14669_COOKE, ARCHIE_19950922

CAMA AND DREDGE AND FILL
GENERAL t �,
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PERMIT A OAT
as authorized by the State of North Carolina U t
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Department of Environment, Health, and Natural R , p,UrC ►+d-ttr Cha"
in an area of environmental concern pursuant to 15A NCAC t k,i
esources Commission
Applicant NameKPhone Number , f :`A
Address
City . 1 lr.k e State Zip_
Project Location (County, State Road, Water Body, etc.)�+�,+'�;'
Type of Project Activjty `s sr�'y: ru- ra C:ac��s$!e'y,��- 3� �o-.�C`st •��Ua��e w�:'h:
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PROJECT DESCRIPTION
SKETCH
(SCALE:`
Pier (dock) length
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Groin length
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number
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Bulkhead length
FS
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max. distance offshore
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Basin, channel dimensions
cubic yards
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Boat ramp dimensions
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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.
r�/ %, . n.<3���t,_
applicant's signature
permit officer's signature
issuing date expiration date
attachments ~7 Y, . VW
In issuing this permit the State of North Carolina certifies that�,,�
this project is consistent with the North Carolina Coastal application tee`=-
Management Program.