23803_NC DOT_20000114

F
CAMA and DREDGE AND FILL '1 U\,16
G E N E R A L;fl
PERMIT Fie °° z°°°
as authorized by the State of North Carolina coAS?,>,:
Department of Environment and Natural Resour c a e'CoasY AZesa xrces Commission
in an area of environmental concern pursuant to 15 NCAC 10 .117r)O
Applicant Name Phone Number
Address
City State Zip U 4 U
Project Location (County, State Road, Water Body, etc.)
Type of Project Activity
PROJECT DESCRIPTION SKETCH I (SCALE:
Pier (dock) LengthiT7T[fR
Groin Length i
number
Bulkhead Length
max. distance offshore tJ
,T7TTFFT,TTTT�T
Basin, channel dimensions 1f—O
cubic yardsUJ r
t.
Boat ramp dimensions
Other ;(i:� i `a
t. .j-777
r
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.
applicant's signature
permit officer's signature
issuing date expiration date
attachments
application fee
4
PROJECT DESCRIPTION SKETCH I (SCALE:
Pier (dock) LengthiT7T[fR
Groin Length i
number
Bulkhead Length
max. distance offshore tJ
,T7TTFFT,TTTT�T
Basin, channel dimensions 1f—O
cubic yardsUJ r
t.
Boat ramp dimensions
Other ;(i:� i `a
t. .j-777
r
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.
applicant's signature
permit officer's signature
issuing date expiration date
attachments
application fee