HomeMy WebLinkAbout16991_TEMPLE, DAPHNE_19970310O
CAMA AND..DREDGE AND FILL ! A
GENERAL p016S9 -
PERMIT JV11
as authorized by the State of North Carolina
Department of Environment, Health, and Natural Resources and the C.oasta.l Resources Commission
in an area of environmental concern pursuant to 15A NCAC
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Applicant Name Number
T_
Address
City i '' fr` "'Q- �� - - - - - - State fw% 6 zip
Project Location (County, State Road, Water Body, etc.) tj`l_/ / l &"�!i _t I ,r r .. !', r'ri•l`.
Type of Project Activity
PROJECT DESCRIPTION
SKETCH��n�
(SCALE:
Pier (dock) length
y,
Groin length
number
Bulkhead length
max. distance offshore
Basin, channel dimensions
cubic yards
w ,�
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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.
applicant's signature
This permit must be on the project site and accessible to the r! permit officer's signature
permit officer when the project is inspected for compliance.
The applicant certifies by signing this permit that 1) this pro ti ' r�' cj
ject is consistent with the local land use plan and all local issuing date expiration date
ordinances, and 2) a written statement has been obtained from
adjacent riparian landowners certifying _that_th hf2 . (' 7�f f
attachments f e�'
objectlo" nos t"o the proposed work. p ;
In issuing this permit the State of North Carolina certifies that rP'
this project is consistent with the North Carolina Coastal application fee
Management Program.
DAPHNE M.TEMPLE
NCDL 1051718 PH 919-447-8750
2455 TEMPLE PT RD
HAVELOCK, NC 28532
Fay to the
Order of '0
� 01IRST CTIZENS z,a
D Aj� First- Illxens Bonk A crust Company
Havelock, NC 28532
7
For -�.L; , G k-1 L q 9-/
I:0 5 3 100 3001: 2 78 788 709 7n'
1170
66-30/531
$ a
Dollars
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