24627_POLLARD, MAX_20000321

CAMA and DREDGE AND FILL
,..� G E N E R A L 4627- Z)
PERMIT iv,
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 _�U l 1,.O_)
Applicant Name � Phone Number
Address U !--—
City State zip
Project Location (County, State Road, Water Body, etc.) C� w'-: t
Type of Project Activity x LJ ��-•.
PROJECT DESCRIPTION c"cTr"
Pier (dock) Length
I Groin Length
number
Bulkhead Length
max. distance offshore
Basin, channel dimensions
cubic yards
Boat ramp dimensions
Other ' ' i
IC('dl C.
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
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-
J permit officer's signature
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
issuing date expiration date
land use plan and all local ordinances, and 2) a written statement has
been obtained from adjacent riparian landowners certifying that they
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have no objections to the proposed work.
attachments
In issuing this permit the State of North Carolina certifies that this project
',�y �( 0 A 10
is consistent with the North Carolina Coastal Management Program.
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application fee

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