17522_WARD, JIM E_19970811

Applicant Name
Address
City
CAMA AND DREDGE AND FALL
GENERAL
PERMIT
017522-D I
as authorized by the State of North Carolina
Department of Environment, Health, and Natural Resources and the C astal Resources Commission
in an area of environmental concern pursuant to 15A NCAC
Phone Number
�• x
Project_ Location (County, State Road, Water Body, etc.)
Type of Project Activity
"6
PROJECT DESCRIPTION SKETCH
Pier dock) length
C
Groin length
number
Bulkhead length
max. distance offshore
Basin, channel dimensions
cubic yards
Boat ramp dimensions
Other d oc,. --
57
�F t la.. Y i (�
State
6
zip
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This permit is subject to compliance with this application, site
drawing and attached general and specific conditions. Any r
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 tfie
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
d' d 2 b' d f
appucanus signature
y permit otticer's signature
issuing date expiration date
or finances, an ) a wntten statement has been o tame rom 6
adjacent riparian landowners certifying that they have no 44t
objections to the proposed work. attachments
In issuing this permit the State of North Carolina certifies that
this project is consistent with the North Carolina Coastal application fee V °✓'
Management Program.