12575_THE MATLOCK CO. & SERVICKY, RON_19940721

CAMA AND DREDGE AND FILL,
No .,
GENERALI
PERMIT-
.,..__.-------------------- R"
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 —T Phone Number -
Address '
F.
City State Zip
Project Location (County, State Road, Water Body, etc.)
Type of Project Activity
PROJECT DESCRIPTION SKETCH (SCALE: )
Pier (dock) length
Groin length
number
Bulkhead length
max. distance offshore 1g ,
Basin, channel dimensions
cubic yards J'
Boat ramp dimensions
Other
i
•i- l
LA
----f --x-11: - –•
u
This permit is subject to compliance with this application, site )
drawing and attached general and specific conditions. Any'1 r
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. t
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.
i J permit officer's signature
issuing date expiration date
attachments
application fee {