27197_GAY, WILLIAM_20010416

CAMA and DREDGE AND FILL n02001
G E N E R A LrAPRP E R M I T
as authorized by the State of North CarolinaTMOREHE,4DAL MENT
271 7A
Department of Environment and Natural Reso n e oastal 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.)
Type of Project Activity ..
PROJECT DESCRIPTION CKFTCH E . 1
Pier (dock) Length
Groin Length
number
Bulkhead Length
max. distance offshore
Basin, channel dimensions
cubic yards
Boat ramp dimensions
Other
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and attached general and specific conditions. Any violation of these terms
may subject the permittee to a fine, imprisonment or civil action; and - f'
may cause the permit to become null and void. a�
This permit must be on the project site and accessible to the permit of-
ficer when the project is inspected for compliance. The applicant certi-
fies by signing this permit that 1) this project is consistent with the local issuing date
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
expiration date
Attachments
application fee