11689_TIPPIT, WR._19930601

Applicant Name
Address
CAMA AND DREDGE AND FI L
GENERAL t - 9
I J -UN 0 V lu�
PERMITLUC5uLLJLIU
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as authorized by the State of North Carolina Lwo
Department of Environment, Health, and Natural Resources and the Coastal Resources Commission
in an area of environmental concern pursuant to 15 NCAC
City
Project Location (County, State Road, Water Body, etc.)
Type of Project Activity
State
Phone Number
Zip
PROJECT DESCRIPTION
SKETCH
(SCALE:
)
Pier (dock) length
.,
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Groin length•
number
Bulkhead length
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it
s I
E
max, distance offshore
Basin, channel dimensions
cubic yards
Boat ramp dimensions
Other
I
i
This permit is subject to compliance with this application, site
drawing and attached general and specific conditions. Any i
violation of these terms may subject the permittee to a fine,
imprisonment or civil action; and may cause the permit to be -
applicant's signature
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.
permit officer's signature
issuing date expiration date
attachments Ilw
In issuing this permit the State of North Carolina certifies that /�'
this project is consistent with the North Carolina Coastal application fee
Management Program.