29213_GILL, LERRY_20011001

CAMA and DREDGE AND FILL
G E N E R A L 21211
OCT 11 Z001
P E R M I T
as authorized by the State of North Carolina
Department of Environment and Natural Resources and the Coastal Resources Commission f.
in an area of environmental concern pursuant to 15 NCAC
Applicant Name Phone Number /
Address
City State / �'J .. - Zip "2- =
Project Location (County, State Road, Water Body, etc.)
Type of Project Activity
ana attacneu generai ana SPeclllc cUf 1UMU11b. /V ly VIUIdUUI l UI U UZIU M-1I I1J
may subject the permittee to a fine, imprisonment or civil action; and
may cause the permit to become null and void.
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
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
7
permit officer's signature
issuing date
expiration date
attachments
application fee