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CAMA AND DREDGE AND FILL
GENERAL iit: 018292 -D
PERMITSEF 101998
as authorized by the State of North Carolina
Department of Environment, Health, and Natural Resources and the Coastal Resources Commission
in an area of environmental concern pursuant to 15A NCAC
Applicant Name I ?' Phone Number
Address
City State Zip
Project Location (County, State Road, Water Body, etc.)
Type of Project Activity
PROJECTDESCRIPTION SKETCH
,
Pier (dock) length'` `
y
Groin length
number
Bulkhead length
max. distance offshore
Basin, channel dimensions
cubic yards
Boat ramp dimensions
Other
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This permit is subject to compliance with this application, site
drawing and attached general and specific conditions. Any 9
I ; f h t b'ect the er 'ttee to a fineIJA
v at o t ese erms may su p mi
imprisonment or civil action; and may cause the permit to be
applicant's signature
i
come null and void.
This permit must be on the project site and accessible to the
!�
permit officer's signature
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
issuing date
expiration date
ordinances, and 2) a written statement has been obtained from
adjacent riparian landowners certifying that they have no
attachments
objections to the proposed work.
In issuing this permit the State of North Carolina certifies that, c
this project is consistent with the North Carolina Coastal application fee
Management Program.