23474_DAVIS, DICK_20000516

CAMA AND DREDGE AND FILL
GENERAL N`! 234'1"4 /4
PERJUL a 200
MIT
as authorized by the State of North Carolina
Department of Environment, Health, and Natural Resources and the Coastal Resources Commission
in an area of environmental concern pursuant to 15A NCAC
Applicant Name i ii" t2A,IIS Phone Number
Address I
City S,Vn1, ul_ Sl "?�i�rr State/ /c _ Zip
Project Location (County, State Road, Water Body, etc.)
L ' L G ,1 IAl 4 !/i J
Type of Project Activity v'��ll;�L1'4 11 �%�. < Gyi Sl44111 )—
PROJECT DESCRIPTION I SKETCH
Pier (dock) length
Groin length
number
Bulkhead length
max. distance offshore
Basin, channel dimensions
cubic yards
Boat ramp dimensions
Other
Wt -
(SCALE: C� )
r�1
All
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 be-
come null and void.
This permit must be on the project site and accessible to the
permit officer when the project is inspected for compliance.
The applicant certifies by signing this permit that 1) this pro-
ject 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.
Nct
applicant's signature
permit officer's signature
6 f-, V& 'U-) 0J • 1�i/ UJ
issuing date expiration date
attachments 0 7 t- ' /�L +
In issuing this permit the State of North Carolina certifies that ,&ILI
this project is consistent with the North Carolina Coastal application fee
Management Program.