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CAMA and DREDGE AND FILL
G E N E R A L 241.14A
PERMIT
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 '% //, // 0 `
Applicant Name ,C! // e4,11 61)n.Ile /� Phone Number
Address f,, L, r1 i- K A,- � 'I
4-2?. 3,�(,
City Te' G) State /y. C. Zip - _? � 7 S cf
Project Location (County, State Road, Water Body, etc.)L)+?K'i �� ✓�r�� r `r', CO - 2 & 0
A,1d�-i� 1��/r� l' ay�4 L ��"r Salfl�L
Type of Project Activity 30 A,)e 6,) !7�W e"Iy
CIIIU dlldl.I ICU 6el leldl CIIIU 5pet_II II I.VIIUI UV[IS. /111y VIUIdLIU1I VI Ulebe Lei [115
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.
applicant's signature
permit officer's signature
issuing date expiration date
00
attachments
In issuing this permit the State of North Carolina certifies that this project ` 1 d G ��
is consistent with the North Carolina Coastal Management Program. application fee