show Sketch of Proposed <br /> <br />Ro:a=ing Beacon <br /> <br />A. Distance from runway ends =o near's= public roads. <br />B. Dis~ande from runway cen~erline Co nearest public roads. <br />C. Eleva=ion of the runway wi=h respec: to roads .identified ~) or (B). <br />D. Any physical obs~ruc=lons (crees, houses, streams, u=ill=y lines). <br />E. Identify all public roaJ$ sho~n (i.e. US X, NC 4~, ~R ~002). <br /> <br />(Norm Da=e - 7/I/87) <br /> <br /> <br />