HomeMy WebLinkAbout22215_BOONE, THOMAS_19990428,. i
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CAMA AND DREDGE AND FILL
GENERAL ? 22215 —C
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 I f) C'>:
Address �' �'X,
City
Project Location (County, State Road, Water Body, etc.)
Type of Project' Activity
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State
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Phone Number`s lc�
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PROJECT DESCRIPTION
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Pier (dock) length
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Groin length
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number
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Bulkhead length
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max. distance offshore
Basin, channel dimensions
cubic yards'
Boat ramp dimensions
Other
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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
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permit officer's signature
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issuing date expiration date
attachments
In issuing this permit the State of North Carolina certifies that a
this project is consistent with the North Carolina Coastal application fee
Management Program.
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SENDER:
I also wish to receive the follow-
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it Complete items 1 and/or 2 for additional services.
Complete items 3, 4a, and 4b.
ing services (for an extra fee):
❑ Print your name and address on the reverse of this form so that
we can return this
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card to you.
❑ Attach this form to the front of the mailpiece, or on the back if space does not
1' El Addressee's Address
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permit.
❑ Write 'Return Receipt Requested' on the madpiece below the article number.
2. ❑ Restricted Delivery
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❑ The Return Receipt will show to whom the article was delivered
delivered.
and the date
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rticle Addressed to:
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7. Date of Delivery
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6. Signature (Addressee or Agent)
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PS Form 3811, December 1994 102595-99-6-0223 Domestic Return Receipt
First -Class Mail
UNITED STATES POSTAL SERVICE Postage & Fees Paid
LISPS
Permit No. G-10
..............................................................................................................._..................... ...........................................................................................................................
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• Print your name, address, and ZIP Code in this box •
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First -Class Mail
UNITED STATES POSTAL SERVICE Postage & Fees Paid
USPS
Permit No. G-10
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• Print your name, address, and ZIP Code in this box 10
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SENDER:
I also wish to receive the follow
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❑ Complete items 1 and/or 2 for additional services.
Ing services (for an extra fee):
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Complete items 3, 4a, and 4b.
Print your name and address on the reverse of this form so that
we can return this
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card to you.
1. ❑ Addressee's Address
2
`
❑ Attach this form to the front of the mailpiece, or on the back if
space does not
2. ❑ Restricted Delivery
permit.
❑ Write 'Return Receipt Ruquested'on the mailpiece below the article number.
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❑ The Return Receipt will show to whom the article was delivered and the date
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delivered.
3. Article Addressed to:
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4 . Service Type
❑ Registered ❑ Certified
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❑ Return Receipt for Merchandise ❑ COD
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7. Date of Delivery
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6. Signature (Addressee or Agent)
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PS Form 3811, December 1994 102595-99-B-0223 Domestic Return Receipt
vSENDER: I also wish to receive the follow-
v, ❑ Complete items 1 and/or 2 for additional services. ing services (for an extra fee):
N
Complete items 3, 4a, and 4b.
❑ Print your name and address on the reverse of this form so that we can return this a
> card to you. 1. ❑ Addressee's Address
m ❑ Attach ihts lurm to this front of the mailuiece. or on the back if spac,s dui+s nra ?
m permit. 2. ❑ Restricted Delivery ui
.r- ❑ Write 'Rutuin Receipt Requested" on the mailpiece below the article number.
❑ The Return Receipt will show to whom the article was delivered and the date
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p delivered.
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4a. Article Number ?3
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4b. Service Type
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❑ Registered ❑ Certified
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B. Addressee' Address (Only if requested and c
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—,December 1994
102595-99-B-0223 Domestic Return Receipt