17513_BLACK, CARLOS_19970916

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CAMA AND DREDGE AND FILL��
GENERAL
PERMIT
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 O ei ;�` -
Applicant Name S --M c 6 C. k=-�/o C�aV S �X'/+�hone Numberr41
V LA's EE Z
Address E SS '
City
Project Location (Coun
tate Road, Water Body, etc.)
Type of Project Activity
PROJECT DESCRIPTION
Pier (dock) length
Groin length
number
Bulkhead length
max. distance offshore
Basin, channel dimensions
cubic yards
Boat ramp dimensions
0 egg
MW W -I
• 4 ra
t
State Q
• i e
SKETCH : ti t (SCALE: + i
i
20, I
#4 x 14- I.L4
1
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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.
NI +f(n a
applicant's signature
! This permit must be on the project site and accessible to the permit officers signature
permit officer when the project is inspected for compliance. )
The applicant certifies by signing this permit that 1) this pro- f � / �' ��� 6C7
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 4
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—
Management
ee Management Program.