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CAMA AND DREDGE AND FILL
GENERAL -
J U N 2 3199117
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
Applicant Name Phone Number
Address
City State Zip
Project Location (County, State Road, Water Body, etc.)
Type of Project Activity
PROJECT DESCRIPTION SKETCH y r (SCALE. �i
Pier (dock) length
Groin length
number 1 /' -_ •.�:.. 1 ,i'. r I f
,r
Bulkhead length r j
max. distance offshore f — -`-
i
Basin, channel dimensions
cubic yards T1 I _
jLqJ-�
Boat ramp dimensions—
Other
imensions Other
This permit is subject to compliance with this application, site p
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 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
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
objections to the proposed work. attachments
In issuing this permit the State of North Carolina certifies that
this project is consistent with the North Carolina Coastal application fee
Management Program.