26249_FOREST BY THE SEA_20001205

CAMA and DREDGE AND FILL "4
G E N E R A L
D
DEC 12 2000
PERMIT �(
as authorized b the State of North Carol L�:es
�te
y
Department of Environment and Natural Resources Commission
in an area of environmental concern pursuant to 15 NCAC l
Applicant Name G i�',� r f Phone Number
Address A
f State
City �"3 � '�' , � n
Project Location (County, State Road, Water Body, etc.)
Type of Project Activity
This permit is subject to compliance with this application, site drawing
and attached general and specific conditions. Any violation of these terms —
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.
zip
applicant's signature
permit officer's signature
issuing date expiration date
attachments
application fee