12416_MOTLEY, JOE_19940722

CAMA AND DREDGE AND FI
GENERAL
PERMIT
as authorized by the State of North Carolina Ubm
Department of Environment, Health, and Naturatft'e813u r?vI ,IndTE5 Co istaI Resources Commission
in an area of environmental concern pursuant to 15 NCAC 1 !
Applicant Name �,I.1f
Phone Number
Address
City r State i Zip
Project Location Location(County,State Road, Water Body,etc.) 1'4 3 s GO f, 1-1.1i IV.
t i I i A..f KI
Type of Project Activity
* Construction of a bulkhead, pier, dock, etc. may also recut e a building. f it.
�I
RUG 0 2 1; 4 i
PROJECT DESCRIPTION SKETCH (SCALE: r. )
Pier (dock) length 1L(
Groin length ti q
number
Bulkhead length
i
max. distance offshore ( I
IV
Basin, channel dimensions
cubic yards
Boat ramp dimensions
OtherJyfY,
} i �
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 i ) 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.
applicant's signature
permit officer's signature
issuing date expiration date
attachments
6o r
application fee