8684_BURNETT, ED_19910712

LAUG
CAMA AND DREDGE AND FILL �' 8 8GENERAL 91
PERMIT
as authorized by the State of North Carolina,
Department of Natural Resources and Community Development an the c,Qastal Resources Commission
in an area of environmental concerp pursuant to 15 NCAC
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Applicant Name �i
Address
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City . i- I r (i-'s
Project Location (County, State
Type bf-Project Activity
, Water Body„etc.
Phone Number �j=� K I I
State f i .( Zip
E
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PROJECT DESCRIPTION
SKETCH
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(SCALE: )
Pier (dock) length x��
Tl
'
Groin length
/tit` k i p
number
Bulkhead length
/I
rQ7Z��
max. distance offshore
(5i �'r1c�n:J
Basin, channel dimensions
cubic yards
Boat ramp dimensions
OCr� 27 C
rf-oo
Other
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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.
'! I.
, � 1 -'.I applicant's signature
ermit officer's signature
/J' ca /ge �/
I I issuing date ( I I expiration date
attachments C')-�
�v application fee G:2 O ( \ )
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