18062_RILEY, PHIL_19970819

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CAMA AND DREDGE AND FILL -�
GENERALI r,�' r
(D
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 —AA - t AU(J
Applicant Name ` i Phone Number
Address
CityState` zip���
Project Location (County State Road, Water Body, etc.) �''� Q�°"fLJ
Type of Project Activity
PROJECT DESCRIPTION SKETCH
Pier (dock) length
Groin length
number
Bulkhead length
max. distance offshore
Basin, channel dimensions
cubic yards
Boat ramp dimensions
Other
(SCALE:V_
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This permit is subject to compliance with this application, site
drawing and attached general and specific conditions. Any 7-FA
violation of these terms may subject the permittee to a fine,�—
imprisonment or civil action; and may cause the permit to be-
come
e / applicant's signature
come null and void. l
This permit must be on the project site and accessible to the r Permit officer's signature
permit officer when the project is inspected for compliance. V
The applicant certifies by signing this permit that 1) this pro-
ject
ro 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 %oc;
objections to the proposed work. attachments
In issuing this permit the State of North Carolina certifies that` 0
this project is consistent with the North Carolina Coastal application fee.
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Management Program.
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