12344_JACKSON, TOE_19940421

CAMA AND DREDGE AND
GENERAL _
PERMaY � 3
MIT
as authorized by the State of North Caroli .�...........+•..w�
Department of Environment, Health, and atura esources and the Coastal Resources Commission
in an area of environmental concern pursuant to 15 NCAC , i
Applicant Name
~/S C' 1 Phone Number—
Address
umber
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Address
s
City a State I� (;_, zip
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Project Location (County, State Road, Water Body, etc.)' "� (n + f-^ I:+ _ _�" < % ,' t: �+ ✓+ it
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Type of Project Activity F r
PROJECT DESCRIPTION SKETCH t (SCALE: ,& L yr, )
Pier (dock) length
Groin length
number
Bulkhead length -L-3-
max.
Smax. distance offshore
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4
t -{ +
Basin, channel dimensions i � I '� � i �,�,��j}(-•+
cubic yards
Boat ramp dimensions
Other ,_..�' � ; _tr It • I i Iv _ .�._._.';- . t �'
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This permit is subject to compliance with this application, site
drawing and attached general and specific conditions. Any ' t
violation of these terms may subject the permittee to a fine, ` "" -
applicant's signature
imprisonment or civil action; and may cause the permit to be-
come null and void. ��•r,:—� !f
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.
In issuing this permit the State of North Carolina certifies that
this project is consistent with the North Carolina Coastal
Management Program.
issuing date
attachments
application fee
permit officer's signature
7�-
expiration date