12349_MARSH, JACK_19940511

1
CAMA AND DREDGE AND F1
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v GENERALo
N .
PERMIT
1 �
_r_YYYYYY
as authorized by the State of North Carolina •" i
Department of Environment, Health, and Natural Resources and the Coastal Resources Commission
in an area of environmental concern pursuant to 15 NCAC
Phone Number /
Applicant Name
PP
Address
t
City -F " I State Zip %
Project Location (County, $tate Road, WatQT _8_ody, etc.)-
Type of Project Activit ' f
YP 1 Y
PROJECT DESCRIPTION I SKETCH
Pier (dock) length
Groin length
number
Bulkhead length
max. distance offshore
Basin, channel dimensions
cubic yards
Boat ramp dimensions
Other
(SCALE: nj0
fi t
T! V_ t
--i
This permit is subject to compliance with this application, site
drawing and attached general and specific conditions. Any ' �J
violation of these terms may subject the permittee to a fine, �'.✓�i--9 e r
imprisonment or civil action; and may cause the permit to be- -�applicant's signature
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.
Theapplicant 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.
attachments
application fee
permit officer's signature
s'—I/—%
issuing date expiration date