21076_PITMAN, LIBBY_19981022

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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 I: r"'
Applicant Name
Address
City
Project Location (County, State Road, Water Body, etc.)
Type of Project Activity
PROJECT DESCRIPTION I SKETCH S 4
Pier (dock) length I _
Groin length
number
Bulkhead length i L'L j " ' r rf
max. distance offshore
Phone Number=,
State Zip
(SCALE:
Basin, channel dimensions
cubic yards
Boat ramp dimensions-
i
Other
- i
IL
i-,
L _
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.
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.
applicant's signature
L
permit officer's signature
ad-i�
issuing date expiration date
/l ) J )1 attachments (—r � C � r� V f"
In issuing this permit the State of North Carolina certifies that
this project is consistent with the North Carolina Coastal application feed 41
C ' 1 ✓ "r1 �1
Management Program.

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P 845 917 837
Receipt for
Certified Mail
M No Insurance Coverage Provided
L,NITE- Do not use for International Mail
POSTAL SERVICE
(See Reverse)
Sent to '�
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Street *i
P.00tate and IP Code
K%// r eZ77
Postage
$
V s
Certified Fee
5
Special Delivery Fee
Restricted Delivery Fee
Return Receipt Showing
to Whom & Date Delivered
1
Return Receipt Showing to Whom,
Date s ddress
Postage
ees
Is v
Postmark or Date
.�
C7' 6 1998rw
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