16543_BLALOCK DENNIS_19970212

CAMA AND DREDGE AND FILL
GENERALmu Fln 016543 r;
PERMIT 2- ® 9 7
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as authorized by the State of North Carolina
Department of Environment, Health, and Naturai;F#eso%irdes'&hd"tlI — - sources Commission
in an area of en t I t t 15A N
vironmen a concern pursuan o CAC
Applicant Name 'l�' s 1 J �'� t Phone Number
Address J o{ _ t '1 ( I% � w r—
Citylk
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Project Location (County, State Road, Water B dy, gtc.)
Type of Project Activi�0 % fes'"
PROJECT DESCRIPTION SKETCH
Pier (dock) length
Groin length
-
number
Bulkhead length
pp
I1i1'n�
max. distance offshore
Basin, channel dimensions
cubic yards
Boat ramp dimensions
Other
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is permr is su i o comp i wi is app ca ion, si
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 aBplicant's signature
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.
/ { I permit officer's signature
issuing date expiration date
attachments
In issuing this permit the State of North Carolina certifies that S a U 0 ��
this project is consistent with the North Carolina Coastal application fee
Management Program.