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CAMA AND DREDGE AND FILL
GENERAL1_4V 2_x.328 A
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
City State zip `
Project Location (County, State Road, Water Body, etc.) d 4 ! - �♦ ' " f �```, i'- "' f E
f% ,-L i L` b 4 1 2 �` iii ifi'� r �• .�.- � Y� F �. 1 Y r �E� A, t V �` 6'1� A% A 1, i t
Type of Project Activit +: F--1 i' 7 kit v'j
PROJECT DESCRIPTION SKETCH (SCALE:,r) )
Pier (dock) length
Groin length
number
IV
Bulkhead length
max. distance offshorel(�Q-��;� i` t
a
Basin, channel dimensions
cubic yards
Boat ramp dimensions Ala:
Other
\I d
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
applicant's signature
imprisonment or civil action; and may cause the permit to be-
come
e come null and void.
This permit must be on the project site and accessible to the w permit officer's signature
permit officer when the project is inspected for compliance.
The applicant certifies by signing this permit that 1) this pro- ��'� (; 14 i
ject is consistent with the local land use plan and all locali T fissuingdate expira ion date
ordinances, and 2) a written statement has been obtained from t
adjacent riparian landowners certifying that they have no attachments
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 application fee
Management Program.