8313_FORBES, WILEY D_19910802

CAMA AND DREDGE AND FILL TM;>:' r-�' ? 13 `d
GENERAL I ® 3 1991
_Y ;.
a; }
PERMIT
as authorized by the State of North Carolina,
Department of Natural Resources and Community Development and the Coastal Resources Commission
in an area of environmental concern pursuant to 15 NCAC 71l 100
Applicant Name 5 Phone Number 2115 - aaV- 0455- H
Address � CD 0o­NC?,5ti1
City
Project Location (Coun
State N C zip
State Road, Water Body, etc.)
PROJECT DESCRIPTION SKETCH JJ (SCALE: Nc)ivL )
Pier (dock) length
Groin length
L
number
Bulkhead length. } 1,
max. distance offshore r
Basin, channel dimensions
✓
cubic yards
Boat ramp dimensions L
I
Other"�i `
r�Jtil3L I �IP
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.
applicant's signature
permit officer's signature
issuing date expiration date
attachments D�A . `k06
v
In issuing this permit the State of North Carolina certifies that 9-0
n�a.
this project is consistent with the North Carolina Coastal application fee��C-V
Management Program.