28290_GROSSNICKLE, WAYNE P_20010918 (2)

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D := GE .`AND
P T'R M I T
as aut iorizeo by the State of North Carolina
Depart-^�t of Environment and Natural hesourcec and the Ccastai Resources Commission
in an area of environmental concern pursuant to 1 5 NCAC 7:' . v
Applicant Name D Phone Number (D '� �!
b / . 3 • - >
Address �rq a -
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City ��' s �'k✓ Mate /,/-C- 7ic b G
Project Location (County, Mate Road, Water 60d;, etc.)
Type of ProieC ActivityG-�c
Lii41 9f-0)•. ! �.�d i \ /1���✓�/ A1� ✓✓; .
PROJECT DESCRiPTIONi SKETCH
(SCALE !
Pier (dock) Length
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Groin Length ---• -• ?:
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pumper
Bulkhead Length
max. distance offshore '-%z-.1:! ,-
Basin, channel dimensions —
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cunt_ yards t i _
Boatramodimensions
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till-......._ _.......
Omer
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4-4_
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:This permit is subject to compliance with this application., site drawing � V 1% � � ( �
and 2;�acneo aener ., and SDeClil� conditions. Any violation or these wing
�— .�
} G 11 i applicant's signature
may subject the CeTmll?ee t0 a Tine, imprisonment Or CIVii action; tali I I
may cause the permit to become null and void.
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This Dwhen the DTO1e�i [S InSermit must be on the Droiect site and accessible to the Dermit Of- permit offiicer's sig
TICernature
DeCted for COmDiiance. The appiicant certi-
fies py signing this Dermit that 1 ) this Droie�L is consistent with the IOCaI
issuing sate expiration sate
land use Dian and all iota' ordinances, an[ 2? a written: siatem.en, has
Deer, omained from ad•tacen: riparian landowners cerrifvin� that they
have no obiections m, the pi-ODOSeV wori:. 3iacnments
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in. issuin`' this Dermi; the Siate o. NoTtn --aroiina trial -this DroieC "n0, �� ,
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I_ COITStsLen= Witni tn�- h;prt(; --ai0iir,Z ..Gasiai tVianaRem'?n: L'rOCraTT'.,
aDDit: ation Tee