12321_HADDOCK, GENE_19940331

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CAMA AND DREDGE AND FILL
GENERALj O 7t
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 15 NCAC :`•
Applicant Name Phone Number
Address
City State zip.
Project Location (County, State Road, Water Body, etc.)
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Type of Project Activity
PROJECT DESCRIPTION
SKETCH
drawing and attached general and specific conditions. Any
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Pier (dock) length
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imprisonment or civil action; and may cause the permit to be-
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come null and void.
Groin length
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number
Bulkhead length
max. distance offshore
Basin, channel dimensions
The applicant certifies by signing this permit that 1) this pro-
ject is consistent with the local land use plan and all local
cubic yards
ordinances, and 2) a written statement has been obtained from
Boat ramp dimensions
IOther .
(SCALE:
This permit is subject to compliance with this application, site
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drawing and attached general and specific conditions. Any
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violation of these terms may subject the permittee to a fine,
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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's signature
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
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.