25832_BILLS, ANITA_20001011

V/
CAMA and DREDGE AND FILL �� "`-t►I �'
� VElv 2 2 2QOp 25,F32 R
i
.� G E N E RAL ��
Co -S C_ {-L 1414
P E R M I T MOR HE Nf NT
as authorized by the State of North Carolina
Department of Environment and Natural Resources and the Coastal Resources Commission
in an area of environmental concern pursuant to 15 NCAC
Applicant Name
Address
City
Project Location (County, State Road, Water Body, etc.)
Type of Project Activity
PROJECT DESCRIPTION SKETCH % t
Pier (dock) Length
Groin Length
number
Bulkhead Length /!
i
max. distance offshore L �)
Basin, channel dimensions
cubic yards
Boat ramp dimensions
Other
( 'V.
State
Phone Number
zip
(SCALE: U 5.) )
This permit is subject to compliance with this application, site drawing
and attached general and specific conditions. Any violation of these terms\ applicants signature
__
may subject the permittee to a fine, imprisonment or civil action; and 1 ; ^. 1
may cause the permit to become null and void.
This permit must be on the project site and accessible to the permit of- permit officer's signature
ficer when the project is inspected for compliance. The applicant certi- 10 41 2 L'•'
fies by signing this permit that 1) this project is consistent with the local issuing date expiration date
land use plan and all local ordinances, and 2) a written statement has __7 , r
been obtained from adjacent riparian landowners certifying that they t
have no objections to the proposed work. attachments
In issuing this permit the State of North Carolina certifies that this project
is consistent with the North Carolina Coastal Management Program. application fee