18702_ELLINWOOD, GEORGE_19970707

70
CAMA AND DREDGE AND FILL 9ro 14
GENERAL
n—Y)
PERM IT
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' ' t Phone Number
Address
City State Zip
Project Location (County, State oad, Water Body, etc.)
Type of Project Activity _ tt
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This permit is subject to compliance with this application, site
drawing
r
and attached general and specific conditions. Any�f}
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r aC a7
io r,
violation of these terms may subject the permittee to a fine,
,
imprisonment or civil action; and may cause the permit to be-
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applicant's signature
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.
7" 7`
The applicant certifies by signing this permit that 1) this pro-
1 /
ject is consistent with the local land use plan and all local
issuing date
expiration date
ordinances, and 2)„a written, st.tem�t�ha,
adjacent , riparian .landowners.. ceriifyin¢ +hh?�_haxe moo.
objections to the proposed work. ,
attachments
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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��i�—
Management Program.'

GEOgGE �--�
OBA LL
ELLINWOO D SIGNNwDOD
P. O, BO 125,34 ASSOCIATES
RALEIGH, NC 27605
PAY TO TyE 934
ORDER OF
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$T,J on
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RALEIGM, NORi'{ANa iRusi colNpAryy
MEMO CAROLINA 2�60z
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DOLLARS