13196_FORDHAM, J.M._19940920

CAMA AND DREDGE AND FILL lz� 91, 7 �Vr IV 96
GENERAL IN
PERMIT (of
,^ as authorized by the State of North Carolina kesou
Department of Environment, Health, and Natural Resources and the Coastal Res Commission
in an area of environmental concern pursuant to 15A NCAC ; �! /l r
Applicant N,am.e, _ Phone Number
Address
City /,." f' <' State - zip
Project Location (County, State Road, Water Body, etc.) f �
Type of Project Activity
PROJECT DESCRIPTION
Pier (dock) length
SKETCH- j G4,'!%J-.
_ T
.7
(SCALE:
)
Groin length
E —s
t O r.. oI� —.
�� I /i E%r .to ra
fi
I
1
a
`
71
h I I
v F -
�, k
o
e
cLL
-
',T
number
Bulkhead length
�i
1
_
ax. distance offshore
Basin, channel dimensions
cubic yards
—
Boat ramp dimensions
Other
I
f
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 -
is consistent with the local land use plan and all local
nances, and 2) a written statement has been obtained from
adjacent riparian landowners certifying that they have no
objections to the proposed work.
7 dr- (/y
issuing date
attachments
applicant's signature
permit officer's signature
expiration date
In issuing this permit the State of North Carolina certifies that
his project is consistent with the North Carolina Coastal
nagement Program.
application fee

�
J. M. FORDHAM 2858
227 E. WALNUT STREET
GOLDSBORO, NC 275W !i
66-112
PAY 19 1 531
TO THE
ORDER OF
F ik
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BW
.II.NCR OARMIIW ANO TRUIT COMIARV
GOIO SBpgp, ryORTN CAROIINA 27330
FOR � - YA Ii//^.--
Il'0000 28 5811' 1:0 5 3 10 1 1 2 11: 1 1 2 30 20 8 4ij'

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