22576_UPCHURCH, DAVID_20000518

F"D
LAMA and DREDGE AND FILL NY 25576-0-,
G E N E R A L
PERMIT
as authorized by the State of North Carolina
Department of Environment and Natural Resources and the Coq5tal Resources Commission
in an area of environmental concern pursrd fii oto 15 NCAC a�
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Applicant Name Phone Number
Address
City
Project Location (County, State Road, Water Body, etc.)
G �Y
Type of Project Activity .
PROJECT DESCRIPTION
Pier (dock) Length
groin LenP;th
number
Bulkhead Length,
N max. distance offshore
Basin, channel dimensions
cubic yards
Boat ramp dimensions//
Other �F--
State Zip
SKETCH 7 nJ�� (SCALE:...
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C.,C�CLt—t� r t
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 become null and void.
This permit must be on the project site and accessible to the permit of-
ficer when the project is inspected for compliance. The applicant certi-
fies by signing this permit that 1) this project 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
ha v- no objections to the proposed work.
In iso -wing this permit the State of North Carolina certifies that this project
is co,isistent with the North Carolina Coastal Management Program.
r
signature
/ pemit offi is signature
C[�J/ C0 ___[ I I (0 (f-)
suing date piration date
(� attachments
application fee