13324_BELK, HENRY_19941130

17F
CAMA AND DREDGE AND FILL x
GENERAL®®� ��
t�'M" 332,c —
PERMIT
94
as authorized by the State of North Carolina """"`"O'*a■*Osman""•«wswWM
Department of Environment, Health, and Natural Resources and the Coastal Resources Commission
in an area of environmental concern pursuant to 15A NCAC 'i4 11 r) c3
Applicant Name i ki
Phone Numbel4 t
Address _% L( —
City
Project
Type of Project Activity
State Wr_ - Zip
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 Iri,downers certifying that they have no
objections to the proposed work.
i� applicant's signature
permit officer's signature
i ;tJ t
issuing date
attachments i K
In issuing this permit the State of North Carolina certifies that Go „
this project is consistent with the North Carolina Coastal application fee '
Management Program.
expiration date