16699_POTTS, W A_19970414

2
CAMA AND DREDGE AND FILL �LL
GENERAL� �.s, . �►�,.� ::
APR 2 119
PERMIT
as authorized by the State of North Carolina��'
Department of Environment, Health, and Natural Resources and thodstaMIRIN urces Commission
in an area of environmental concern pursuant to 15A NCAC
Applicant Name 4 1V a Phone Number -:3 ! �L, 41 C>�
Address �� �+ t 4,+ -1) "'l
City In T. () i a U'C State —Zip
Project Location (County, State Road, Water Body, etc.) —',P f\rl r + (j)tAAl vj j? •- �� , }{"nr�� r`1 _,",
Type of Project Activity >ie_d rf o k_ r �! �,� C ` f�!rn"1" ft4 fk
(
PROJECT DESCRIPTION SKETCH �. `�z: S�v `�A�t � (SCALE:
uis [•Jy -�.
Pier (dock) length i
Groin length
16,
number
Bulkhead length
max. distance offshore j
Basin, channel dimensions 1
cubic yards ♦
Boat ramp dimensions i�,1i (tet
UIQ , Ck 1 •f)
Other c �- -
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.
In issuing this permit the State of North Carolina certifies that
this project is consistent with the North Carolina Coastal
Management Program.
dpplicant's signature
{ } permit officer's signature
v ~issuing date expiration date
L �
attachments _"� i U
application fee