26912_BLAND, WILLIAM_20001120 (2)

-Ma'r'14-01 11:07A
CAMA-and DREDGE AND FILL N? M 12 -
.� G E E R A L
P E R M I Tom--
as authorized by the State of North Carolina -[<
Department 611 Environment and Natural Resources and the Coa tal Reso= omm►ssion
in an area of environmental concern pursuant -to 15 NCAC - - L-Q,�
Applicant Narme L- � t ry ti A Pl, A, Phone Number
�r
Address
City State 'INzip„
Project L cation {County, State Road, Water Body, etc.}
Type of Project Activity ' c_
PROJECT DESCRIPTION
SKETCH
Pier (dock) Length
a
'Groin Length
a
number--!�
I
Bulkhead Length
1 R
max. distance offshore
Basin, channel dimensions
�J U
rnm
cubic yards
o
Boat ramp dimensions
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C d
Otherrn
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�} �rCA
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This permit is subject to compliance with this application, site dtawing
and attached general and specific conditions. Any violation of these�et*s
may subject the permittee to a fine, imprisonment or civil action; 40d
may cause the permit to become null and void.
This jrmit must be on -the project ske-arnd-accesm-Mb to the permit of-
--'flcer when the project is inspected for compliance. The applicant certi-
fies by signing this permit that 1) this project is consistent with the local
land use plan and all local ordinances, and 2) a written statement has
been obtained from adjacent riparian landawners 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.
plicaht's signature
per fficer's signatur .
ssuing date expiration date
3ttachm
rts
application fee
t