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CAMA and DREDGE AND FILL
G E N E R A L 2:
P E R M I T 3 2000
as authorized by the State of North Carolina
Department of Environment and Natural Resources and the Coastal Resources Commission
in an area of environmental concern pursuant to 15 NCAC
Applicant Name 6/A f4 Phone Number
Address
City
State
Zip
Project Location (County, State Road, Water Body, etc.) !A'
Type of Project Activity !/)C t --k (-: /3c.-et-tZ) t✓1
PROJECT DESCRIPTION SKETCH
Pier (dock) Length
Groin Length
number
head Length
ax. distance offshore
(.m
Basin, channel dimensions
cubic yards
Boat ramp dimensions
Other
(SCALE:
This permit is subject to compliance with this application, site drawing
and attached general and specific conditions. Any violation of these terms
�+ applicant's signature
f
may subject the permittee to a fine, imprisonment or civil action; and
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may cause the permit to become null and void.
This permit must be on the project site and accessible to the permit of-
ficer is inspected for The
J permit officer's signature
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when the project compliance. applicant certi-
c2, c5' �
Alffis by signing this permit that 1) this project is consistent with the local
issuing date expiration date
d 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.
attachments
In issuing this permit the State of North Carolina certifies that this project
is consistent with the North Carolina Coastal Management Program.
application fee