17689_ADAMS, GLENN_19970724

CAMA AND DREDGE AND FILL
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GENERAL
PERMIT
as authorized by the State of North Carolina
Department of Environment, Health, and Natural Resources and the Coastal Re ources_Gommission
in an area of environmental concern pursuant to 15A NCAC % r J
Applicant Name 't' ` `tt" �� M t ��' j Phone Number
Address 6 �.�
city 1,X C -01" -
Project Locaion ,Vunt ,State Road, Water Body, etc.)
Type of Project Activity 1 �
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PCI 1, r 1026 tt-1 .l [ w I* r t
PR6JECT DESCRIPTION SKETCH
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Pier (dock) length 1L1 _
Groin length
number
Bulkhead length
max. distance offshore
Basin, channel dimensions
cubic yards
Boat ramp dimensions 1t
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_ State A/ L Zip
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This permit is subject to compliance with this application, site
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drawing and attached general and specific conditions. A( ___
violation of these terms may subject the permittee to a fine,
f imprisonment or civil action; and may cause the permit to be-
come null and void.
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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.
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_ 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
�y
C)
attachments
objections to the proposed work.
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In issuing this permit the State of North Carolina certifies that
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this project is consistent with the North Carolina Coastal application fee
Management Program.
Management